By JUAN A. LOZANO, Associated Press – 2 hours ago 

LUFKIN, Texas (AP) — A former Texas nurse accused of killing five kidney dialysis patients by injecting them with bleach caused others to fear for their lives after they witnessed some of the injections, a prosecutor told jurors during closing arguments Thursday.

Two patients testified that they saw Kimberly Clark Saenz inject bleach into the IV lines of two other patients, Angelina County District Attorney Clyde Herrington reminded jurors. Prosecutors allege that Saenz, 38, caused the patients' deaths in April 2008 by injecting bleach into their dialysis lines at a clinic in Lufkin, a city about 125 miles northeast of Houston.

The two patients "saw something that was unusual and scared them to death. Had it not been for (the patients) we might not be here," Herrington said.

But defense attorney Ryan Deaton told jurors that Saenz is innocent and is being targeted by the clinic's owner for faulty procedures at the facility, including improper water purification. Deaton also suggested that clinic officials have fabricated evidence against Saenz.

The clinic where Saenz worked is owned by Denver-based health care giant DaVita Inc.

"All we have here today is Ms. Saenz being a scapegoat for the sins of a Fortune 500 company," Deaton said.

If convicted of capital murder, Saenz could face the death penalty. Her trial, in its fourth week, began March 5.

She didn't take the stand in her own defense. But in a recording played at trial, the former nurse could be heard testifying before a grand jury that she felt "railroaded" by the clinic and "would never inject bleach into a patient."

Saenz is charged with one capital murder count that accuses her of killing as many as five patients. She's also charged with five counts of aggravated assault for injuries to five other patients.

Investigators testified that they found Internet searches on Saenz's computer about bleach poisoning in blood and whether bleach could be detected in dialysis lines.

Bleach is commonly used to disinfect plastic lines and other dialysis equipment at the clinic. Saenz's attorneys said she was spotted measuring bleach into a syringe because she wanted to put the right amount into cleaning water.

Former DaVita employees who testified for prosecutors told jurors that they never used syringes instead of measuring cups to ensure the proper amounts of bleach were being used in cleaning solutions. Dialysis patients spend up to three days a week tethered for hours to a machine that filters their blood because their kidneys can't do so.

Saenz was charged a year after the clinic was closed for about two months in the wake of a rash of illnesses and deaths in April 2008. Emergency crews had been called to the clinic as many as 30 times that April and made at least 19 runs. Seven of the calls were for cardiac problems.

There had been only two calls during the previous 15 months, according to the Texas Department of Health Services.

DaVita Inc. investigated along with local, state and federal agencies.

A Food and Drug Administration report found some samples linked to some victims tested positive for bleach while others showed bleach "may have been present at one time."

Copyright © 2012 The Associated Press. All rights reserved.

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By Staff reports

For the AJC

Authorities said the Kentucky-Louisville basketball rivalry boiled over at a Kentucky dialysis clinic when one patient punched another during an argument about the two teams.

According to Georgetown police, the altercation began Monday with a verbal exchange between the 68-year-old Kentucky fan and the 71-year-old Louisville fan.

The Kentucky fan, who was receiving treatment,  flipped off the Louisville fan, who responded with a punch to the face.

Police were called, but the Kentucky fan declined to file charges.

The Wildcats and Cardinals, hated rivals, meet Saturday in New Orleans for a spot in the NCAA championship game Monday. Some wags are calling it the biggest sporting event in the state's history.

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In 2009, Michael Durr became ill in Panama he tried to just work through it. Being retired Navy personnel and a busy real estate developer in Panama, his work ethic pushed him onward.

But when he couldn't go on any further and feeling gravely ill, he was taken to a hospital in Panama, where he was told that he had pneumonia for starters. When he flew back home to the U.S., he was immediately placed in the ICU, where he later was diagnosed with kidney failure. He began dialysis, initially at a hospital, then at a dialysis center later on in 2009 in Spring Hill. A year later, he was able to start dialysis at home.

Durr was placed on the national waiting list for a kidney transplant to await a kidney donation from an organ donor who had passed away. Over 80,000 people were listed on the national waiting list at the time. He was told that it could take between three to five years to find a donor match.

From the most recent data, there is an average of 2.5 million deaths in the U.S., if each of those people chose to donate their organs, there would be no shortage and many people may not die waiting for an organ transplant.

National Donate Life Month is celebrated in April.

An average of 18 people die each day waiting for organ transplants, because there is such a shortage of donated organs, according to the U.S. Department of Health & Human Services statistics.

During that time, he bought a drag race car. Even then, Durr was not going to let life's troubles get in his way of living life to the fullest. He was going to fulfill his life's "to-do" list.

May 2011, Durr and his wife of 35 years, Gigi, were told of the National Kidney Registry paired exchange program from the Lifelink of Florida staff at Tampa General Hospital. In this paired exchange program, a living donor is matched with a person who is need of a kidney through its common registry of donors.

