I can not believe I found this today...
time to find an attorney....
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Pulling the Sheet Down
An Independent Weekly investigative report on the Lafayette Parish Coroner's office uncovers disturbing allegations of mismanagement and a questionable autopsy contract.
By Leslie Turk
Wednesday, August 01, 2007
It was the topic of political conversations in 2003, one that left some Lafayette Parish residents wondering why a 73-year-old would run again for coroner after a decade in the position and 13 additional years as deputy coroner. It certainly didn't appear to be about money. Funded by tax dollars from Lafayette Consolidated Government, Dr. Charles Boustany Sr. gets $16,591 a year, another $50 from funeral homes for each cremation he signs and is paid a fee by mental health facilities to determine whether patients committed involuntarily need to stay at the facility for further treatment.
Rarely visible during the campaign — his high-profile wife Madlyn sometimes appeared on his behalf at public events — the well-liked coroner's ability to serve out another term began to fuel speculation that voters would favor the only other candidate in the race, Dr. Ed Day, a heart surgeon in his late 50s.
But on Oct. 3, 2003, it was Democrat-turned-Republican Boustany who came out on top, besting his Democratic opponent by a little more than 5,000 votes.
Less than four years later, however, serious questions about his competence and how the office is being run have emerged.
Dr. Collie Trant, a forensic pathologist who worked as a deputy coroner for the office for about 18 months, leaving his $130,000-a-year job in December, claims Boustany has not been in control of the office he was elected to hold for some time due to health reasons. He says Boustany once told him he went to the gas station but had to ask for assistance because he could not remember how to work the pump. During the time Trant was with the office, the pathologist contends he had no more than a handful of conversations with the coroner, maintaining that Boustany rarely inquired about his work; when the coroner did have a question, Trant says he had to repeat himself several times.
Trant further claims every decision was made or dictated to Boustany by Roy Provost, whom Trant describes as ambitious but prone to shortcuts. Trant alleges a pattern of ineptitude on the part of the seven-year employee. "I left because of the incompetence and the fact that we had a high school graduate running the office," Trant says. "A forensic pathologist should be running the autopsy part of an office when they're doing autopsies. Because Boustany wasn't running anything and wasn't competent to supervise these people, Provost was getting away with anything he wanted."
Trant says he was hired in 2005 to perform approximately 225 autopsies per year but ended up doing almost 300, often without basic information from investigator reports that were required to be compiled by Provost and another investigator, Keith Talamo. The pathologist says he was willing to accept the unexpected increase in volume after the 2005 hurricanes but claims Provost actively recruited more than 100 cases from Rapides Parish in an effort to generate additional fees for the office and make himself look good in the eyes of the Lafayette City-Parish Council.
Provost regularly attended meetings on Boustany's behalf. Says Trant, "[Provost] made the comment one time that 'there were a lot of smiles at the council meeting when I presented our budget to them this month because we're making a lot of money now.'"
According to Trant, Provost exercised undue influence over the coroner, routinely discouraging him from pursuing autopsies in Lafayette Parish to avoid having to help on them (investigators are required to assist the pathologist during autopsies of their cases) and because those local cases would not add to the office's bottom line. Trant claims a dangerous pattern of routinely excluding certain cases from the autopsy table emerged. "They didn't autopsy car accidents; they didn't autopsy overdoses," Trant continues. "You miss homicides. You miss opportunities to answer questions in court. And if you don't perform an autopsy and sign off letting the family cremate the body, there goes the evidence."
According to Lafayette attorney Glenn Armentor, the coroner's office potentially compromised untold criminal and civil cases. "There are criminal cases, where murders are concerned, that have to be duly investigated so that cause of death can be accurate," Armentor says. "From my standpoint, there are civil cases where people die where autopsies have to be accurate so the cause of death can be pinpointed to determine whether or not I should sue somebody."
Says Trant, "Basically, I should [have been] working for [Boustany], but he wasn't asking me should he do an autopsy." Instead, Trant says the ailing coroner put all of his faith in his chief investigator, Provost.
