License to Kill (2019–…): Season 1, Episode 4 - Deadly Dialysis - full transcript

In a small Texas town, people
receiving medical treatment

were in extreme danger.

- My mother had
several hospitalizations,

and I just didn't understand.

- It just seemed like there'd
be one setback after another.

Every time he'd go,
he'd get sick.

- During dialysis, the patient

should be getting better,
not worse.

- Was it just a
horrible coincidence...

- It was something
there-- faulty equipment,

tainted Heparin, tainted water.



Something is not right.

- Or was it something
more menacing?

- The patient said,
"What did you give me?"

and I had never seen that
before.

- These people are seeing their
friends just fine one moment

and then in severe cardiac
arrest the next.

- Police demanded
an explanation

and turned the clinic
into a crime scene.

- They collected every sharps
container

in the entire facility.

- Thousands would d t be
an exaggeration.

- The clock was ticking
to figure outouou

why patients were dying.

- I wanted to know who
disconnected her that day.



- It's almost as if you have
this silent killer

that's just striking people
down seemingly at random.

- It was pure evil.

- Who's next?

- As a doctor
and certified expert

for the California
Medical Board,

I know firsthand that
most medical professionals

will go to any length
to help their patients.

But in some cases, there are
those

with a deranged mind

and a license to kill.

In the first half
of the last century,

kidney failure
was a death sentence,

but the invention
of the dialysis machine

has become a lifesaver
for over half a million people

in the United States.

Receiving kidney dialysis
is a routine procedure

that very rarely results
in complications,

but for Thelma Metcalf,

it turned into her
worst nightmare.

a lot of shopping
and things to do.

We're close to Houston

if you need something
from the big city.

I really like it.
I like the people.

- Lufkin, it's a small town,
but it's a busy little town.

You're gonna go to Walmart,

and you're gonna see
a lot of people that you know.

- Thelma Metcalf was my
mother-in-law.

I'm married to Johnny Metcalf.

That would be Thelma Metcalf's
youngest son.

She was very loving.

She was not one that, you know
interfered much.

You know, as long as her kids
were happy, she was happy.

- My mother was
such a jokester.

She was a happy person,

and she just kind of took
things kind of lightheartedly.

You know, she was a kind of
"go with the flow" type person.

- Thelma was very social.

She liked to go to church,
women's group,

or exercise groups,
Bible study-- anything like

that she could find a way
physically to do it.

Sometimes there would be
challenges,

but she would do it.

- She was a diabetic,
and she had hypertension.

- Her level of care was a
little bit more,

you know, involved.

It took a little bit
more hands-on.

It was a little bit more
than my father-in-law

could handle on his own.

My sister-in-law is,
you know, a nurse.

She's an RN.
She was very hands-on

with her health care.

- I just fell into that role,

even before going
through nursing school.

I'd fill her medication box
for every week.

I always went with her
to the doctor.

Stayed on top of what
we should be doing

and what we shouldn't be doing
as far as physical therapy

or exercises at home or diet.

- Mobility had gotten a little
bit harder after some strokes,

so, you know, things were
just getting a little harder.

- Mother began to lose
some of her kidney function

because of the hypertension
and the diabetes.

Her kidneys had not
completely failed,

but we found out
that she was going to have

to go onto dialysis.

Even though I'm a nurse,
I mean, I don't know dialysis.

I'm not a dialysis nurse.
I had to go in and learn

exactly what the patient
should experience.

We asked for recommendations,
and we had

a couple of facilities
here in Lufkin at the time.

- We picked DaVita.

We knew that they're probably
one of the best in the nation,

so she and my father-in-law

decided that was the best
course of treatment for her.

That's where she was gonna go.

- My dad would drive her in
to the dialysis unit

on Tuesdays, Thursdays,
and Saturdays.

She had nurses
that she really liked.

She enjoyed the other patients,

almost become like family,

friends, definitely,

and they look
after one another.

- It wasn't long after Thelma
started going to dialysis

that it just seemed let there'd
be one setback after another.

We'd get a phone call.
She's at the emergency room.

She had an episode
at the dialysis clinic.

Several times,
it was too much Heparin

had been administered to her.

- Of course, being a nurse,

I didn't want to accuse anybody
of doing something wrong,

but something
there was not right.

- I remember one time,
Thelma had woke up one morning,

and she couldn't move.
She couldn't talk.

