Forensic Files - Season 9, Episode 8 - Bad Medicine - Full Episode | Forensic Files

[Music] a series of medical mix-ups left one woman dead and her doctor in prison for
negligent homicide but that wasn't the entire story in a single strand of hair a forensic
toxicologist found evidence of another medical mystery one that made headlines around the world
[Music] [Music] [Applause] [Music] hi say happy halloween [Music] happy halloween who is that guy
1997 looked like it would be a banner year for the pignotaro family dr anthony pignataro had a thriving
medical practice a wife two children and social standing dr pignataro was also an entrepreneur he
invented and wore the snap-on toupee held in place by four bolts drilled into the skull
he's always been different and he just came up with this idea i could say off the top of his head but
i remember laughing about it it was subject of many many many jokes around you know about the family and even when
he was around but he was dead serious about it his medical practice consisted primarily
of cosmetic surgery which he performed in his office one of his patients was 26 year old
sarah smith a young mother of two scheduled to have breast augmentation dr pignitaro had no anesthesiologist or
registered nurse present his only assistants were his wife and a licensed practical nurse
sarah smith was feeling pain so dr pignatar ordered a little more sodium pentathol to dull the pain
when you did that her system started shutting down and she was losing oxygen at that point he broke scrub and
i remember him tapping around the chest and calling out her name but there was no answer and then
all hell broke loose sarah smith was dead the result of too much anesthesia with
no anesthesiologist to monitor her and there was no ventilator to help her breathe
i knew that things would never be the same once this happened when local prosecutors learned about the
incident they conducted an investigation they learned that dr pignatara was not a
board-certified plastic surgeon in fact he wasn't a plastic surgeon at all he did train for ear nose and throat but
did not finish so technically it did not make him an ear nose and throat doctor he didn't finish all the
things necessary to become one medical experts told investigators that sarah smith would have survived if dr
pignataro had the proper resuscitation equipment the procedure that sarah smith was
undergoing was a trans umbilical breast augmentation was a very invasive procedure and should have been done in a
hospital setting or a recertified surgical area dr pignitaro claimed that deaths from anesthesia do occasionally
happen nevertheless prosecutors charged him with manslaughter to avoid a trial he pled guilty to
criminally negligent homicide he was fined five thousand dollars sentenced to six months in prison and
250 hours of community service he also lost his medical license although it seems hard to imagine
the pignotaro's problems were far from over [Music] when tony pignataro was released from
prison he had difficulty finding a job since his medical license was revoked and the terms of his parole prevented
him from leaving the area for years he had you know went to school done residencies
he'd gone quite a few years to do this and that was taken away from all of us to make matters worse
vandals spray-painted the word killer on the side of the pignotaro's home he claimed to have received death
threats but he didn't know where they were coming from other than you're going to pay for sarah smith's death
tony realized he would never get his medical license back the stress took its toll
and the pignotaro separated her life was falling apart after the sarah smith case her husband couldn't
find work he was probably depressed in his own right because he had lost his ability to support his family
a few months later the couple reconciled tony pignataro's mother supported them financially or their situation would
have been far worse anthony pigeon tarot came from a good family his father was a
well-respected and excellent surgeon in buffalo mother was a fine person i guess life was handed to him on a
platter after the pignotaro's reconciliation debbie started to feel ill i had thought i had the flu
for months just maybe a little case of the flu because i would get nauseous and vomit and just not be myself
initially neither her husband nor her doctors knew what to make of it i was having trouble walking where i
couldn't lift my legs there was numbness in my legs and my hands i diagnosed myelodysplastic state
possible myelodysplastic state the neurologist diagnosed possible guillain-barre the
gastroenterologist diagnosed pancreatitis and and we just we didn't know how to bring it all
together so we were all puzzled tony thought debbie's gallbladder should have been surgically removed but her
doctors disagreed i was so weak and my condition was so grave that i probably would have died on
the table i was told but she got better and when she got better we relaxed and thought wow this isn't going to happen
again but debbie's symptoms returned again and again the pain was getting worse even more disturbing
her daughter started to experience the same symptoms but not nearly as severe throughout that summer
