Claws and Effect (19 page)

37

Bruce dropped by Pediatrics to check on a ten-year-old boy on whom he had operated.

Tussie Logan stood by the sleeping boy, hair dirty blond. She adjusted the drip of the infusion pump, took his pulse, and whispered on his progress to Bruce, who didn't wish to wake him.

They walked back into the hall.

“That pump's old, an IVAC 560 model. I keep pushing Sam for new equipment but I might as well be talking to a wall.”

“Forget new pumps. These work perfectly well and the nurses know how to use them.” Tussie had no desire to get in the middle of a Bruce versus Sam disagreement. The nurse always loses.

“They can learn.”

“Dr. Buxton, they are overworked now. Keep it simple. The old pumps are really simple.”

“You sound like Sam.”

Her face tightened. “I hope not.”

“Cheap.”

“We do have budget restraints.”

“We're falling way behind the technology curve, Nurse Logan. He's got to spend money to catch up. Go in debt, if necessary. He's too cheap, I tell you.”

“Dr. Buxton, I can't really criticize the director of this hospital. It's not a wise policy.” A flicker of fear danced in her hazel eyes. “And if you're going to fight for new equipment, fight for another MRI unit or something. Leave the nurses out of it.”

“Afraid to lose your job?” He snorted. “Cover your ass. Ah, yes, the great American answer to the future, cover your ass.”

“If you'll excuse me.” She turned, walking down the hall to disappear into another patient's room.

“Chickenshit. Everyone around here is just chickenshit.” Disgusted, he headed back toward his office in the newest wing of the hospital.

38

Chain store after chain store lined Route 29; fast-food restaurants, large signs blazing, further added to the dolorous destruction of what had once been beautiful and usable farmland. The strip, as it was known, could have been anywhere in the United States: same stores, same merchandise, same food. Whatever comfort value there was in consistency was lost aesthetically.

Back in the late sixties the Barracks Road shopping center at the intersection of Garth Road and Emmet Street, Route 29, broadcast the first hint of things to come. It seemed so far out then, three miles north of the University of Virginia.

By the year 2000 the shopping centers had marched north almost to the Greene County line. Even Greene County had a shopping center, at the intersection of Routes 29 and 33.

The city of Warrenton wisely submitted to a beltway around its old town. Charlottesville eschewed this solution to traffic congestion, with the result that anyone wishing to travel through that fair city could expect to lose a half hour to forty-five minutes, depending on the time of day.

As Harry and Coop headed north on Route 29 they wondered how long before gridlock would become a fact of life.

They chatted through Culpeper, the Blue Ridge standing sentinel to their left, the west. At Warrenton they latched onto Route 17 North which ran them straight up to Route 50 where they turned right and within six miles, they were at the door of Salvage Masters, a new four-story building nestled in the wealthy hills of Upperville, ten miles west of Middleburg proper.

Harry's chaps, needing repair, were tossed in the back of the Jeep, Coop's personal vehicle. She didn't want to draw attention to herself by driving a squad car, although she could have flown up Route 29 without fear of reprisal from another policeman lurking in the hollows, radar at the ready. The small towns relied on that income although they were loath to admit it, ever declaring public safety as their primary concern for ticketing speeders.

“Think my chaps will be okay?” Harry asked automatically, then grinned.

“There must be millions of people here just waiting to steal a pair of chaps needing repair—because you wore them.” The blonde woman laughed as she picked up a leather envelope containing papers.

When they knocked on the door, a pleasant assistant ushered them in.

Joe Cramer, a tall muscular man at six four walked out of his office. “Hello. Come on in. Would either of you like coffee, or a Coke?”

“No thanks. I'm Deputy Cynthia Cooper and this is Mary Minor Haristeen, Harry, who has been involved in the case.” Cynthia shook his hand, as did Harry.

“Come on.” He guided them into his office, a comfortable space.

“This is quite an operation.” Coop looked around at the employees seated at benches, working on IVAC units.

“Infusion pumps are sent to us from all over the world. These machines are built to last and for the most part, they do.”

“You aren't from Virginia, are you, Mr. Cramer?” The lean deputy smiled. “Do you mind giving me a little background about how you developed this business?”