My father-in-law took her
to the emergency room,

and they admitted her.

The doctors had said that she
had been given so much Heparin

that her blood
had thinned enough

that it was able to permeate
through her spinal column

and into her spinal fluid,

and so, when that spinal fluid
was tainted,

it caused her some paralysis.

- Heparin is an essential
blood-thinning medication

that makes dialysis
treatment effective.

Patients' reaction to the agent
may vary, however,

making it crucial for nurses

to carefully monitor
their dosage of Heparin.

- She had had
several hospitalizations,

being admitted directly
from the dialysis unit itself,

and I just didn't understand.

The things that went through
my mind were,

"What's going on?
Why is this happening?"

- I think she was torn.

She knew that her health care
was important,

but I think she'd just made
such a routine

there that change
was a little concerning to her.

We all felt like her level
of care

was not where it needed to be.

Every time you go,
you get sick.

Something there-- faulty
equipment,

you know, tainted water,
whatever the theories

could have been-- but
just something is not right.

- She can come to the hospital
and have dialysis

for two or three days,
and she's back, happy-go-lucky,

and then, in a month,

will go back down
in that valley,

same things
are happening again.

We're back in the ER.
We know something's going on,

but we-- well,
we have no clue what it is.

We actually reached out
to the clinic at this point

wanting answers,
wanting my mother's records.

- While the family was waiting
for the medical records,

it was crucial for Thelma

to continue her life-saving
dialysis treatment,

so she decided
to stay at DaVita.

- Though she even admitted
she felt better

when she wasn't going there.

She would say,
"I'm happy there.

"I sit in the chair
next to my friends.

"We share pictures
of our grandchildren.

We talk about our days."

She didn't want to leave
those people

that she had
become friends with.

About this time,
we started hearing the news

that there was a recall
on Heparin, so we thought,

"This must be it.
The Heparin must be tainted."

So we're getting back
in the routine,

we're doing our three days
a week. We felt good.

- Miss Metcalf,
she was a sweet lady,

and I would sit back there
with them a lot

just conversating
with Miss Metcalf,

and she enjoyed that.
But the last time

I saw Miss Metcalf, she told me
that she felt funny.

- One morning,
we just got a phone call

that it wasn't good,

and that something had happened
at the dialysis clinic again.

I made a phone call
to my husband, who was at work,

and he answered the phone,

and he said,
"It's my mom, isn't it?"

And I said,
"Yes, it's not good."

We just felt the pull this time
more than the others

to get there
as quick as possible.

- My mother was
in cardiac arrest.

Of course, I immediately
come up there.

But when I get there,
she had already passed.

They'd already
pronounced her dead.

And we walk into the room,
and my younger brother's there

and my sister-in-law,
and my older brother

and my dad.

It was just almost
like a meltdown.

I wanted to scream
and break down,

but, you know,
you try to be strong

and be there for my father

and my brothers, my sister.

There's really no words
to describe

how it is to lose your mom.

- And so we're all
just kind of reeling.

"What happened this time?"

"Was it the Heparin again?
Was it poor care?

"Was no one watching her,

not measuring her vitals?"

- I was angry,
because DaVita didn't call me.

I could have been there,

and I could have seen her
before she passed,

which is probably one
of the hardest things for me.

You know, you always want
to blame somebody

when you're angry like that,

and we just didn't know
who to blame,

so I wanted to know
who took care of her

that day-- who
disconnected her that day.

That's what I wanted to know.

- Coming up...
- The doctors let us have

some alone time with her,

and I was just leaning down
just to kiss her good-bye,

and I remember this smell.

- Kind of burned your eyes.

It was the smell-- bleach
is what it smelled like.

- They collected every
sharps container

in the entire facility.

- I was concerned someone
was actually

hurting
these patients intentionally,

and I don't know how
I'm gonna prove that.

- After several trips

- After several trips
to the hospital

following dialysis treatment,
Thelma Metcalf passed away.

Surprisingly, her death was not
caused by kidney failure,

but instead by a heart attack.

- The doctors let us have
some alone time with her,

and I was just leaning down
just to kiss her good-bye,

and I remember this smell.

And it burned my eyes,
made my eyes water.

I just thought maybe
it was a chemical in the room,

or maybe some medicine had been
administered to her, something.

- I noticed an odor,
and I have been in the room

and around people
when they have passed,

of course, being a nurse.