Roy Provost says he left the coroner's office in June. By June 19, the Lafayette City-Parish Council had passed an ordinance that essentially put Provost's new company in business. The council authorized the elimination of the forensic pathologist's position in order to hire Provost's Louisiana Forensic Center to provide all autopsy services in the parish on a contractual basis that began July 1 and ends June 30, 2008 — with automatic, successive 12-month renewals.
Because this is defined as a "professional services" contract, in much the same way the parish does business with attorneys, architects and engineers, the contract did not go out for bid. Because its value exceeds $5,000, it had to be approved by the professional services committee, even though the council had already approved it.
Though it is still awaiting City-Parish President Joey Durel's signature, the contract was executed July 3, less than two months after Boustany penned a letter (addressed to no one in particular) explaining that Trant's departure left him with no alternative but to outsource autopsy services, which were being handled temporarily by a pathologist from New Orleans. "After careful review, it was discovered to be more economically feasible to eliminate the position of pathologist and continue to contract autopsies as well as transportation for our parish," Boustany wrote May 15.
Provost is now renting 1,000 square feet of the Lafayette Parish Coroner's office, a deep-red brick structure on Bertrand Drive between University Medical Center and Delhomme Funeral Home. He pays $1,250 a month, a price LCG says was determined by appraisal. The leased space includes the morgue, two separate "executive" offices, a decontamination room, lab area, utility closet, and all furniture and equipment of the city-parish-owned building he worked in for seven years. According to the lease agreement, he can exercise an option to purchase "all autopsy stations, trays and related equipment ... for $2,000." Trant, who recently priced new equipment for the facility he plans to set up in Rapides Parish, contends that price is ridiculously low. He says an autopsy carrier and tray are $2,500 each. The Lafayette coroner's office has approximately eight.
Provost, who describes himself as one of only 14 "board registered medicolegal death investigators" in the state, had apparently been building his business and lobbying to take over the autopsy services in Lafayette Parish long before his departure. Trant contends that in 2005 Provost asked him to be part of a venture like LFC, but nothing ever came of it. Louisiana Forensic Center LLC filed with the Louisiana Secretary of State's Office on Dec. 29, 2006, two days before Trant's official departure date. Roy B. Provost Jr. is listed as the registered agent and member, along with members Amy Doerle Provost, his wife, and David E. Doerle — all of Youngsville.
"There's a desperate need for autopsies in Louisiana," maintains Provost, who says he has already amassed a large client list, including Lafayette, Iberia, St. Martin, St. Landry, Allen, Vermilion, Rapides, East Baton Rouge and Winn parishes — all of whom Provost maintains can vouch for the quality of his company's autopsy services. All of the autopsies are being performed by Dr. Joel Carney, a Lafayette forensic pathologist. "He's very proficient," Provost says.
According to state ethics law, a person cannot perform a government service, leave that office and contract to perform the same service for a period of at least two years, which is why the contract specifically prohibits LFC and Provost from conducting crime scene investigations for LCG.
It's unclear just how many cases Provost's LFC will handle annually or how much he'll be paid, but in Lafayette Parish, he'll get $1,550 per autopsy. For the next year, according to LCG's budget, he'll collect about $46,500 for performing 30 autopsies on city cases and $26,350 for 17 cases in the rest of the parish. The flat rate includes toxicology, microbiology, histology and radiology tests and analyses ("if applicable," according to the contract), delivery of a preliminary cause of death report and a final autopsy report. For what's described in the contract as "special testing" that will require prior approval of the coroner's office, LFC can bill LCG up to $2,000 more per case. The contract does not define this special testing.
In the year before he left, Provost says he does not know how many deaths were handled by the Lafayette Parish Coroner's office, nor the number of autopsies performed, information that presumably would have been used in his negotiations with officials in all of the parishes he serves. "I wouldn't have those numbers," he says.
Trant was taken aback by local government's agreement to pay Provost's company $1,550 per autopsy. On the average, he says the coroner's office had been billing about $965 per case, adding other costs only when the additional services were necessary. Based on his calculations and recent experiences as a contract pathologist for the Rapides Parish Coroner's office, the $1,550 exceeds that average by about $450 per case.
