Friday, June 22, 2012 - 3:00 p.m.
Dwight Kramer is an assistant administrator at Baptist Memorial Hospital where Dr. Veronica Smith sometimes performed procedures. Detectives Armstrong and Murphy re-interviewed him at the Yoknapatawpha County Sheriff's Department. The interview was recorded with the witness's knowledge and consent.
- Detective T. Armstrong
- Detective S. Murphy
- Dwight Kramer
Detective Armstrong: Would you state your name and address for the record please?
Dwight Kramer: Dwight Kramer. 237 Sivley Street.
Detective Murphy: Things still busy for you, Mr. Kramer?
Dwight Kramer: Things are always busy.
Detective Armstrong: Let’s get to it then. According to the coroner's report, Dr. Veronica Smith had ketamine in her system. Are you familiar with that drug?
Dwight Kramer: We use it at the hospital. Ketamine is a TNMDA receptor antagonist, creating a state of dissociative anesthesia.
Detective Armstrong: Ketamine is a controlled substance, is it not?
Dwight Kramer: There are dozens and dozens of controlled substances used in a hospital setting.
Detective Armstrong: Has any ketamine gone missing?
Dwight Kramer: The hospital has very strict standards regarding use of controlled substances. Everything's computerized. If we were meeting in my office instead of yours, I could give you a complete count and location of every bit of controlled substances on hospital grounds.
Detective Armstrong: Sounds impressive.
Detective Murphy: Mr. Kramer, isn't it true that the quality of those reports entirely depends on human beings entering the correct information when the drugs arrive as well as correctly tracking any movements or dispersals?
Dwight Kramer: Well, there is a human component to the system.
Detective Armstrong: I repeat, has any ketamine gone missing from the system?
Dwight Kramer: The hospital takes the safe and secure handling of controlled substances very seriously. In the last five years, we’ve upgraded our system and completely redesigned the policies and procedures to ensure a proper inventory to better manage our resources.
Detective Armstrong: Since you're not answering the question, may I take it that ketamine has gone missing from the system?
Dwight Kramer: Minute quantities of drugs are sometimes misplaced or misreported and are thus unaccounted for until the situation is resolved.
Detective Murphy: So could the ketamine that shows up in Dr. Smith’s toxicology report be accounted for by the so-called “minute quantities” that are currently misreported or misplaced?
Dwight Kramer: It is within the realm of possibility, yes.
Detective Murphy: And is there any way to determine when that ketamine went missing?
Dwight Kramer: Even real-time inventory is a moving target. Even when mistakes are being corrected, fresh mistakes are being made.
Detective Armstrong: We understand the predicament you're in, Mr. Kramer. Every organization has discrepancies from time to time, and we're not holding you personally accountable. We just want to know if the ketamine found in Dr. Smith's system could have come to from the hospital.
Dwight Kramer: Ketamine could have come from everywhere.
Detective Armstrong: Last time I checked at the convenience store where I get my coffee, ketamine wasn't available. It's a controlled substance, hence the term "controlled."
Dwight Kramer: There are many possible sources of ketamine.
Detective Armstrong: And is the hospital one of them?
Dwight Kramer: Yes.
Detective Murphy: Does the hospital investigate shortages?
Dwight Kramer: Of course we do. We have checks and balances in place to ensure the safe and secure handling of controlled substances.
Detective Murphy: Have any of these investigations ever linked any misplacements or misreportings to Dr. Smith?
Dwight Kramer: Not to my knowledge. Dr. Smith had exemplary handwriting.
Detective Murphy: What does handwriting have to do with anything? I thought you said the whole system was computerized.
Dwight Kramer: It is. Some doctors, however, still take notes that they or others enter into the system at another time. As I said, some physicians often think themselves above stated policies and procedures.
Detective Murphy: Have you ever heard that Dr. Smith might be using controlled substances recreationally, perhaps even in her own home?
Dwight Kramer: No, she would have lost all privileges at the hospital.
