CLINTON, Ind. (AP) Ä It was an anonymous letter with an alarming claim: Patients were dying mysteriously in a tiny hospital, each case marked by an eerie consistency Ä the same nurse was on duty.
''Would you want one of your loved ones to be a patient in that hospital with a death angel working,'' the letter asked. '' ... We need to stop this nurse and I hope you will help us.''
After the Indiana Department of Health received that letter Ä one of several copies apparently sent this spring to newspapers and authorities Ä it dispatched investigators to Vermillion County Hospital.
They were looking for answers. They weren't alone.
State police already were on the trail, having been contacted by the hospital, which was concerned about a startling rise in deaths in intensive care Ä so concerned, in fact, that it had suspended a male nurse.
The mystery at Vermillion County Hospital has since mushroomed into an unnerving tale of anxiety, suspicion and questions about some disturbing numbers: In a 22-month period ending in March, 147 people died in the intensive care ward; in 130 cases, one nurse was on duty. In 1994, 100 people died in that unit Ä more than triple that of previous years.
Whether this is a benign twist of tragic coincidences, shoddy medical care or perhaps, more ominously, a diabolical pattern of evil is something the police, lawyers and courts will sort out.
The hospital says it has done nothing wrong. Orville Lynn Majors, the 34-year-old licensed practical nurse who has been temporarily stripped of his license, says he is a scapegoat and that he, too, has done nothing wrong.
But several anguished families whose relatives died Ä sometimes, unexpectedly Ä sense something isn't right.
''Each person who lost somebody needs to know the answers for all of us to have peace of mind,'' said Judy Miller, whose 51-year-old husband, Tom, died in October. ''If we don't, we're not going to be able to go on with our lives.''
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The stories are strangely similar: In each case, relatives seemed to be holding their own Ä or even improving Ä in intensive care, then died within a day. Some remember seeing Majors; others don't.
Tom Miller, who had been suffering from bronchitis, died less than 24 hours after being hospitalized last October. The death certificate listed the cause as pneumonia.
''They told me he wasn't that sick,'' his wife said, wearily. ''We never dreamed that he would die.''
Majors, she said, twice asked her to leave the room while he tended to her husband, but she has no proof he acted inappropriately. After learning of the investigation, she began to cry. ''Why didn't the doctors notice an increase in the patients dying?'' she asked.
John Rozsa is looking for answers in the 1994 death of his wife, Ethel, 61, who entered intensive care after experiencing heart attack symptoms. His wife was doing well the next morning, but after he stepped out briefly, he says, he returned to find her lying in the dark, unplugged from all monitors.
An emergency code was called. Soon after, he was told Ethel was dead.
''I could not accept the circumstances surrounding her death,'' Rozsa said, shaking his head. ''There was something wrong there, something drastically wrong.''
Marjorie Doran is wondering, too, about the October death of her father-in-law, John, 76, who was hospitalized after complaining of loss of appetite. The next morning, she said, he seemed OK until he was moved to intensive care, where his breathing became more erratic. She said Majors treated him, giving him injections into his intravenous tube.
''We all feel guilty,'' she said. ''We put our faith and trust in the hospital. ... We had talked him into going there.''
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Vermillion County Hospital, a concrete-and-glass building, sits on Main Street in this southwest Indiana town of 5,000, part of a tranquil area that is home to many retirees and several nursing homes.
The unusual rise in deaths at the 56-bed hospital Ä only four beds are in intensive care Ä coincided with Majors' work schedule.
Majors, who was rehired in May 1993 for a second stint at the hospital, has repeatedly maintained his innocence.
''I know I have done absolutely nothing wrong,'' declared the husky, shaggy-haired nurse in a recent interview. ''I'm an excellent nurse.''
His 1994 job evaluation seemed to agree: It said Majors ''exceeds expectations'' and praised his accuracy, judgment and people skills.
Clifford Beyler, a lawyer acting as hospital spokesman, would say only the suspension Ä he didn't name Majors Ä was ''the appropriate action to protect the health and safety of our patients.''
But he also insisted there has been no improper care at the hospital, including intensive care.
''Our doctors have said they are not aware of any inappropriate medical treatment of these patients,'' he said. ''Our nurses have said the same thing by virtue of the care that was given and by review of the death charts.''
An 11-member state police team is now examining medical records and interviewing relatives and staff. They have not identified Majors as a suspect.
''We have not been able to determine any crime has been committed,'' said State Police 1st Sgt. Mark Hartman. ''If you don't have a crime, you don't have a suspect.''
The hospital clearly did have problems, according to the state health department, which fined the institution $80,000, citing eight violations.
Among them: It didn't notify the agency of suspicions about increased deaths, and the administrator didn't act when he became concerned about a jump in cardiac arrests.
''He had a gut feeling in November that something was amiss in the ICU'' because of the high number of code blue calls Ä cardiac or respiratory arrests Ä and unexpected deaths, but he didn't act until March, said Art Logsdon, assistant commissioner of consumer health services.
Logsdon said doctors didn't review death records as required and ''from 1993 to 1994, deaths in ICU tripled and the hospital simply didn't have a clue.''
A state inspection in December, however, didn't detect the problem either; Logsdon insists it's the hospital's responsibility to alert the agency of anything unusual.
The hospital has developed a plan to correct problems cited by the state, but a national quality-monitoring group decided this month to deny it accreditation Ä a step that could affect some insurance coverage.
The hospital is appealing the fines, said Beyler, the attorney. He offered a simple explanation for higher death numbers: Sicker, older people are ending up in intensive care.
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