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[Music]
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a series of medical mix-ups left one
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woman dead and her doctor in prison for
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negligent homicide
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but that wasn't the entire story
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in a single strand of hair a forensic
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toxicologist found evidence of another
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medical mystery
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one that made headlines around the world
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[Music]
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[Music]
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[Applause]
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[Music]
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hi say happy halloween
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[Music]
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happy halloween who is that guy
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1997 looked like it would be a banner
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year for the pignotaro family
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dr anthony pignataro had a thriving
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medical practice a wife two children and
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social standing
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dr pignataro was also an entrepreneur he
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invented and wore the snap-on toupee
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held in place by four bolts drilled into
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the skull
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he's always been different and he just
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came up with this idea i could say off
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the top of his head but
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i remember laughing about it it was
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subject of many many many jokes around
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you know about the family and even when
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he was around but he was dead serious
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about it
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his medical practice consisted primarily
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of cosmetic surgery which he performed
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in his office
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one of his patients was 26 year old
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sarah smith a young mother of two
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scheduled to have breast augmentation
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dr pignitaro had no anesthesiologist or
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registered nurse present
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his only assistants were his wife and a
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licensed practical nurse
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sarah smith was feeling pain
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so dr pignatar ordered a little more
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sodium pentathol to dull the pain
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when you did that
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her system started shutting down
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and she was losing oxygen
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at that point he broke scrub and
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i remember him tapping around the chest
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and calling out her name but there was
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no answer and then
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all hell broke loose
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sarah smith was dead
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the result of too much anesthesia with
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no anesthesiologist to monitor her
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and there was no ventilator to help her
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breathe
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i knew that
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things would never be the same once this
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happened
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when local prosecutors learned about the
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incident they conducted an investigation
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they learned that dr pignatara was not a
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board-certified plastic surgeon in fact
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he wasn't a plastic surgeon at all
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he did train for ear nose and throat but
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did not finish
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so technically
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it did not make him an ear nose and
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throat doctor he didn't finish all the
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things necessary
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to become one
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medical experts told investigators that
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sarah smith would have survived if dr
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pignataro had the proper resuscitation
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equipment
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the procedure that sarah smith was
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undergoing was a trans umbilical breast
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augmentation was a very invasive
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procedure and should have been done in a
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hospital setting or a recertified
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surgical area dr pignitaro claimed that
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deaths from anesthesia do occasionally
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happen
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nevertheless prosecutors charged him
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with manslaughter
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to avoid a trial he pled guilty to
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criminally negligent homicide
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he was fined five thousand dollars
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sentenced to six months in prison and
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250 hours of community service
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he also lost his medical license
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although it seems hard to imagine
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the pignotaro's problems
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were far from over
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[Music]
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when tony pignataro was released from
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prison he had difficulty finding a job
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since his medical license was revoked
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and the terms of his parole prevented
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him from leaving the area
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for years he had
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you know went to school done residencies
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he'd
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gone quite a few years to do this and
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that was taken away from all of us
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to make matters worse
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vandals spray-painted the word killer on
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the side of the pignotaro's home
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he claimed to have received death
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threats but he didn't know where they
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were coming from other than you're going
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to pay for sarah smith's death
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tony realized he would never get his
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medical license back
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the stress took its toll
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and the pignotaro separated
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her life was falling apart after the
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sarah smith case her husband couldn't
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find work he was probably depressed in
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his own right because he had lost his
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ability to support his family
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a few months later the couple reconciled
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tony pignataro's mother supported them
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financially or their situation would
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have been far worse anthony pigeon tarot
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came from a good family his father was a
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well-respected and excellent surgeon in
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buffalo
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mother was a
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fine person
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i guess life was handed to him on a
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platter
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after the pignotaro's reconciliation
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debbie started to feel ill
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i had thought i had the flu
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for months just maybe a little case of
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the flu because i would get nauseous and
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vomit and just not be myself
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initially neither her husband nor her
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doctors knew what to make of it
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i was having trouble walking where i
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couldn't lift my legs
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there was numbness in my legs and my
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hands
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i diagnosed myelodysplastic state
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possible myelodysplastic state the
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neurologist diagnosed possible
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guillain-barre the
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gastroenterologist diagnosed
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pancreatitis and and we just
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we didn't know how to bring it all
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together so we were all puzzled
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tony thought debbie's gallbladder should
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have been surgically removed but her
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doctors disagreed
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i was so weak and my condition was so
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grave that i probably would have died on
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the table
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i was told
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but she got better and when she got
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better we relaxed and
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thought wow this isn't going to happen
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again
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but debbie's symptoms returned again and
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again