Founded by the National Kidney Registry's founder and president, Garet Hil, the living donor, usually a family member or friend of someone in need of kidney donation, "pays it forward" and donates a kidney in the name of their loved one who is need of a kidney donation. In return, their loved one is matched with a donor through the same living donor common registry, usually receiving a kidney within six months.

Gigi and Michael had to find a living kidney donor because the waiting list from a deceased donor was so long.

Gigi immediately started a rigorous four months of medical testing to see if she could qualify to be a kidney donor. The four months of medical tests and exams were assessing to see whether she would experience any adverse effects of what is known at this time after donating a kidney.

"They had to make sure I was healthy enough so that I would not be compromised if I were to donate a kidney", explained Gigi.

September 2011, Gigi had passed all the tests and was cleared to be a living kidney donor, placed on the Nation Kidney Registry's common registry. She was scheduled for surgery at Tampa General Hospital last December to donate her kidney.

Through the common registry, a match was found for Gigi's husband right away. They were ecstatic. Michael was scheduled for surgery at Tampa General Hospital to receive his new kidney the same day as Gigi's surgery.

Later, they learned much to their surprise, they were part of the longest kidney donation chain, linking 60 people and 30 living kidney donors from across the country.

The National Kidney Registry and the longest kidney donation chain was recently featured on ABC's World News with Diane Sawyer and in a New York Times article last month.

Michael's kidney donor, Becky Clark, from Sarasota, was scheduled for surgery to donate her kidney the same day. Gigi and Becky were able to meet each other a couple days later while they were in the hospital, recovering from their surgeries.

"We just cried together and hugged each other. And Becky still stays in contact with Michael through Facebook, asking him how her kidney is doing", explained Gigi.

Gigi and Michael Durr are embracing life together and moving onward with their active lives without the hindrances of dialysis and illness. They have plans to go back to Panama and to drag racing, two of their passions in life.

The need is so great for organ donors, Gigi and Michael are fortunate to have found a match through the living donor program. Michael could have died waiting on that list for a deceased organ donor.

Consider signing up as an organ donor today and help to save the lives of those waiting for an organ transplant.

For more info about organ donations, visit organdonor.gov or and to register as an organ donor, go to donatelifeflorida.org.

INFORMATION BOX:

For further info about the living kidney donor- paired exchange program, contact:

Candace Skelton, RN

Living Donor Coordinator, Lifelink of Florida

(813) 844-5667 or (813) 844-5650 or (800) 844-9302

National Kidney Registry

(800) 936-1627

www.kidneyregistry.org

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"Because papillary renal cell carcinoma (pRCC) only affects ten to 15% of kidney cancer patients, the small number of patients enrolled in individual studies makes it hard to draw meaningful conclusions about how the disease will progress" says lead author Dr Vincenzo Ficarra, associate professor of urology at the University of Padua, Italy.

"Bringing together data on 577 patients from 16 academic centres across Italy has enabled us to study this subtype in more detail than a single-centre study would allow."

The patients with pRCC were identified from 5,463 patients with suspected renal cell carcinoma at the centres between 1995 and 2007. Follow-up ranged from 22 to 72 months and the median was just over 39 months.

Key findings of the study, which forms part of a larger research project promoted by LUNA, the clinical research office of the Italian Society of Urology, include:

• Patients averaged 62.4 years of age and 77% were male. The majority had presented with incidental symptoms (64%) and the size of the pathological tumours ranged from 3cm to 7cm, with a median size of 4.3cm.
• Most patients (62%) had radical nephrectomy surgery, where the entire kidney and its collecting system is removed, along with the adrenal gland, the fat tissue around the kidney and the associated lymph glands.
• At follow-up, 81% of the patients were alive and disease free. A further 14% had experienced disease progression, 11% had died from the disease and 5% had died from causes other than cancer.
• The overall average recurrence-free survival rates after surgery were 85.5% and 73.1% respectively. The cancer-specific survival rates after surgery were 87.9% at five years and 83.3% after ten years.
• Multivariable analysis, which determines the relative contributions of different causes to a single event, identified three independent predictors of recurrence-free survival rates. These were: Fuhrman nuclear grade (predictive grading system for renal cell cancer), N stage (coding system indicating absence or presence of secondary cancer in the regional lymph nodes) and M stage (coding system indicating absence or presence of distant secondary cancers at first therapeutic intervention).
• In this study 60% of patients were N stage pNx (regional nodes cannot be assessed), 97% were M stage MO (no indication that cancer has spread to distant parts of the body), 52% were Fuhrman grade G2 (low grade in a grading system of one to four) and 10% of patients had tumours at multiple sites.
• Fuhrman nuclear grade was found to be a particularly strong predictor of both recurrence-free and cancer-specific survival rates. In contrast, only a non-statistically significant trend was found for the 2009 pathological T stage (coding system that identifies the presence, size and extent of a primary tumour).

More information: Prognostic factors in a large multi-institutional series of papillary renal cell carcinoma. Zucchi et al BJUI. 109, pp1140. (April 2012). doi:10.1111/j.1464-410X.2011.10517.x

Provided by Wiley (news : web)

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