Detective Murphy: Well, has anyone at the hospital either been disciplined or terminated due to drug irregularities in the inventory, say, within the last year?
Dwight Kramer: I’m afraid I’m not free to discuss personnel matters.
Detective Murphy: OK, then. How about this? If someone at the hospital was involved or implicated in irregularities in the inventory, what would happen to them?
Dwight Kramer: If there was proof, that person would be terminated immediately, and their actions reported to law enforcement for prosecution.
Detective Armstrong: And if there wasn't proof?
Dwight Kramer: If a hospital internal investigation turned up no proof, but still there was suspicion about one or more people, I’d say those people would be under stringent observation even after the hospital’s investigation was completed.
Detective Armstrong: And has anyone been under that sort of scrutiny lately?
Dwight Kramer: Again, I'm not free to discuss personnel matters.
Detective Armstrong: Yeah, yeah, yeah. Who has access to drugs such as ketamine in your system?
Dwight Kramer: That’s part of the problem. I’ve proposed a new system that would greatly restrict access to controlled substances and improve reporting of both controlled and uncontrolled substances better improving our inventory to protect our product.
Detective Armstrong: Could anyone who works at the hospital have taken ketamine from the premises?
Dwight Kramer: Well, the volunteers that staff the information desk are limited to stealing toilet paper.
Detective Armstrong: So, excepting the volunteers who work at the front desk, anyone who works at the hospital could have taken the ketamine?
Dwight Kramer: Of course not. Access to all controlled substances is restricted. Pharmacists have access, of course, and doctors and nurses. However, there are controls I would like to see put in place that would greatly restrict access and ensure proper reporting in order to protect our inventory.
Detective Murphy: You know, it's no wonder that you find comfort in making beautiful things. After all this trouble at the hospital, well, following a simple pattern for a stained-glass lamp must seem like paradise.
Dwight Kramer: Yes, there is great satisfaction and fulfillment in my hobby, yes.
Detective Murphy: Mr. Kramer, have you ever let your family think that you were in your workshop when you in fact left your property?
Dwight Kramer: Never.
Detective Murphy: Even though not one person in your family can verify your location?
Dwight Kramer: That is correct.
Detective Armstrong: As an employee of the hospital, would you be able to remove ketamine from the hospital?
Dwight Kramer: Theoretically.
Detective Armstrong: And did you?
Dwight Kramer: I did not.
Detective Murphy: Well, if you didn't, who else besides you would have ‒ not would have but could have pilfered that ketamine? Don’t think. Say the first name that comes into your mind.
Dwight Kramer: I don’t know.
Detective Murphy: Yes, you do. I saw it in your face. Who was it? It doesn’t mean they did it.
Dwight Kramer: Look, I don't feel comfortable stating a name without proof.
Detective Murphy: Come on, Mr. Kramer. All you need to‒
Detective Armstrong: Oh, forget it. He can’t give us a name because he’s the only one who could’ve stolen it. That’s the truth, isn’t it?
Dwight Kramer: It wasn’t me. Look, ask Ruthie Foreman. Not that I believe she did it because I don’t believe she did, but she knows everything that goes on in that hospital.
Detective Armstrong: Now, if she knows who took it, why wouldn’t she report it?
Dwight Kramer: Well, like me, she holds herself to high professional standards. She wouldn’t state a name without proof.
Detective Armstrong: So she doesn’t actually know anything, and you’re just blowing smoke, trying take us off the trail.
Dwight Kramer: No! I’m saying, even though she doesn’t have proof, I believe she has a pretty good idea, and you might be able to convince her to tell you. She wouldn’t tell me, but then again, you have more effective matters of persuasion than I do.
Detective Armstrong: Now, you know if she doesn’t give us anything, we’re going to think you lied just to get us to leave you alone.
Dwight Kramer: I can’t help that. Look, I’ve done everything I can to help you.
Detective Armstrong: I guess we’re going to find out if that’s true or not.
Detective Murphy: Thanks for your time, Mr. Kramer. We will be in touch.
Interview ends: 3:17 p.m.