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the pain
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was getting worse
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even more disturbing
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her daughter started to experience the
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same symptoms but not nearly as severe
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throughout that summer
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debbie's condition deteriorated she had
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severe memory loss and was relegated to
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a wheelchair because she was no longer
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able to walk
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once again she was admitted to the
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hospital
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this time dr schneiderman analyzed a
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sample of debbie's bone marrow
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under a microscope
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i looked once i looked twice and i
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couldn't believe my eyes
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it looked like something that i
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remembered reading about in medical
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school
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debbie's red blood cells had degenerated
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a condition known as karyorexis
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i ran down to the library and i got out
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a book on toxicology and i also went on
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to something called medline on the
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on the computer
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the medical literature described some
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possible causes
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when her doctor factored in her other
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symptoms numbness of her hands and legs
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disorientation and nausea
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the answer became clear
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i was able to complete the description
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of arsenic in my mind and it fit her
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perfectly
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arsenic is a heavy metal poison
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and not one you normally encounter
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further testing indicated debbie had a
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arsenic level of 29
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580 micrograms per liter
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one of the highest ever recorded in a
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living person
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almost sounds like a mistake in a lab
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reading
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but it wasn't
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the amount i had
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i shouldn't be here
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usually if a person has between 50 and
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100
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milligrams per liter in their system
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they could die from it
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it's a miracle that she survived
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she was immediately put under 24-hour
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security protection
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but the question remained
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how was she poisoned
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and who
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wanted her dead
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when debbie pignataro was diagnosed with
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arsenic poisoning doctors also tested
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her husband tony and their two children
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their daughter had higher than normal
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levels of arsenic in her system but her
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son and husband were normal
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well our first thoughts were we needed
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to
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look at the source of water for that
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area of west seneca
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prior to 1900
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arsenic was the primary ingredient in
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embalming fluid and it caused
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groundwater contamination near several
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older cemeteries
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tests showed no such problem in the
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water supply near the pignotaro's home
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investigators began to suspect that
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debbie
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may have intentionally poisoned herself
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it made me very angry
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i mean if anybody knew me
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they would know that i would never do
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this to myself
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i mean first of all
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i wouldn't do it to my children
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second of all it's just
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if i wanted to hurt myself i wouldn't do
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it this slow
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torturous painful way
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tony suspected sarah smith's family may
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have had something to do with the
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poisoning
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sarah smith was tony's patient who had
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died during surgery
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anthony thought that
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dan smith
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was
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trying to get even with him for taking
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his wife
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away from him and he thought enough to
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say well maybe then dan was trying to
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take my wife away from me
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investigators searched for arsenic
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throughout the pignotaro's home we
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searched the house you know top to
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bottom looking for arsenic
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pesticides insecticides
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anything that may
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contain arsenic
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anything that looked suspicious powdery
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was taken to be analyzed at the lab
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and
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came back negative
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detectives interviewed debbie's daughter
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since she too had some of the same
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symptoms as her mother
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they asked her what she ate on the day
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she became ill
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there was soup left on the kitchen table
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and she
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ate some of it
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and that night she was vomiting
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[Music]
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debbie then remembered an important
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detail
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that tony made the soup that day
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he brought me the bowl
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and i remember saying i can't eat all
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this it's like no eat it it's good for
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you
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their daughter found
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some of that soup left over on the stove
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and took some
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to find out exactly how long debbie had
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been ingesting arsenic doctors decided
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to study her hair
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the arsenic combined
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to keratin which is the major protein in
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hair
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so as the blood circulates
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through the body and it circulates to
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the root of the hair follicle
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some of the arsenic will become
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incorporated in the hair follicle
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when poison circulates in the body it
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comes into contact with the hair
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follicles
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so traces of the poison will remain in
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the hair as it grows
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since hair grows approximately one
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centimeter per month
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a strand of hair can identify exactly
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when a person was poisoned
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first
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debbie's hair was divided into pieces
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each one centimeter long
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we first need to convert it from the
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solid hair sample
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to a liquid air sample
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and we do that by
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adding some acid to it and digesting it
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in a specially designed microwave oven
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using atomic absorption
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spectrophotometry
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a beam of light is passed through each
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hair sample
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when that light is absorbed the amount
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of light that is hitting the detector on
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the other end decreases
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that change in the intensity of light
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that's reaching the detector is directly
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proportional to the amount of arsenic in
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that sample
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the computer-generated results
