Code Blue Junkie

Nurse Joseph Dewey Akin, 35, who worked at Cooper Green Hospital in Birmingham, Alabama, was tried in September 1992 for killing Robert J. Price, 32, a quadriplegic, with a lethal dose of lidocaine.

Investigators suspected Akin in over one hundred deaths in the area over the past decade in twenty different facilities where he worked. However, many of those facilities had thwarted investigations.

Akin had long been suspected of causing many Code Blue medical emergencies, both in Alabama and in hospitals around the metro Atlanta area. The number of such emergencies at one hospital in Georgia was unusually high when Akin was working there, and colleagues noticed that at least four types of heart drugs had been stolen.

Nurse charged in patient's death to face third trial

This articles is from Topside Loaf an online newspaper located in the Birmingham, Alabama area.

BIRMINGHAM, Ala. - Jurors failed to reach a verdict in the retrial of a Georgia nurse charged in the death of a paraplegic patient, prompting the judge to declare a mistrial.

The Jefferson County jury reported Wednesday it was unable to reach a verdict at the murder retrial of Joseph Dewey Akin of Marietta, Ga.

Circuit Judge J. Richmond Pearson said Akin would be tried again on March 17, 1998.

Akin is charged in the 1991 death of Robert J. Price of Birmingham. At the time of his death, Price, 32, was a patient at Cooper Green Hospital and Akin was working there as a nurse.

An Alabama appeals court overturned the 1992 conviction, ruling that the judge erred when he did not dismiss a potential juror who said she thought Akin was guilty.

Prosecutors contend Akin injected Price, a paraplegic, with a fatal overdose of lidocaine, a local anesthetic and heart medication. Prosecutors say Akin got a thrill from listening to the man's heart rate monitor sound an alert and watching hospital workers race to save him.

Akin's attorneys contend Price died of natural causes and that the lidocaine was mistakenly administered during efforts to resuscitate him.

Akin was also suspected but never charged in at least 17 suspicious deaths at North Fulton Regional Hospital in Roswell, Ga., where he worked in 1990.

Price's mother, Mary Price, said Wednesday she is praying that God will give her strength for a third trial.

Mary Price saw Akin convicted for the murder at his first trial in 1992, but the Alabama Court of Criminal Appeals overturned the conviction last year.

Jurors at the retrial, which spanned about three weeks, started deliberating last week. They reported a deadlock Friday afternoon, but Pearson told them to continue deliberating. Then on Monday, jurors had to start deliberations over after a juror's illness prompted the judge to replace him.

Mary Price said each trial brings back her son's death like it just happened.

"It makes it harder, harder on me," she said.

David Cromwell Johnson, one of Akin's lawyers, said Georgia "turned up no evidence to implicate him and cleared him of any wrongdoing."

Jefferson County Chief Deputy District Attorney Roger Brown challenged Johnson's claim.

That "is not what the GBI (Georgia Bureau of Investigation) investigator and the deputy DA from Georgia told me," Brown said, declining to give details.

Johnson said medical examiners from the two Atlanta area counties involved in the investigation gave affidavits saying there was no wrongdoing on Akin's part.

"This case is not about medicine. This case is a Salem witch hunt. This case is Joe the serial killer. Joe who has killed so many people and will kill again if we let him out," Johnson said.

Code Blue for the Angel of Death?

Fulton County reopens investigation into suspicious hospital deaths, following Joseph Akin's manslaughter conviction in Birmingham, Ala.

Nearly seven years ago, Joseph Dewey Akin was convicted in the court of public opinion of being an angel of death.

A nurse at North Fulton Regional Hospital in Roswell, Akin stood accused of deliberately injecting patients under his care with drugs that induced heart failure. Then, he allegedly played the hero by rushing in to revive them, once their hearts stopped or in hospital lingo, they went "code blue."

As investigation, speculation and voracious media attention spread in the summer and fall of 1991, including an expose on ABC's "20/20," Akin's name was linked to perhaps as many as 17 suspicious deaths at the Roswell hospital. Assertions were also made that Akin could have allegedly injured or killed as many as 100 patients at hospitals where he had worked, both in metro Atlanta and his native Alabama.

But despite an extensive investigation by the Georgia Bureau of Investigation and Roswell police, as well as medical examiners and prosecutors in several metro counties, Akin has yet to be charged with killing or harming a single patient in Fulton County or anywhere in Georgia.

In Alabama, Akin was charged and convicted of killing a patient at a Birmingham hospital where he worked after being fired from North Fulton. But that 1992 conviction was overturned on appeal because of an error by the trial judge, and his second trial for that crime last November ended in a hung jury.