“No. I'm originally from Long Island. Went to college in the Northeast and started working in the medical industry. I was fascinated by the technology of medicine. I worked for years for a huge corporation in New Jersey, Medtronic. That's when I came up with the idea of rehabilitating infusion pumps and other equipment. The smaller hospitals can afford to repair their equipment and they can often afford to buy used equipment, but they often can't afford to buy new equipment. As I said, most of these machines are well built and will last for decades if properly maintained.”

“Do you visit your accounts?”

“Yes. I haven't visited our accounts in India,” he answered in his warm light baritone. “But I've visited many of the accounts here.”

“What about Crozet Hospital?”

“Oh, I think I was there four years ago. I haven't had much business from them in the last few years.”

“You haven't?” Cynthia's voice rose.

“No. And the machines need to be serviced every six months.”

“Let me show you something.” She pulled invoices out of the leather envelope, placing them before him.

Joe studied the invoices, then hit a button on his telephone. “Honey, can you come over to the shop for a minute?”

A voice answered. “Sure. Be a minute.”

“My wife,” he said. “We put everything on the computer but I trust her memory more than the computer.” He punched another button. “Michael, pull up the Crozet Hospital file, will you?”

“Okay.”

A tall, elegant woman swept into Joe's office. “Hello.”

“Honey, this is Deputy Cynthia Cooper from the Albemarle Sheriff's Department and Mary Haristeen. Uh, Harry.”

“Laura Cramer.” She shook their hands.

“Do you remember the last time we got an order from Crozet Hospital?”

“Oh—at least four years.”

Just then Michael walked into the office. “Here.”

Joe reached up for the papers as Michael left. He and Laura read over the figures. “Here, Deputy, look at this.”

She reached for the papers. The bills stopped four years ago. “They've given us no notice of moving their business,” Laura said.

“Well, Mr. and Mrs. Cramer, the last billing date on the last invoice I have is December second of last year.”

“It's our letterhead,” Joe said, as Coop handed him an invoice.

“It's our paper, too.” Laura studied the invoices, tapping them with her forefinger. “But Joe, these aren't our numbers.” She looked up at Coop and Harry. “We have our own numbering system. These fake invoices copied the numbers from four years ago, running them up sequentially. But each year I alter the numbers. It's our internal code for keeping track of business, repair cycles, and it's all in those numbers.”

“It'd be a pretty easy matter to print up invoices with your logo,” Harry volunteered. “Someone with a good laser printer could do it and it would be cheaper than going to a printer. Also, no records of the printing job.”

“Some of those laser systems are very sophisticated,” Laura said, obviously upset.

“Has there been a problem with the equipment? Is that why you're here?” Joe asked because the reputation of his business was vitally important to him.

“No. Not that we know of.” Coop walked around and sat back down, as did Harry.

“Can you tell me just what it is that you check on the infusion pumps, if check is the correct term?”

“We check for electrical safety, something like good current leakage. Or a power cord might be damaged. Sometimes orderlies will drop a unit. Stuff happens. We take the unit apart and check the circuits. Here, let me show you.” He stood up and ushered them into the spanking-clean shop area.

“Here.” Laura pointed to the digital screen on the face of the unit, above a keyboard of numbers like telephone push buttons. “The nurse punches in the flow, the time frame, the amount of fluid, and the rate, which is displayed here.” She pointed to the screen. “The nurse on duty or doctor has only to look on the screen to know how much is left in the unit, whether to increase flow or whatever.”

Harry remembered Larry punching in information on a unit.

“And you can put any fluid in the bag?” Coop pointed to boxes filled with sterile bags.

Joe nodded. “Sure. Blood. Morphine. Saline solution. Anesthesia. OBs use IVAC units to drop Pitocin, which stimulates the uterus to go into labor. The infusion pump is very versatile.”

“And simple,” Laura added.

“Here.” Joe picked up a unit from the table. “You can even medicate yourself.” He placed a round button attached to a black cord into Coop's hand. “You hit the button and you get more drip.”

“Are these units well made?” Harry was curious.

“Oh sure. They're built to last and it's like everything else, newer models are more expensive, more bells and whistles, but I service units that are twenty years old—they usually come in from Third World countries.”