It was a familiar odor,

but it was not something
that you would expect.

Kind of burned your eyes
as you got close to her,

and it was the smell-- bleach
is what it smelled like.

We thought they, you know,
used a cleaner or whatever.

The smell, you know,
it was kind of strong,

which was strange.

We walked outside
just to kind of get a break.

Security officer came up

and said that she had been
the third person

from the dialysis unit
that had came in that day

and the second one
that had died that day.

- And we were shocked.

Clara Strange was one of her
friends at the dialysis clinic.

They both passed away.

- I think we all had kind of
a gut feeling

that something
unusual happened.

It was just off.

- DaVita was not releasing
a whole lot of information,

and you just feel like,
"This is surreal."

- Nobody was telling us
nothing.

Everything that I was saying
in my mind,

"Is something going on?"

And I
just didn't know what it was.

- Two deaths on the same day
at the same clinic?

It seemed unlikely
they were just a coincidence,

given the high success rate
of dialysis treatment,

so what was
really going on here?

- Garlin Kelly was the most
friendly thing

coming up in that clinic,

and that particular day,
me and another coworker

was working a group of people,
us together.

I went to break for 15,
20 minutes.

The machine went off.
I just heard something pop.

And I looked over there,
and when I looked at it,

it looked like some big old gob
or

something jumped in that tube.

I thought it was hair.

- The patient care tech
described it looked

like a black hairball,

and it went in
through the line,

and the patient, Garlin Kelly,
said, "What did you give me?"

and immediately
went into cardiac arrest.

- It's like he
wasn't breathing.

He went to the hospital
and passed away.

Garlin Kelly was
the only patient died on me.

It was a bad day for me.

I didn't talk no more that day.

I didn't socialize
no more that day.

I was just trying to figure out
what the hell was going on.

- It is extraordinarily rare
to have a patient code

while being dialyzed.

In fact, only 1
in about 180,000 dialysis

sessions actually involves
a patient

going into full-blown
cardiac arrest.

Yet, in just 15 days, a total
of three patients at DaVita

died of cardiac arrest.
Understandably,

the clinic launched their own
internal investigation

to figure out the potential
cause of this anomaly.

- DaVita as a health care
provider said,

"Something's wrong,

and we've got to find out
what it is."

One of the things that DaVita
did for each patient

that had suffered
a cardiac event,

they collected and preserved
their dialysis lines.

They also collected
all of the Heparin

and switched it out,
and they tested the water.

They tried to find out,
"What's going on?"

- The staff on the floor
was just on edge.

Everybody was just on edge,
because patients were dying,

and I had never
seen that before.

Things was happening to the
machines that we had never saw.

We knew something
was not right.

- Opal Few was
an elderly woman,

but in otherwise great
health-- I mean, very spry.

Just a very lively woman
in her 90s.

Everyone knew Miss Few
and really liked Miss Few.

- Miss Few was a sweet pea.

I mean, she would say,
"Look at you."

I'd say, "Yeah, honey,
I'm here," you know,

and she'd get on over
in the chair.

- The nurse, Kim Saenz,
was attending to Miss Few,

and takes a break.

That nurse is in the back area

outside smoking a cigarette,

and immediately after
she goes on break,

Miss Few codes on the machine.

She's in cardiac arrest.

One of the other nurses
comes out and says,

"You need to come now.
Miss Few's coded."

And Kim Saenz said,

"I got to
finish my cigarette first."

That's insane.

When you hear that
a patient is coded, you run.

You don't walk. You run.

- When a person code, you gonna
throw that chair back,

and you're gonna get ready
to do CPR.

That's what I don't understand.
How can you not help a patient?

- Miss Few died almost
immediately.

- When he called me and told me
she had passed,

it really upset me,

'cause that old lady
had started doing good.

- There's a great deal of fear
going through the clinic.

You know, who's next?

It's almost as if you have
this,

you know, silent killer,
this unseen thing

that's just striking people
down

seemingly at random.

It was terrifying.

- There's a fair amount of fear

- There's a fair amount of fear
and panic at the clinic.

These people are seeing their
friends just fine one moment

and then in severe
cardiac arrest the next,

and it's happening over
and over again.

- While receiving
frequent dialysis,

a patient's health
should be improving,

but at the DaVita dialysis
clinic in Lufkin, Texas,

patients were dying
at an alarming rate.

