Death Man Walking

Dozens of patients died on nurse Richard Williams' watch, but he was never charged. Did authorities do too little, too late?

The summer sky darkened slowly outside Truman Memorial Veterans Hospital in Columbia, Mo., as Elzie Havrum's wife, son, daughter-in-law and granddaughter sat at his bedside. The frail 66-year-old World War II veteran had checked in that day because his emphysema was acting up, and he complained of a "sour stomach" and swollen legs.

His physician had monitored him carefully and ordered blood tests. Havrum seemed to be improving. His family expected that he would leave the hospital in a day or two to go back to the brick home he'd built years earlier in Fulton, Mo. Family and friends missed him when he wasn't around. He was the auctioneer on Friday evenings at the family's popular sale barn behind the Havrum home, and his calling style was well known in the area.

After decades of marriage, Helen Havrum was still very much in love with the man she had met outside a Fulton movie theater when she was just 16. It was a wartime romance, and the couple married after less than a year of courtship, in August 1943. They had one year together, living in a small apartment, before Havrum shipped out to the Philippines in 1944.

In a 1992 television interview, Richard Williams denied killing patients: "I'd never do anything like that."
In a 1992 television interview, Richard Williams denied killing patients: "I'd never do anything like that."

A shrapnel injury to his face and a bad case of malaria soon brought Havrum back to his young wife with a Purple Heart on his chest. He recovered from the disease, but health problems lingered from his injuries.

Over the next few years, Helen Havrum gave birth to two sons and a daughter. Elzie Havrum drove trucks, then got on at the brick factory, where he would work for more than 40 years. Havrum "loved his family dearly," his wife would later recall. "He got up and went to work every morning, sick or not ... he provided well for us," she said. Their three grown children didn't move far from home, so the Havrums saw their six grandkids often.

As Havrum aged, he started taking medication for emphysema. After retirement, he occasionally checked in at the Veterans Affairs hospital with breathing trouble. On June 14, 1992, he checked in again. His family chatted at his bedside until late that night. His wife and granddaughter left around 11:30, and his son David and daughter-in-law slipped out at midnight.

Nurse Richard Williams' rounds brought him to Havrum's room not long after family members had gone. Medical charts show that he gave Havrum Tylenol 3, a medicine that contains the pain medicine acetaminophen and small amounts of codeine, for his back pain. But the charts do not explain how Havrum ended up with fatal concentrations of codeine in his body -- but only therapeutic levels of acetaminophen -- and an unexplained injection mark on his buttocks.

Years later, a Kansas City lawyer would win a lawsuit against the hospital in Havrum's death. But Richard Williams has never been charged with murder; he now lives quietly in suburban St. Louis despite suspicions that he killed as many as 42 patients.

By the time Williams entered Havrum's room that night, he had acquired a bad reputation among colleagues because of the unsettling numbers of deaths that occurred -- mainly in private rooms -- whenever he was working. Nurses had gone to their bosses, begging them to take Williams off patient care. In whispers among themselves, they called him the Angel of Death.

Helen Havrum's phone rang very early June 15, rousing her from sleep just hours after she had left her husband. A doctor from the VA hospital said her husband was dead. It was the 28th death of a VA patient under Williams' care during his short tenure.

A scratched-out death note bearing the initials "RW" on Havrum's chart says Williams entered Havrum's room at 1:15 a.m. A second death note claims that Williams entered the room at 1:10 and found Havrum "in severe respiratory distress." He paged a doctor, the note says, and the doctor "arrived as [patient] stopped breathing." Williams then wrote, "Body to morgue," and signed the note "Richard W."

The doctor's chart note says Havrum was "found unresponsive by nursing": The patient wasn't breathing and had no pulse, no heart rate and no blood pressure, and his pupils were dilated and fixed. The doctor wrote that Havrum was pronounced dead at 1:15 a.m., the time Williams originally claimed to have entered the room.

The Havrums were devastated, but they didn't question their patriarch's death until an FBI agent showed up at their door several months later, asking permission to exhume Havrum's body.

Many doctors at the VA hospital had never noticed Williams before they heard rumors he was killing patients. Balding, doughy-faced and soft-spoken, with a slight lisp, Williams usually kept to himself. "There was nothing special about him, nothing that stood out," one nurse remembered. It wasn't until later that one doctor would describe him as "creepy-looking and dumpy with big shark eyes."

Only top administrators at the VA knew that Williams had been fired from his previous job at St. John's hospital in Springfield, Mo. He'd withheld medicine from patients and falsified charts to indicate they had received their dosages, but human-resources officials at that hospital were tight-lipped about Williams' firing; VA administrators hired him anyway. He started at the VA as a licensed practical nurse, working with a registered nurse, so he was rarely alone with patients. In midwinter of 1992, he completed training to become a registered nurse, meaning he could handle a shift by himself. He started working nights, coming in a little before midnight.

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