Akin's defense lawyer, David Cromwell Johnson, who characterizes the charges against Akin as a "Salem witch hunt," raised eyebrows after the second trial when he was quoted as saying that Georgia authorities "turned up no evidence to implicate [Akin] and cleared him of any wrongdoing."

Not so, said the Alabama prosecutor, Roger Brown, who told reporters, "That is not what the GBI investigator and the deputy DA from Georgia told me."

But with his attorney convinced that Akin could never get an acquittal due to all the publicity -- and with Alabama prosecutors vowing to keep trying him over and over until they could get another conviction -- Akin, who has always maintained his innocence, finally accepted a manslaughter plea agreement and a 15-year sentence in January.

Having already served six years in prison, Akin could soon be eligible for parole. And if he really is a serial killer, that means he will walk away a free man, unless he is arrested and brought back to Georgia.

So just what is the status of the case against Akin here?

GBI spokeswoman Pamela Swanson tells Topside Loaf that its investigation has been completed and the findings turned over to the Fulton County district attorney's office. But she says the GBI does not consider the matter closed.

"It's not closed until the district attorney tells us it's closed," she says.

Back in 1991, the Fulton DA's office, then under the leadership of Lewis Slaton, decided not to pursue charges against Akin.

Cases involving alleged medical serial killers are hard to prosecute. Often, the perpetrator and the victim are the only witnesses to what happened -- and the victim is dead. Patients are often very ill to begin with, so deaths are attributed to natural causes. And drugs found in the bodies of victims can be explained away as the result of something other than homicide.

The best case against Akin was in Alabama -- where a fellow nurse said she witnessed him coming from a patient's room at the time of a "code blue" -- but after he was convicted there, charges weren't pursued against him here.

But now, Fulton County has a new district attorney, Paul Howard. And after inquiries by Topside Loaf and several Alabama news organizations in the wake of the hung jury and subsequent plea bargain, officials at the DA's office began a new review of the voluminous case file, according to Howard's spokeswoman, Terry Lawson-Adams.

"We are investigating the case," she says.

Akin's saga in metro Atlanta began in 1983, when he was licensed as a nurse by the state of Georgia and spent the next four years working in Atlanta at Grady Memorial Hospital. He went on to work at Georgia Baptist Hospital and the now-defunct Physicians and Surgeons Hospital before becoming a critical care nurse at North Fulton Regional Hospital in June 1990.

By many accounts, Akin was a dedicated, top-notch nurse, a perfectionist and stickler for detail. His specialty was working in the pressure-cooker atmosphere of trauma units, where he thrived.

But Akin was also detested by many of his co-workers, according to statements made during the investigation. Loud and given to bouts of braggadocio about his skills as a nurse and his ability to revive patients, Akin had been dismissed from an Alabama hospital years before for failure to get along with his co-workers.

Akin was also openly gay and reportedly had once complained of being the target of a homophobic supervisor.

Suspicions about Akin's conduct at North Fulton Regional Hospital began with four of his fellow nurses. They started compiling information on "code blues" after they noticed that the number of those incidents -- some involving patients whose conditions weren't life threatening -- seemed to be rising alarmingly. And some of those patients weren't surviving.

During a six-month period in 1990 when Akin worked at the Roswell hospital, there were 32 "code blues" -- 20 more than the usual average of two per month. And of those 32 events, Akin was present at 22. Subtract the "code blues" Akin attended from the total number and you have a total close to the hospital average. Count them, and the number of such episodes is nearly triple the norm.

"When you graphed it, it stuck up like Mount Everest," says Clifford Steele, a Sandy Springs attorney who represented five of Akin's alleged victims in civil suits and spent two years investigating the case.

The nurses also discovered that four different drugs that could cause sudden heart failure if injected in a patient were missing from crash carts in the intensive care unit, where Akin worked.

A search of Akin's Cobb County home by police would later turn up a vial of one of those missing drugs, epinephrine, a drug commonly used to treat bee stings and allergic reactions. Used inappropriately, however, it can lead to heart failure.

On top of that circumstantial evidence were the allegations made by Bambi Plumlee, a woman who had been under Akin's care in 1988 when he worked at Physicians and Surgeons. She went to the hospital after experiencing what she thought was an allergic reaction to penicillin, given to her by her dentist. She says Akin suggested to the emergency room doctor that he give her an injection, and the doctor agreed. She quickly went into cardiac arrest.

But Plumlee survived to point the finger at Akin, the doctor and the hospital in a malpractice lawsuit, which was filed more than five months before Akin went to work at North Fulton. She alleged that Akin either "negligently or intentionally" gave her the medication.