But after an internal
investigation,

no evidence of foul play
was found.

That is, until one morning,
when a patient

at the clinic noticed
something very disturbing.

- We were contacted
by our chief,

and he said,
"Y'all need to go down

to the dialysis clinic there.
They've got a problem."

When we arrived, we were met
by lawyers for the facility

as well
as the district manager.

They laid out this tale
of

what had happened that day.

- Two patients reported to the
employees of the DaVita clinic

that they had seen the nurse

draw bleach up in the syringe,

and she went over
to the patient.

- They see her go to a patient,

pull a syringe out of her
jacket,

inject it into
the patient's line,

and then she would go
to another patient

and do the same thing.

They are horrified.

They call another health care
provider over

and tell her what they've seen,

and they say, "We don't want
her treating us."

The two victims she injected
go into cardiac arrest.

- The nurse who's suspected of
injecting patients with bleach

was Kim Saenz.

- Saenz's job was to administer
medications to the patients,

and she often did that through
the intravenous approach,

so you really wouldn't suspect
she was doing anything wrong

by connecting syringes
to patients' dialysis lines.

It was the bleach accusation
that was outrageous.

Could the witnesses
have been mistaken?

- The clinic, before they call
the police,

kind of does their own internal
investigation, like,

"Did this really happen?
Is this really what you saw?"

- The regional manager
at the dialysis clinic

made the decision to sequester
two sharps containers

where the two syringes
had been thrown.

- They end up testing
the syringes to determine

if there's any bleach
using test strips,

and they come back positive.

DaVita's flummoxed
by what is going on.

- The clinic immediately
put Kim on leave for the day

until they can sort things out.

- I was shocked. I really was.

I couldn't imagine something
happening like that at DaVita.

I worked with Kim.

I just didn't want
to think of Kim as a person

like that, you know?
That's what bothered me

the most-- that
I couldn't see nothing.

- The clinic found bleach
in syringes used by Saenz,

but she denied any wrongdoing.

Without an admission of guilt,

police did not have enough
to arrest her,

so law enforcement
closed the clinic

and launched
an official investigation.

- We're all hearing that
they've been shut down.

The newspaper just said
"unusual spike in patient death

at the dialysis clinic."
So now we want to know,

is our loved one part
of that unusual spike?

How many is unusual?
What's the number?

- Based upon what had happened
that day,

I was concerned that there was
a possibility either A,

there was
some medical malpractice,

or B,
someone was actually hurting

these patients intentionally,
and made the decision

to treat the entire facility
as a crime scene.

We told them that we were
going to take items,

and they agreed to allow us
to take them rather than get

a search warrant
and make a bunch of publicity.

We started processing
the scene that night.

If they mentioned and thought
it might be relevant,

we took it.

We learned they had kept all
the dialysis lines from people

who suffered cardiac events
during the month of April,

so we decided to take those.

- They collected

every sharps container
in the entire facility.

- We took 36 containers,

which contained over a month
of medical waste,

so thousands would not be
an exaggeration.

We also wanted to be able to
trace those sharps containers

back to the seats they were
at the night we found them,

so we had photographs
taken of them in place,

every sharps container,

showing the sharps container,
the station number,

and the machine
it was associated with.

We stayed there
till about 10:00 that night

removing all the items
we felt we might need.

We were working with
the CDC's epidemiology team.

They had people who pored
over every medical chart

for every patient in there
for the time of the events.

The only person who was present
for every incident

which occurred in April

where somebody died
was Kim herself.

- The medical records directly
linked Kim Saenz to the deaths

at DaVita dialysis clinic,
but the next day,

an even more shocking piece
of evidence was discovered.

- Kimberly Saenz's husband
contacted a lawyer

to make an inquiry
about a divorce,

and the lawyer notified
the police department.

They went and talked to him,

and they got a search warrant

for a computer
that Kimberly Saenz had used.

- We see internet searches
at 4:30 in the morning,

and internet searches
for things like,

"Can bleach be detected
in a dialysis line?"

and "Effects of bleach
in adult bloodstream."

She might as well
be searching for,

"Am I going to get caught?"

and at that point, it's really
hard to not accept the reality

that's staring you in the face.

- The main thing that we wanted
to do as soon as possible

is interview Kimberly Saenz.