“May I ask you something?” Laura smiled.

“Of course.”

“Is someone stealing IVACs and selling them to poor countries?”

“What we have are two murders which we believe are connected, and I think we just found the connection. We don't know if the units are sold on the black market or not. What we have to go on right now are these false bills.”

“Murders?” Laura's eyes widened.

“Yes, the plant manager of the hospital was killed three weeks ago and a doctor was killed just a week ago.” She paused. “Both of those men must have stumbled onto something relating to these billings.”

“Have you added up the amount of the billings? You've got three years' worth.” Laura checked the figures and the dates.

“Yes, we have. It comes to seven hundred fifty thousand dollars for that time period.”

“Someone's rolling in dough,” Laura flatly stated.

“We've looked for that, too, Mr. and Mrs. Cramer. We didn't know this was the problem but we knew something had to be going on. We had no reports of suspicious patient deaths. We thought there might be a black market in human organs.”

“There is.” Joe leaned forward. “A huge black market.”

“We found that out, too, but we also discovered that wasn't our problem. You two have shown me what's at stake here, a lot of money and more to come, I should guess.”

“Joe, I think we'd better contact our lawyers. Officer, do you mind if I make copies of these?”

“No, but I ask you both to keep quiet about this. You can't sue anyone until we catch them and we won't catch them if they have warning.”

“I understand,” Laura agreed.

“This just knocks me out.” Joe shook his head.

“The only reason the sheriff and I noticed these particular invoices, and it took time, I might add, was we crawled over the hospital, over billings, maintenance bills, you name it, but what finally caught our eye was that these bills were so neat.”

“What do you mean?” Laura was curious.

“Well, they have a receipt date, as you can see.” Coop pointed to the round red circle in the middle of each bill. “They have a pay date.” She pointed to another circle, this one in blue with a date running across it diagonally. “But the invoices are so white and crisp.”

“What do you mean?” Laura picked up an invoice.

“The other bills and invoices had gone through a couple of hands, a couple of shufflings. Fingerprints were on the paper, corners were a little dog-eared. These are pristine. It was a long shot but it was just peculiar enough for me to come up here.”

“I'm glad you did.” Joe, upset, looked into the young officer's eyes.

“Is there anyone who stands out in your mind at Crozet Hospital?” Coop had been making notes in her notebook.

“No. Well, I met the director and the assistant director, that sort of thing. I talked to a few of the nurses. The nurses are the ones who use the infusion pumps. That's why the simpler the model, the better it is. You can make these devices too complicated. Nurses have to use them, they're overburdened, tired—keep it simple.” His voice boomed.

“How serious would a malfunctioning unit be?” Coop asked.

“Life and death.” Laura folded her long fingers together as if in prayer. “An improper dosage could kill a patient.”

         

After they left Salvage Masters they drove east on Route 50, ten miles into Middleburg. Harry took her chaps to Journeyman Saddlery to have them repaired, since Chuck Pinnell in Charlottesville was off to another Olympics. As he was one of the best leatherworkers in the nation, with a deep understanding of riders' needs, he had been invited to the Olympics to repair tack for all the competitors, not just Americans.

“Coop, look at these neat colors and the trims you can get, too.”

Cynthia felt the samples, played with putting colors together. “It really is beautiful.”

“They can put your initials on the back or on the side. They can make leather rosebuds on the belt or whatever. It's just incredible.”

“I can see that.”

“Mine's a plain pair of pigskin chaps with cream trim and my initials on the back, see?” Harry showed her the back of the chaps belt.

“Uh-huh.” Cynthia was gravitating toward black calfskin.

“You know, if you had a pair of chaps made to your body, you might even learn to jump. I'd let you ride Gin Fizz. He's a sweetie. Then, too, chaps have other uses.” She had a devilish glitter in her eye.

Coop weakened, allowing herself to be measured. She chose black calfskin, smooth side out, no fringe, and a thin green contrasting strip down the leg and on the belt, also calfskin. She had her initials centered on the back of the belt in a small diamond configuration. The waiting period would be three months.

All the way back to Crozet the two women discussed uses for the chaps as well as the pressing matter at hand: how to trap the killer or killers into making a mistake.

It only takes one mistake.