Dissecting Dr. Carter

Harris County's chief pathologist finds herself under the microscope.

But somewhere along the road to forensic bliss, the relationship between Holmes and Carter took a U-turn and Johnny and Joye were no longer the happy crime-fighting duo.

First, HPD homicide detectives complained that Carter was restricting their access to bodies at both crime scenes and the morgue. Holmes also contends that Carter was under the impression that she could send any of her assistant pathologists to testify about autopsies during murder trials even though the district attorney's office would subpoena the specific doctor who had done the cutting.

Additionally, after Carter took over as medical examiner, county commissioners raised the rate Harris County charged other counties for autopsies from $900 to $1,200. (Under Jachimczyk, assistant pathologists had been allowed to pocket $400 of the $900. The commissioners also voted to end that policy.)

Last fall, however, Carter went back to the commissioners with a proposal to reduce the rate from $1,200 to $1,000. Carter attempted to justify her recommendation by citing statistics showing that since the rate increase, the demand for outside autopsies had declined significantly. But since there was still a backlog of in-county autopsies to be performed, Carter's plan infuriated the district attorney, and county commissioners eventually voted to keep the rate for out-of-county autopsies at $1,200.

Nor was Holmes pleased with what he says was Carter's plan to destroy all tissue and blood samples that were over a year old because of a lack of storage space at the morgue. Holmes admits he went ballistic during one meeting with Carter while trying to point out to her that she couldn't go around destroying evidence for cases just because the material was a year old and she didn't have a place to put it.

"Suppose the case isn't solved," says Holmes. "But I said something like, 'do whatever you want to do. You're the fucking medical examiner, but don't ask us to sign off on it,' and I left. I still didn't consider it personal."

But according to whom you believe, Carter apparently did. The Houston Chronicle quoted Carter as describing Holmes as "unprofessional" and a member of "the old boys club." But while giving her deposition in the whistle-blower case last November, Carter denied ever having made the statements attributed to her by the Chronicle.

"That's not accurate," Carter testified during the deposition when asked about the story.

Likewise, Holmes maintains that the problems between himself and Carter have been exaggerated -- the current criminal investigation into the practices of her office notwithstanding. That's why, says Holmes, he has distanced himself from the probe that is being led by Assistant District Attorney Keno Henderson.

Specifically, Holmes says Henderson and his two investigators are trying to determine if anyone at the medical examiner's office has engaged in the unauthorized practice of medicine -- a Class A misdemeanor.

Last month, Holmes confirmed that his office was investigating allegations that Dr. Delbert Van Dusen -- who was licensed to practice medicine in Georgia but not in Texas -- was being paid $90,000 a year to perform autopsies at the Harris County morgue. At least 15 of the autopsies performed by Van Dusen are believed to have been conducted on suspected homicide victims, although in each case another pathologist signed the death certificate. So far, no legal challenges from defense attorneys have been mounted against any of the autopsies involving Van Dusen. But, since Texas law requires that a doctor establish the cause of death, and the cause of death is vital to proving a murder case, those homicide investigations could now be in jeopardy.

"This is a major screwup," says Holmes, who concedes he's having a hard time getting a handle on the facts of the case and whether or not a law has been broken. The district attorney says while the state's medical practice act apparently allows a licensed physician to have certain persons working under his supervision and performing what would otherwise require a medical license, the question is, "what is supervision?"

"Does it mean that the person is standing there watching what he's doing?" asks Holmes. "Or does it mean that he's there in the office? Does it mean he's in the building? Or does he even have to be there? That's going to be a more difficult task in determining what the facts are, because I've personally talked with people who have different views of what supervision is."

The district attorney also acknowledges that there is precedent for doctors licensed in another state, but not in Texas, to perform autopsies here. For example, in the 1970s, during the John Hill case, Dr. Jachimczyk had a pathologist from New York travel to Houston to inspect the brain of Hill's dead wife, Joan, whom Hill was suspected of having murdered.

But in the current situation, says Holmes, the question involves someone who is living in Texas and being paid to dissect bodies and render an opinion as to the cause of death.

"Do they need to be licensed?" asks the district attorney rhetorically. "Unquestionably, they do. But if they are being supervised by a licensed physician, can that licensed physician sign off on their death certificates and opinions? It's not as easy as looking at whether someone has stolen money or hijacked a bank."

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