Gertrude I. Bryant, a 63-year-old woman, was a patient in the cardiac care/intensive care unit at Community Hospital of the Valleys in Perris, California, when her condition suddenly and violently deteriorated in April 1981. The California Supreme Court record identifies the episode as the April 7, 1981 death of Gertrude Bryant, rather than April 11. Bryant had been hospitalized with high blood pressure and congestive heart failure and was receiving Nipride to reduce her blood pressure.
At the beginning of the 11:00 p.m. nursing shift, she was coherent and able to speak, but as the night progressed she began muttering incoherently.
Around 5:00 a.m., another ICU patient, Winnifred Hammond, suddenly went into seizures followed by cardiac and respiratory arrest. As hospital personnel concentrated on saving Hammond, Bryant also began convulsing. She was given Valium in an attempt to control the seizures, but soon suffered respiratory arrest. By the time the day shift began at approximately 7:00 a.m., Bryant remained alive but was unconscious. Registered nurse Robert Rubane Diaz, who had been working the night shift, told incoming nurse Lyn Race that Bryant was “going to code.” Witness testimony described Diaz as appearing excited. While the nurses were still receiving their shift briefing, Diaz interrupted them to report that Bryant was again having seizures. Her condition quickly progressed to cardiac arrest. Resuscitation efforts failed, and Bryant was pronounced dead at 7:33 a.m.
The circumstances surrounding Bryant's death later became important because investigators and prosecutors believed her symptoms were consistent with a massive overdose of lidocaine, a heart medication normally used in controlled amounts to treat abnormal cardiac rhythms. A nursing note recorded that at approximately 5:30 a.m. Bryant's EKG showed a nodal rhythm. A prosecution cardiology expert testified that such a rhythm could have resulted from excessive lidocaine. Laboratory testing of tissue collected from Bryant also revealed substantial quantities of the drug. Prosecutors presented expert testimony concluding that she had received a significant overdose and that lidocaine poisoning caused her death. The California Supreme Court later ruled that the evidence was sufficient to support the finding that Bryant had been murdered through an overdose of lidocaine administered by Diaz.
The defense disputed that interpretation. Diaz's attorneys pointed out that Bryant had previously experienced seizures and a stroke and argued that another stroke could have caused the medical crisis. They also raised the possibility that complications from Nipride might have produced seizures if the medication had been improperly administered. Defense experts challenged the prosecution's interpretation of Bryant's heart-monitor records and argued that the amount of lidocaine detected in some of her tissues could have been consistent with medication administered for legitimate treatment. The trial judge ultimately rejected those alternative explanations in favor of the prosecution's evidence.
Bryant's death was not investigated in isolation. Diaz had begun working the night shift in the Perris hospital's cardiac and intensive care unit on March 29, 1981. Over approximately the next three and a half weeks, at least 13 patients on the night shift experienced unusual violent seizures that were generally followed by respiratory and cardiac arrest; nine of those patients died. Nurses testified that the seizure activity was unlike what they normally observed among cardiac patients. As concern mounted over the unusual number and similarity of the deaths, the hospital eventually closed its intensive care unit. Diaz then began working at San Gorgonio Pass Hospital, where another patient died after exhibiting similar symptoms while Diaz was on duty. Investigators arrested Diaz within roughly a day or two of that later death and ultimately accused him of murdering 12 patients.
Investigators developed a largely circumstantial but extensive case against Diaz. Prosecutors argued that he had access to the patients shortly before their medical emergencies and was capable of administering lidocaine without attracting immediate suspicion because he was a registered nurse. Tests showed unusually high concentrations of lidocaine in the blood or tissues of several victims. Investigators also discovered hospital syringes containing concentrations of lidocaine far greater than their labels indicated. On May 1, 1981, authorities executed a search warrant at Diaz's home and seized syringes, an empty lidocaine box and a vial containing the medication. Prosecutors never established a clear motive and did not characterize the deaths as mercy killings.
Diaz was formally prosecuted for Bryant's death along with 11 other patient deaths. A lengthy preliminary hearing resulted in him being ordered to stand trial on all of the murder charges. Diaz waived his right to a jury trial, leaving the case to a judge. He was found guilty of 12 counts of first-degree murder, including the murder of Bryant, and multiple-murder special-circumstance allegations were found true. The court determined that the deaths had been caused by deliberate overdoses of lidocaine and concluded that Diaz had administered the fatal doses. A judgment of death was entered against him on June 15, 1984.
Diaz appealed, continuing to challenge the medical and circumstantial evidence used to connect him to the deaths. On August 31, 1992, the California Supreme Court affirmed his convictions and death sentence, although it ordered 11 of the 12 multiple-murder special-circumstance findings stricken because they were legally duplicative. The underlying murder convictions, including the conviction for killing Bryant, remained intact. Diaz continued to maintain his innocence during his years on death row. He was never executed. After approximately 26 years under a death sentence, he died of natural causes on August 11, 2010, while still a condemned California prisoner.