- It's an unbelievable story

- It's an unbelievable story
that an LVN, a nurse,

would intentionally inject
her patients with bleach.

Your first reaction is,
"There is some other plausible

"explanation for this
that doesn't involve a random

"health care worker

intentionally murdering her
patients."

That's really not the first
conclusion you want to draw.

- People kill people because
they're mad at them,

or people kill people
because they get revenge,

but why would someone
kill a patient

that's no threat to them,

that they don't get
any financial benefit out of?

It doesn't make sense.
But Kimberly Saenz

is the person
that the witnesses reported

seeing draw the bleach up
and inject it,

and that was
the immediate concern.

- Is it Kimberly or Kim or...

- You go by Kim?

- All right, Kim.
I'm Corporal Shirley.

This is Sergeant Abbott.

- It's really an information
gathering event.

We're just trying to identify

where she was
when these events occurred,

what occurred, what her actions
were, what her reactions were.

- Did you work the whole day
yesterday?

- As she told her story,
some of the actions

paralleled what were seen
by the witnesses.

- Okay, were you near any
patients

when all this happened?

- She brings up bleach
before we do.

- Was this a guilty
slip of the tongue?

Detectives need to learn more
about bleach in the clinic.

- Can you tell us anything
about the bleach in procedures?

- At DaVita, when they use
bleach as a disinfectant,

the nurses mix
a dilute bleach solution

to wipe down the patient areas,

things that the patients
have contact with.

- I'm a little bit confused,

so maybe you can help
clarify this.

Do you use a syringe to pull

your 10 Ccs of bleach up?

- Protocol for creating

a disinfectant solution
at the clinic

dictates
the 10 CCs of bleach

should be used
in each bucket of water,

and bleach should only be
poured from a measuring cup,

never drawn into a syringe.

So why is Saenz using a
syringe

as a delivery method
for bleach?

- Kimberly Saenz alleges

that she used a syringe
to measure bleach

because they were out
of measuring cups.

- When you use a syringe
to draw up the bleach

before you make
your mixture up,

what happens to that syringe?

- Kim, at least at some level,
knew,

"I need to explain why
there's bleach syringes

in sharps containers,"
and I guess she felt

that some explanation
was better than none,

even if it's a bad explanation.

But because Kim admitted

that she drew the bleach
in the syringe,

she is essentially
putting the gun in her hand.

- We charged her with five
charges of aggravated assault

for the patients
who did not die

and five counts
of capital murder,

and so she was arrested,

but she refused
to talk any further.

- We just opened up the paper
one morning,

and there it was.
Front page.

Kim had been arrested
for capital murder.

There were the five murder
victims, including Thelma.

- I was shocked. I really was.

I just couldn't believe
Kim would shoot bleach up

in people like that,
just kill people.

Who would think to do
something like that?

And them old folks still had
a lot of life in them too.

You know? You don't just
take nobody's life.

- Honestly, I think
that the day Mother died

was not the first time that
Kim had done something to her.

You know, she experimented.

She did different things,
giving her too much Heparin.

That's why she had had
several hospitalizations,

being admitted directly
from the dialysis unit.

It wasn't an accident.

It was pure evil.

- The next day, Kim Saenz
was released on bond.

She maintained her innocence
while she awaited trial,

but her nursing license
was suspended,

and she was required to wear
an ankle monitor at all times.

- Kim Saenz obtains her bond,

but one of the conditions
of her bonding

is that she is not to work
in a health care facility.

- Little by little,
people kept telling us,

"I saw her."
You know,

"She goes to basketball games.
I saw her at the nail salon."

That left a very uncomfortable
feeling for us,

because this is
a small community,

and we have kids the same age
as Kim and her husband,

so we would go to a youth
sports event or something,

you're always looking around
to see, 'cause, you know,

we saw her mug shot,
we knew what she looked like.

So that was very uncomfortable,

to know that we could
run into her any time.

- You could see her at Walmart.
I mean, she had times

that she could go out

and do things in the community,
and I didn't understand,

how could she be
accused of this

and be able to wear
an ankle monitor and be out.

- Coming up, while the families
waited anxiously for justice,

investigators encountered
an unexpected roadblock.

- There's not a lot of research
on, "Does bleach kill people?"

- It's just not the kind
of thing

to the standard lab panel.

It's just not tested.

- And fears grew that Kim
Saenz

may have committed
the perfect crime.

