Robin Cook - Critical

"We have two good witnesses," Lou said. "And the king of all ironies is that Angelo is the one who saved you by shooting Adam before Adam shot you."

"That part I don't remember," Laurie admitted. "In fact, I don't remember anything else until gradually waking up in the hospital."

"It's a good thing," Lou said. "When we got there in the middle of Upper New York Bay, they had you rigged up with what they used to call cement boots."

"So I heard," Laurie said with a shudder.

"That reminds me," Jack said. "First, how did you know she was out there, and once you did, how in tarnation did you find them out there in the middle of New York Bay in the dark?"

"That's the best part," Lou said. "And truthfully, I don't mind taking a little credit. The floater we picked up Monday night scared the bejesus out of us, making me worry about a Mob war breaking out, like I told you. When I found out that the word on the street was that Vinnie Dominick was behind it, I went over to Paul Cerino's old organization to tip them off, thinking the floater might have been in cahoots with them. As it turned out, he wasn't, but the Vaccarros were concerned enough to follow Vinnie's principle enforcers, Angelo and Franco, and discovered Vinnie had squirreled away a sizable yacht, which they were using for nasty purposes. The next part is the cleverest. What they did was to figure out a way to get the city, meaning me, to get rid of the competition Vinnie represented. And how they did it was secretly to put a GPS tracking device on the yacht and then wait until a good opportunity arose. Louie Barbera, Paul Cerino's replacement, called me up Thursday evening right at the point I was despairing and offered me the website and the password and user name for the GPS device. He also told me what he thought was about to happen so we wouldn't waste time, and we didn't. It was just lucky we got there when we did for your benefit. At the same time, the opportunity couldn't have been any better from a law-enforcement angle. We reeled in Vinnie Dominick and all his top guys in one fell swoop, plus another guy by the name of Michael Calabrese. And best of all, we got them all for attempted first-degree murder, hardly a minor charge. Furthermore, while the crime guys have been poring over the boat, trace blood was discovered that belonged to the two floaters, whom we have identified as Paul Yang and Amy Lucas, both from New Jersey, and both worked for Angels Healthcare."

Laurie stiffened. "Angels Healthcare that runs the Angels hospitals?"

"None other. It's a relatively complicated story and the investigation is ongoing, involving the FBI and the SEC. Sadly, it is just another one involving huge amounts of potential money, the kind of corruption we've all heard a bit too much of these days, although in this case there was a generous amount of old-fashioned crime involved, like murder, as well as the newer white-collar variety. As you correctly sensed, Laurie, the MRSA was being purposefully spread, and not just for terrorist purposes. There was a method to the madness. What a group of people was trying to do was sabotage the IPO and, in a sense, the specialty-hospital concept."

"Who was responsible?" Laurie asked.

"Ultimately, the people behind it are lobbyists, mostly former lawyer-politicians who had morphed into becoming lobbyists after either retiring or being voted out of office. Of the particular organization we are speaking of, they had landed the perfect clients: the AHA and the FAH. What they had been hired to do was to make absolutely sure that the Senate moratorium on building specialty hospitals and registering them with CMS, or Centers for Medicaid and Medicare Services, be changed into law. But they didn't do it. Somehow, they dropped the ball. Wanting to keep the AHA and the FAH as clients, they shouldered the responsibility to make absolutely certain the first IPO after the moratorium was lifted would not be successful. Hence, they conjured up the MRSA initiative, as I've been calling it. Their thinking was that it would be viewed as a natural phenomenon, and that investors would be driven away by the cash crunch the post-op infections would cause."

"So it was they who recruited Walter Osgood. Was he just a pawn in this affair?"

"I'm afraid so. We know that he wasn't extorted but did it on his own free will. He had both the background to pull it off and some very specific needs that motivated him. As I think you know, he trained in microbiology, so it wasn't difficult for him to requisition the MRSA from the CDC and the amoeba from National Culture. He had a little private lab where he cooked up what turns out to be a pretty good bioterrorism agent, at least that's what our consults have been telling us. He got the MRSA to invade the amoeba, proliferate, and then he got the amoeba to encyst. Once he got the amoeba to form cysts, which is apparently easy, he could dry the cysts to form an airborne infectious agent. Perhaps the cleverest part, he could use the cysts to flood an OR at the moment when patients with anesthesia with endotracheal tubes are about to be awakened. Timing was critical, and it didn't work a hundred percent of the time, but as Osgood became more and more familiar with particular surgeons and the lengths of particular procedures, he got better and better."

"Sounds like you have all these terms and concepts down pat," Laurie said.

"On a case like this, I needed to be prepared for the sake of the prosecutors. All the arraignments were this morning."

"What were Walter Osgood's needs you mentioned?"

"He had a son who came down with a very severe form of some sort of cancer. The only treatment was deemed experimental, and the Angels Healthcare employees' health insurance company would not pay. Walter had been paying on his own. The involved pharmaceutical company had been charging him twenty thousand a month. Can you believe it?"

"You certainly have learned a lot in a few days."

"It's a hot case, as you can well imagine. I'm lucky the FBI got into it big-time. They have been carrying the ball. The lobbyist organization is in Washington, D.C., as you might imagine."

"So, in a very real way, Angels Healthcare has been subverted for the last number of months."

"That's a good way to describe it. But they have not been lily-white by any stretch of the imagination."

"I should say!" Laurie agreed. "Even if they didn't know the MRSA was being deliberately spread, they kept on doing surgery, even though people kept dying."

"They are guilty of a little more than that in these days of Sarbanes-Oxley. This part of the case is being handled by the SEC investigators. Once Angels Healthcare got into financial difficulty with their cash flow, they were required by law to have conveyed the information to the SEC so investors could protect themselves, especially if there was an imminent IPO. And this isn't the kind of thing you get slapped on the wrist for and told you are bad. Nowadays, this kind of oversight means big fines and stiff prison sentences. The government is intent on making examples of these white-collar criminals, because it is the little guy who is always hurt."

"We've all heard of some notorious cases over the last couple of years," Laurie said.

"That's an understatement," Lou said. "I'm ninety-nine-point-nine percent sure that all the Angels Healthcare principals will be able to spend some time with those more famous brethren. The CEO, CFO, and COO have all been arrested and arraigned. Two posted very high bail, but the third couldn't."

"What if they didn't know they were supposed to file when their cash flow fell?"

"Ignorance of the law is not an excuse," Lou said. "At the same time, they knew. Except for the CEO, they are experienced businesspeople, and the CEO had recently been through business school. They all knew what they should have done. In fact, the reason Paul Yang and his secretary, Amy Lucas, were killed, as near as we can tell, is because Paul wanted to file the necessary paperwork and the others put pressure on him not to do it. That's serious business."