The death at Sunrise Children's Hospital of an infant whose catheter was severed was a homicide, the Clark County coroner has ruled.
Two-month-old Miowne Obote suffered severe bleeding after an umbilical catheter was severed, which caused a fatal lack of oxygen to the baby's brain, according to information released Monday by Coroner Mike Murphy.
Murphy said a ruling of homicide does not necessarily mean murder.
"Our definition of homicide is an interaction between two humans in which a death occurs," he said. "The ruling of homicide does not necessarily mean it's intentional."
Police haven't filed charges in the case.
"Our investigation is nowhere close to being finished," Las Vegas police spokesman Bill Cassell said. "We can't say anything more about it right now."
The licenses of two nurses in the hospital's Neonatal Intensive Care Unit -- Jessica May Rice and Sharon Ochoa-Reyes -- were suspended by the State Board of Nursing after a police investigation into 14 incidents of disrupted catheters at the hospital since February.
Neither Rice nor Ochoa-Reyes was available for comment Monday.
Hospital reports have always described the catheters as "disrupted." The coroner's report Monday was the first time a baby's catheter was described as severed. There was no indication of how it was done.
Medical examiners said secondary causes of the July 22 death were an infection and the baby's extreme prematurity. The infant was born at 23 weeks, while childbirth generally takes place at about 38 weeks.
The baby's mother, Christine Obote, was emotional during a phone interview.
"What do you want me to say?" she said. "Nothing can bring my baby back."
An infant who had emergency surgery to survive a catheter disruption is now at home, according to hospital officials.
The officials have never said what harm, if any, was caused to infants in the dozen other cases.
In the wake of the coroner's homicide ruling, Cassell called on parents who believe their infants died mysteriously at Sunrise to call police.
"We'd really like to talk with them," he said.
And Luana Ritch, a bureau chief in the Nevada State Health Division, said she will ask the state's statisticians to examine the number of deaths in the Sunrise Neonatal Intensive Care Unit, where Rice and Ochoa-Reyes worked, "to see if there are any anomalies."
State investigators believe Sunrise has taken action to make the hospital safe for newborns through increased security and personnel actions, Ritch said.
She complimented hospital personnel for finding out that it wasn't product failures placing the lives of newborns in jeopardy, but rather that products such as catheters "were being tampered with."
"I would certainly hope that the hospital would be looking at where these nurses were when other deaths occurred at the hospital," Ritch said.
Murphy reiterated that a homicide ruling doesn't state whether a death was a murder.
"It could be, but you have to be careful that inference is not automatic," he said. "It would be inappropriate for our office to make a determination. ... Metro still has a lot of work to do."
Under Nevada law, if neglect of a patient -- which can be the failure to provide safe care -- results in death, a professional caretaker is guilty of a category B felony and shall be punished by a minimum term of not less than one year and not more than 20 years.
"But if the act is deliberate, we're talking about murder," said a lawyer in the Clark County district attorney's office.
National safety officials have told the Review-Journal that accidental tubing misconnections cause several deaths among hospital patients each year.
"You can't put diesel fuel in your gas tank, but you can inadvertently mix medication and nutrition for a baby through a tubing misconnection," said Debora Simmons, head of the Houston-based National Center for Cognitive Informatics and Decision Making in Healthcare.
But neither Simmons nor any other safety official had any stories about accidental deaths caused by tubing being severed.
Katherine Ramsland, a criminologist at DeSales University in Pennsylvania who has long studied "angels of death" nurses who have committed what they call "mercy killings," said Monday that Sunrise officials have no choice but to study incidents and deaths in the neonatal unit during the time the two nurses worked there.
"It's the responsible thing to do," she said. "They have no choice."
Ramsland said angels of death, people who love to hold the power of life and death in their hands, generally commit their mercy killing on those who are the most defenseless, either infants or the elderly.
"That's why they are so hard to catch," she said.
Sunrise officials have not said when they asked police to investigate the catheter disruptions, only that they did so after an umbilical catheter, which has a slow failure rate, was disrupted. And they said they asked police to investigate 14 incidents back to February.
Sunrise officials have consistently refused to say how long Rice and Ochoa-Reyes have worked at the hospital. Rice received her Nevada nursing license in 2006, Ochoa-Reyes in 1991. Rice's MySpace page said she previously worked at Cincinnati Children's Hospital.
Debra Scott, head of the Nevada State Board of Nursing, said Monday that both nurses have waived the right for a hearing 45 days after the board stripped them of their licenses.
"They're waiting pending the outcome of the (police) investigation," she said.
On Monday, Sunrise spokeswoman Ashlee Seymour released a statement about baby Obote's death:
"We extend our deepest sympathy to the family of the patient. This is an ongoing investigation being led by the Las Vegas Metropolitan Police Department. This is their area of expertise and we are following their lead in this investigation. Any details of the investigation need to be answered by the Metropolitan Police Department."
Review-Journal reporter Mike Blasky contributed to this story. Contact reporter Paul Harasim at pharasim@ reviewjournal.com or 702-387-2908.