- We were terrified that
this woman was going to walk.

- While Kim Saenz was out

- While Kim Saenz was out
on bond

and charged with the murder
of five patients,

detectives had the challenge
of proving

that bleach found in syringes
and dialysis lines

actually entered the victims'
bodies and caused their deaths.

- This is a really tough case,

because this is
medical science,

and we didn't know
anything about dialysis.

- I don't like people
just to hand me information

and me not be able
to verify it,

so I educated myself
really quickly.

I went and borrowed
a nursing textbook,

started reading it.
Then I immersed myself in it.

- You know, we continued
to work really hard

so there's justice done for

the numerous victims.

- DaVita collected
and preserved

their dialysis lines
for each patient

that they believed
had suffered a cardiac event,

and in Mr. Kelley's line,
there was a syringe

that was found that was still
attached to his dialysis line,

and that syringe
tested positive for bleach.

We actually went
to the hospital,

and we put bleach in the blood
to see what it would do...

And it turned black.

It was really kind of eerie
when we saw that.

It was one of those moments
that we go,

"That makes sense.
That's what the nurse saw."

- When I looked at it,
it looked like

some big old gob or
something jumped in that tube.

I thought it was hair.

- When bleach is introduced
into the bloodstream,

it causes the red
blood cells to burst.

When red blood cells burst,
they release iron,

which produces a thick,
black liquid.

This process
is called hemolysis,

which supports what
the witnesses saw

in the victims' dialysis lines.

The next challenge
investigators faced

was being able to prove

that the bleach actually left
the dialysis lines

and entered
the patients' bloodstreams,

which would cause hemolysis
inside their bodies,

triggering cardiac arrest.

- We had a treasure trove
of evidence.

We have forensic evidence

indicating Kim Saenz
injected bleach.

We have eyewitnesses
indicating she injected bleach.

What we don't have
is proof of bleach

in the bloodstreams
of the victims.

Intuitively, it seems like
it's obvious it must have,

but intuition is not enough
in the courtroom.

You've got to prove,

by reasonable
scientific certainty,

that the bleach
is what caused the injury

or the death to the patient.

- So we go to the CDC and say,

"Is there any way to test blood

for the presence of bleach?"

They said, "Well, no.

It's just not the kind of thing
to the standard lab panel.

It's just not tested.

- Although the result of
the detectives' experiment

was compelling,
it wasn't enough.

They were the ones putting
bleach into a blood sample.

What they needed to be able
to do was to show that bleach

was already present
in the victims' blood,

and at that time,
a test for that did not exist.

Did that means Saenz could have
committed the perfect crime?

- It was daunting.
I'd become convinced

that this person is actively
hurting and killing people,

and I don't know
how I'm gonna prove that.

We began to look for an agency
or a lab

which could test
those items and confirm,

scientifically,
that there was bleach in there.

- There's not a lot of research
on,

"Does bleach kill people?"

because it would be
unethical research.

Chris found an expert who could
actually test the blood

of some of the individuals

who had died
at Kim Saenz's hands.

- Fortunately for us,
Dr. Mark Sochaski

was on a bioterrorism council

and does research
on chlorine gas.

- One of the projects that I
had was developing a test

for evaluating
chlorine exposure,

and that test was
the chlorotyrosine test.

Chlorotyrosine is an amino acid

that is not naturally present
in the body.

It can only be formed
through the exposure

of chlorine or bleach.

- So we send 51 samples
of blood to Dr. Sochaski.

It's a blind test.

All he has is control numbers.
He doesn't have any names.

Those samples include
dialysis patients,

they include
non-dialysis patients,

they include patients
who we suspected

were injected with bleach,
and it included patients

who we didn't think
were injected with bleach.

- I come in the next day and
start analyzing these samples,

and I go through
the first few samples.

There's nothing there.

You know,
I'm a little bit relieved.

I get to the third sample.
There's nothing.

Fourth sample, nothing.

It's probably around
the sixth or seventh sample,

all of a sudden, there's this
huge chlorotyrosine peak

that just shows up.

Suddenly, this goes
from a hypothesis to reality.

These people had been exposed
to bleach in some way.

Otherwise, those chlorotyrosine
peaks wouldn't be there.

We got 100% accuracy.

It wasn't even close.

- Dr. Sochaski identifies nine
samples which he believes

have been exposed
to a chlorinating agent.