A subsequent examination of Plumlee at Emory University Hospital found no underlying heart problems and no explanation for her cardiac arrest, other than that she might have taken too much cold medicine. A forensic medical expert who later examined her records concluded that she was likely given epinephrine or a similar drug.

Plumlee eventually secured a $750,000 judgment against the hospital. But court files show that her suit against Akin was dismissed because he wasn't properly served with legal papers before the statute of limitations for malpractice had expired.

Akin was fired from North Fulton in December 1990 for undisclosed reasons that hospital officials later said were unrelated to the investigation into suspicious deaths. But reports at the time, based on information from police, attributed the firing to Akin's alleged falsification of his nursing credentials.

Akin had previously been fired from both Grady and Georgia Baptist for claiming to have a four-year nursing degree when he actually had a two-year degree.

After leaving North Fulton Regional Hospital, Akin went to work for firms that supplied temporary nurses to hospitals, which put him to work at Clayton General Hospital in Clayton County (now Southern Regional Medical Center) and later Cooper Green Hospital in Birmingham, Ala.

At both of those facilities, Akin was linked to suspicious "code blues." In one incident at Cooper Green, the patient, Robert Price, died.

It was that episode that led to the Alabama murder charges against Akin. What made the case particularly prosecutable was testimony from a fellow nurse, who said she saw Akin in Price's room just before the "code blue" and that he then tried to stop her from going inside.

Lidocaine, a drug which can induce an irregular heart beat, was found in Price's body. The defense maintained that it could have been injected accidentally during attempts to revive him.

Akin's lawyer, Johnson, says that at least five medical experts have concluded that Price -- a paraplegic grievously ill with a terminal disintegration of the central nervous system -- died of natural causes. He also says Akin had an alibi for the time the nurse places him in Price's room.

Johnson believes the Price case was the result of a "witch hunt," motivated by Akin's sexual identity and race -- and fueled by an avalanche of sensational press coverage.

"Joe Akin is a homosexual. And he was a white nurse, working on a floor with mostly black nurses," Johnson says. "This is one of those cases where the ball was rolling downhill and everybody jumped on it."

Indeed, Georgia Baptist investigated "code blues" there during Akin's tenure and found nothing suspicious. Grady officials did not even investigate "code blues" during Akin's tenure there.

However, Steele says that at a large hospital like Grady, which is a major trauma center with a high mortality rate, "code blues" wouldn't be as noticeable as they would be at a small suburban hospital like North Fulton.

As for Johnson's comments that Akin was exonerated in Georgia, Akin's attorney admits he has had no specific communication with law enforcement authorities here clearing his client.

Rather, he said that he has copies of affidavits from two metro area medical examiners, filed as part of civil lawsuits against Akin, that Johnson believes exonerates Akin in deaths at North Fulton and other metro hospitals.

However, that characterization of those affidavits is disputed by Steele, who did much of the legwork on the civil cases, including taking depositions and affidavits from witnesses. He also hired a top medical forensic consultant from France who researched the suspicious deaths and briefed GBI agents and medical examiners.

"I think that may be [Johnson's] interpretation," says Steele. "I don't think there is anything out there that exonerates Joe Akin."

Johnson declined to send Topside Loaf copies of those affidavits, saying it was not in his client's interests to "stir up" news coverage about Akin in Atlanta.

Steele concedes there may be statements in the affidavits in which medical examiners talk about the difficulty in establishing a direct link between Akin and any individual death. But, he says, that's a long way from exonerating him.

Indeed, Steele says he's convinced that the cumulative weight of the evidence is strong, and the clients he represented -- and even some of the police investigators with whom he worked on the case -- were frustrated that the Fulton County DA's office would not present the case to a grand jury.

"We did feel we had shown them enough evidence that they should have made an arrest," Steele says. "I was extremely disappointed that he wasn't tried here. I felt that a jury would have convicted him."

Ten civil cases filed against Akin in metro Atlanta were settled together, with Akin's insurance company putting up more than $1 million and North Fulton Hospital contributing "a substantial amount," according to Steele. The lion's share went to the family of a small Clayton County girl who was left severely brain damaged after a suspicious "code blue."

Now, given the years that have elapsed in a case in which many witnesses were already in frail health, the criminal case against Joe Akin is no doubt weaker than it was when the DA's office opted not to proceed with it in 1991.

Nevertheless, Johnson believes that, given all the publicity, the pressure on metro Atlanta prosecutors to indict Akin will be enormous should he walk out of an Alabama prison.

SEX:  M RACE: W TYPE: N MOTIVE: PC

MO: Hospital nurse who killed patients

DISPOSITION: Convicted on one count in Ala., 1992.