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