According to the contract, either LCG or LFC can terminate the agreement with a 60-day written notice.
Provost would only discuss his new business venture, LFC, with The Independent Weekly. He declined to comment on Trant's assertions of how he ran the office, nor would he say who has been in charge since his June departure. "That's a question for the coroner's office," he said. "I'm not going to address that."
On the issue of whether he played a role in recommending cases for autopsy, Provost said the ultimate decision rests with the coroner, not the chief investigator. "It's always the coroner's decision, or the deputy coroner's," he says.
Trant, who was also a deputy coroner, says Provost stopped asking him whether cases should be autopsied soon after his arrival; pathologist Trant claims Boustany is incapable of making such important determinations.
Dr. Kenneth Odinet, who volunteers as chief deputy coroner and has been involved with the office for about two years, says it would be "inappropriate to discuss Dr. Boustany's mental health." A local plastic and reconstructive surgeon, Odinet acknowledges having limited direct interaction with the office, saying he provides services like signing death certificates.
"There have been no complaints to my knowledge ... no lawsuits," Odinet says. "I don't know anything about that stuff. I think it's well run. I think Collie Trant has an axe to grind," Odinet says, declining to elaborate.
Trant acknowledges he would have liked to work for Lafayette Parish government (ethics laws would prevent him from contracting directly with LCG) — and appears to be highly qualified. A Shreveport native and retired Army Medical Corps colonel, Trant completed his internship and residency (in anatomic and clinical pathology) at the Tripler Army Medical Center in Honolulu, Hawaii, followed by a fellowship in forensic pathology at the Armed Forces Institute of Pathology in Washington, D.C. He was board certified in forensic and anatomic pathology in 1984, and his impressive resume spans 12 pages — including a 1994 to 1997 stint as a quality management consultant to the U.S. Army Surgeon General. From 2003 to 2005, he worked at the Franklin County Coroner's office in Columbus, Ohio.
Provost and Talamo both attended a 40-hour death investigator training in St. Louis, Mo., and on March 17, 2006, passed a test to become registered diplomates of the American Board of Medicolegal Death Investigators. That's the first of two levels of certification for death investigators, who assist pathologists and are deemed critical to helping coroners make an accurate cause of death determination.
Trant claims Provost rarely assisted him, directing Talamo to help on almost all of the cases.
ABMDI spokeswoman Kristin Miserocchi says the course and curriculum are based on national guidelines, and directed The Independent Weekly to a 78-page guide that includes equipment investigators need, along with an extensive list of what their reports should contain. Vital information includes identifying the first responder, documenting time of call and arrival, checking body temperature, obtaining initial incident accounts and confirming location of evidence. The guide states that investigators should always take photographs at the scene. Miserocchi says while the guidelines should generally be followed by registered investigators, it's not uncommon for coroners' office to have their own specific set of guidelines.
Trant says Provost and Talamo rarely turned in investigator's reports, and when they did, the reports were missing important information. "It's basic stuff," he says. "Any high school student who watches TV would know that."
Trant produces a sample of a report done by a college student who worked at the office for a while after being displaced from New Orleans. "He did a couple for me, and [that report's] wonderful," Trant says, adding that Acadian Ambulance medics who moonlighted when Provost and Talamo were out and investigators from other parishes got the reports in as well. "All the other coroners' investigators got their reports in immediately; Provost kept saying, 'You can look 'em up in the file,' but every time I'd go look in the file there wasn't one there."
Provost, however, says he did turn in reports for all of the cases he investigated and maintains he followed ABMDI's guidelines.
So his reports would contain the information the guide stipulates should be in each report? "I guess, yeah," Provost says. "All the proper procedures were followed."
Asked if he could provide reports to support his position, Provost says, "The Lafayette Parish Coroner's office has all my investigative reports."
Trant, however, was able to quickly produce a list of 24 cases of suspicious deaths that he never got a report on: blunt force head injuries; found dead in hotel with mistress; gunshot wound to the head; operating room death; prisoner death; multiple gunshot wounds; young person found dead in bathtub; found dead on floor; drowning; possible child abuse; 2-month-old found dead. He says nine of those 24 cases were subsequently determined to be homicides.