Those were all our victims.

So we have the bleach syringe,
we have bleach

in the lines, we have
the 3-chlorotyrosine research

that Dr. Sochaski did,
we have the internet searches.

A combination of relief
and kind of exhilaration

that we have this
really compelling

and very strong evidence.
This is a person

who randomly selected people
and killed them.

- This was the piece
of evidence investigators

needed
to take this case to court.

- The first day of the trial,

as we were walking
through the courthouse,

we began to kind of pick up
on the feel of,

"There she is. That's her."

- To sit in a courtroom
with her,

you know, maybe 15 feet
at the most away from you

while she smiled
and she laughed,

and it was like it was a big
game and a big joke for her,

it was all I could do to sit
in my seat and behave myself,

but I know causing problems

wasn't going to bring
my mother back.

- It's an enormous pressure

to know that
these families need closure,

and we have to champion
their cause,

and we have to see that
there's some justice.

- The defense counsel,
in his opening statement,

says, "These people were
not poisoned with bleach.

"They were killed because
the water at the facility

was inadequately
filtered and maintained."

So we all look at each other
like, "My God."

We had just not realized
that that would be something

he would attempt to utilize,

and we don't have an expert
designated on that issue.

We were completely ambushed.

We were terrified that
this woman

was going to walk.

- The defense theorized

that the patients died

'cause the water
was not properly purified

that was used
in the dialysis process.

- I remember the defense saying

that it was
the water contamination,

basically, is what would cause
the patient's injury or death,

and not their client,
Kim Saenz.

- The defense's theory had
a significant problem.

Some patients
were absolutely fine,

and others were dropping dead.

- Moreover, in the event
of a chlorine breakthrough,

cardiac arrest
is not the outcome.

It's anemia.
And, you know,

a patient becoming anemic
is a very slow and-- process

you have to determine
through lab results.

Patients don't just
fall over and die.

It wasn't a credible theory.

- A critical point in the trial
is the defense

brought a pathologist
named Amy Grusheski,

and Chris Tortorice
cross-examined her.

- While testifying,
the medical examiner asserted

that the district attorney
should have ordered autopsies

on every victim
before indicting Saenz.

- Chris Tortorice caught her
in a number

of incredibly problematic
mistakes

that made her testimony
totally ineffective,

and she was a key witness
for the defense.

- In final argument, I argued
to the jury,

and I begged them,

"Don't get in a hurry.

"There's a lot of evidence
here,

and if you'll look long enough,
you'll find the truth."

- 48 hours later, the jury
came back with a verdict.

- We just sat together all day
long waiting

for the verdict to come in,
and there's a moment

where you think,
"Why is it taking so long?"

You can kind of feel the buzz
around the courtroom,

and at this moment,
you thought,

"Okay, this is it.
We're fixing to find out."

- The first thing,
the judge said,

"We the jury find
the defendant,

Kimberly Saenz..."

"Guilty of capital murder."

And I said,
"Thank you, God."

- You know, seeing her taken
into handcuffs was gratifying.

Kim Saenz committed these
really heinous,

violent acts,

and did so in a really wanton
and callous way.

- They told me, said,
"She done been convicted."

I said, "How long?"

Said, "I think she got life."
I said, "Lord!"

And that's all I could say,
you know?

I knew they were gonna
hang her out to dry.

He knows up there,

so whatever is for her,
Kim's gonna get it.

- You do find some justice
has been served,

but then, at the same time,

I think the whole time, you
just-- you know when it's over,

it doesn't bring
your loved ones back,

it doesn't undo what she did,

and now how do
we go on past this to heal?

- The final moments
that my mother went through

had to be horrible,

because the bleach went
straight to her heart,

and when you're having all
those red blood cells burst,

and it's fire;
it's almost like

being burned from within.

At that very moment,

I wanted
to put bleach in Kim's veins,

make her feel
what my mother felt.

I honestly wanted her
to get the death penalty,

and I was upset
when she didn't,

but, you know, life in prison
without parole-- all

of her appeals
have been denied.

She is there.
She'll come out in a pine box.

- Prosecutors faced many
challenges,

but in the end, were able to
trailblaze scientific testing

and prove that Kim Saenz
was a sadistic murderer.

With Saenz behind bars,

the Metcalfs
and other victims' families

are now able to begin to heal
from their horrific loss.