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were startling debbie started receiving
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small doses of arsenic
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in may of 1999
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and towards the end of july of 1999
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she received a large dose
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which was approximately 80 times
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what a normal human being should have
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in their system of arsenic
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this timeline
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excluded members of sarah smith's family
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as possible suspects because they had
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moved to the midwest after sarah's death
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investigators had only one other suspect
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with a possible motive
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the scientific analysis of debbie
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pignatoro's hair told a horrific story
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the people who did the hair analysis
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asked when the funeral was
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i remember they just couldn't believe
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that someone with this level was still
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alive
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debbie's hair established a timeline of
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the poisonings
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[Music]
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in march of 1999 when tony and debbie
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were living separately
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debbie had no poison in resistance the
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couple reconciled in may
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and in debbie's hair grown that month
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were the first signs of arsenic
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poisoning
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the largest dose of arsenic was
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administered in july this coincided with
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debbie's hospital visit in which tony
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recommended removing his wife's
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gallbladder a procedure medical experts
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say
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debbie would not have survived
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when questioned by police the couple's
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daughter lauren remembered something
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around this time she saw her father
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setting small traps around their home
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when we asked her
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can you tell us what that bait was
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she said she didn't know what it was
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except that it was little round tins
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that he set out on the floor
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only one manufacturer made insect
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repellent in small round tins
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the president of the company revealed
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their product contained
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arsenic
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he told me that two of those hand stacks
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which would contain four tins
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would be enough to be fatally toxic to a
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150 pound man
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investigators found this brand of
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insecticide in a store not far from the
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pignotaro's home
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you don't want to believe it
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you don't want to believe that someone
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you loved and
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lived with could actually do this to you
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there's no there's no answer i don't
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know
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a check into tony's background
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provided a possible motive
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he became associated with a few
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cons in prison
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and was able to
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get involved with heroin
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and he kept in contact with one
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particular person
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who would supply him with his narcotics
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after he got released from prison
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and investigators discovered tony was
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having an affair with another woman
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after he was released from prison
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friends say tony feared his mother's
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reaction
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his mother was against divorce
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and
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if he had divorced debbie he would have
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been
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cut out of any will
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in his family
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but money wasn't the only motive in the
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pignotaro's home detectives found a
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manuscript tony had written entitled
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md
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mass destruction
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it was about tony losing his medical
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license and what was described as the
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conspiracy
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against him
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it was a story about how he was wronged
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by the
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medical community and by the judicial
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system and you know by everyone on earth
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the great wrong that they did to anthony
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pignataro
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[Music]
00:17:35
investigators believe this entire
00:17:38
episode might have been a ploy for
00:17:39
pignotaro to get his medical license
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back
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he gave debbie poison
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she developed gastric symptoms
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he then tried to convince her doctors to
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perform gallbladder surgery that she
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wouldn't survive
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[Music]
00:17:57
had debbie died during surgery tony
00:18:00
could argue as he did in sarah smith's
00:18:02
case that people occasionally die in
00:18:05
surgery and that he shouldn't have been
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singled out
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and in tony's eyes that would have
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vindicated
00:18:11
let's see my own wife died under a
00:18:14
doctor's care in a hospital while having
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surgery
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and that's what we felt was his prime
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motivation
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but why didn't she die from the massive
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dose of arsenic
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[Music]
00:18:30
medical experts say
00:18:32
this was miscalculation
00:18:34
when tony gave his wife smaller doses of
00:18:36
poison she developed a tolerance for it
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so the higher doses later had less of an
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effect
00:18:43
i'm sure
00:18:44
he was thinking i can't believe she's
00:18:46
still alive i can't believe i gave her
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so much and
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she's still here
00:18:51
i think he just got
00:18:53
panicky and it wasn't working so i think
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that's when he just figured i'm just
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going to give her a massive dose and be
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over with
00:19:02
apparently his daughter's ingestion of
00:19:04
the arsenic was unintentional
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investigators believe
00:19:10
tony vandalized his own home to make
00:19:13
debbie's illness appear to be
00:19:15
retaliation for sarah smith's death
00:19:18
he deserves to be injected with as much
00:19:20
arsenic
00:19:21
as he gave me
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he deserves to go through the hell that
00:19:24
i went through
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and the pain that's what i feel he
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deserves
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when i asked tony if he tried to kill
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his wife
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he looked down at the table and told me
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i can understand why some people might
00:19:38
think that
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but he never said yes and he never said
00:19:42
no
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and they changed the subject and
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continued to look me in the eye
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when faced with the scientific evidence
00:19:50
tony pignataro confessed he pled guilty
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to attempted first-degree assault and
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was sentenced to 15 years in prison
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pignotaro promised to tell where he
00:20:02
obtained the arsenic and how he
00:20:04
administered it
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but he never honored that part of the
00:20:08
plea agreement
00:20:10
although debbie survived massive doses
00:20:13
of arsenic which were 80 times higher
00:20:15
than a lethal dose she will continue to
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suffer side effects for the rest of her
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life
00:20:21
the nerve damage and lack of fine motor
00:20:24
skills are permanent
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i can't believe any human being would
00:20:29
do this to someone
00:20:32
that they even cared about i mean
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maybe he didn't love me anymore but
00:20:36
there's other alternatives you don't
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you know
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do this to someone the mother of your
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kids
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the hair on her head was the key
00:20:46
evidence
00:20:47
that pointed to
00:20:49
again
00:20:50
only one person could have done it
00:20:52
in the long run his arrogance
00:20:55
is what
00:20:56
got him convicted you know
00:21:00
thinking he'd outsmart everyone he
00:21:01
outsmarted himself
00:21:03
[Music]
00:21:26
[Applause]
00:21:28
[Music]
00:21:41
you