It was another case from 2005, however, that recently raised concerns for attorney Glenn Armentor when he was representing the family of a 3-month-old whose death at a local day care center was ruled a "sudden unexpected infant death" by Trant. When Trant was called in for a deposition about the findings, Armentor was stunned that no investigator's report existed. Armentor had to piece together the scene for his case. "The investigator didn't do what he asked him to do, wouldn't get the police report, wouldn't get the fireman's report, wouldn't get the hospital report, wouldn't get the doctor's report, wouldn't get the state day care center reports, so Trant couldn't get the facts of what had happened, who was there, what was seen, heard and said," Armentor says. "We nearly walked away from the case when we got his results."
In Trant's opinion, the baby died from SIDS, but the pathologist Armentor hired as his expert witness, Dr. Emil Laga, determined that it was a choking, and the case was settled for $325,000 in June.
Armentor interviewed Provost as part of the discovery process in May. When The Independent Weekly asked him about the case, Provost couldn't recall the death of 3-month-old Nora Qamhiyeh, even after being reminded that she died in a local day care center. "Unfortunately, we have a lot of babies coming through the office," he says.
"That's amazing to me that he can't remember," Armentor says. "I went over this with him in great detail. We met for one and a half hours."
The only official Trant has shared his allegations with is Chief Administrative Officer Dee Stanley, whom Armentor introduced him to in January. "The allegations made by Dr. Trant are serious in nature and involve not only the performance of individual employees, which cannot be discussed publicly, but also the operation of an office supervised by an elected official," Stanley says. "Dr. Trant's concerns, along with his suggestions to improve operations, were forwarded to the coroner, chief deputy coroner, and the attorney for the coroner's office for proper attention the very day they were submitted to [LCG]." The issues were also discussed verbally with the council liaison to the coroner's office, Randy Menard, and council chair, Rob Stevenson, according to Stanley.
At press time, Menard's office said he was on vacation and Stevenson could not be reached.
CAO Stanley says Trant's resignation left the coroner's office with no choice but to outsource pathology services. "This contract is service-driven, and the pathologist providing this service is also an expert in this field," he says. "LCG expects nothing less than the same quality of service from this firm that it has received from Dr. Trant and his predecessor, Dr. [Cameron] Snider. Appropriate safeguards, including a right to terminate, were incorporated into the contract in order to protect the public interest."
Councilman Bruce Conque says he was never made aware of Trant's problems with the coroner's office. "Certainly, there is cause for concern if there is validity to the allegations," he says. When the contract issue with LFC arose, however, Conque asked that the coroner's office's organizational chart, employees' responsibilities and an accounting of all its finances be studied during the upcoming budget hearings, which begin in August. "While I acknowledge that the coroner is responsible for the administration of his office, it is the charge of the council to be a good steward of the public dollars that fund his operations," Conque says. "I expect to have the response at the Aug. 15 budget hearing for the coroner's office."
Had Boustany's investigators been more cooperative, Trant says he could have handled a workload as high as 400 cases annually. He maintains that the existing work environment also causes problems for families, who can't get benefits until a death certificate is signed. "The coroner is waiting on my autopsy report in order to sign the death certificates," Trant says, "unless he wants to risk changing it later."
If 77-year-old Boustany was no longer able to fulfill the duties of his tax-funded job, what no investigation is likely to answer is the question of why family members, including his son Charles Jr., a retired heart surgeon who was elected to the U.S. Congress in 2004, did not encourage him to step down. The congressman did not return a call for comment before press time.
In declining to comment on Boustany and how the office is being run, both Provost and Odinet said those specific questions should be addressed to the office itself.
The Independent Weekly began requesting an interview with Boustany last Wednesday, July 25, and called again Thursday and Friday to check the status of the request. Boustany's administrative assistant, Carolyn Bouillion, said she had given him the messages and also said that he and his family had not yet decided whether he would seek re-election.
The next day, Saturday, July 28, Boustany announced his retirement, effective this Thursday, Aug. 2.
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Leslie Turk