debbie's condition deteriorated she had severe memory loss and was relegated to a wheelchair because she was no longer
able to walk once again she was admitted to the hospital this time dr schneiderman analyzed a
sample of debbie's bone marrow under a microscope i looked once i looked twice and i
couldn't believe my eyes it looked like something that i remembered reading about in medical
school debbie's red blood cells had degenerated a condition known as karyorexis i ran down to the library and i got out
a book on toxicology and i also went on to something called medline on the on the computer
the medical literature described some possible causes when her doctor factored in her other
symptoms numbness of her hands and legs disorientation and nausea the answer became clear
i was able to complete the description of arsenic in my mind and it fit her perfectly
arsenic is a heavy metal poison and not one you normally encounter further testing indicated debbie had a
arsenic level of 29 580 micrograms per liter one of the highest ever recorded in a
living person almost sounds like a mistake in a lab reading but it wasn't the amount i had
i shouldn't be here usually if a person has between 50 and 100 milligrams per liter in their system
they could die from it it's a miracle that she survived she was immediately put under 24-hour
security protection but the question remained how was she poisoned and who wanted her dead
when debbie pignataro was diagnosed with arsenic poisoning doctors also tested her husband tony and their two children
their daughter had higher than normal levels of arsenic in her system but her son and husband were normal
well our first thoughts were we needed to look at the source of water for that area of west seneca
prior to 1900 arsenic was the primary ingredient in embalming fluid and it caused
groundwater contamination near several older cemeteries tests showed no such problem in the
water supply near the pignotaro's home investigators began to suspect that debbie
may have intentionally poisoned herself it made me very angry i mean if anybody knew me
they would know that i would never do this to myself i mean first of all i wouldn't do it to my children
second of all it's just if i wanted to hurt myself i wouldn't do it this slow torturous painful way
tony suspected sarah smith's family may have had something to do with the poisoning
sarah smith was tony's patient who had died during surgery anthony thought that dan smith
was trying to get even with him for taking his wife away from him and he thought enough to
say well maybe then dan was trying to take my wife away from me investigators searched for arsenic
throughout the pignotaro's home we searched the house you know top to bottom looking for arsenic
pesticides insecticides anything that may contain arsenic anything that looked suspicious powdery
was taken to be analyzed at the lab and came back negative detectives interviewed debbie's daughter
since she too had some of the same symptoms as her mother they asked her what she ate on the day
she became ill there was soup left on the kitchen table and she ate some of it and that night she was vomiting
[Music] debbie then remembered an important detail that tony made the soup that day
he brought me the bowl and i remember saying i can't eat all this it's like no eat it it's good for
you their daughter found some of that soup left over on the stove and took some to find out exactly how long debbie had
been ingesting arsenic doctors decided to study her hair the arsenic combined to keratin which is the major protein in
hair so as the blood circulates through the body and it circulates to the root of the hair follicle
some of the arsenic will become incorporated in the hair follicle when poison circulates in the body it
comes into contact with the hair follicles so traces of the poison will remain in
the hair as it grows since hair grows approximately one centimeter per month a strand of hair can identify exactly
when a person was poisoned first debbie's hair was divided into pieces each one centimeter long
we first need to convert it from the solid hair sample to a liquid air sample and we do that by
adding some acid to it and digesting it in a specially designed microwave oven using atomic absorption
spectrophotometry a beam of light is passed through each hair sample when that light is absorbed the amount
of light that is hitting the detector on the other end decreases that change in the intensity of light
that's reaching the detector is directly proportional to the amount of arsenic in
that sample the computer-generated results were startling debbie started receiving
small doses of arsenic in may of 1999 and towards the end of july of 1999 she received a large dose
which was approximately 80 times what a normal human being should have in their system of arsenic
this timeline excluded members of sarah smith's family as possible suspects because they had
moved to the midwest after sarah's death investigators had only one other suspect
with a possible motive the scientific analysis of debbie pignatoro's hair told a horrific story
the people who did the hair analysis asked when the funeral was i remember they just couldn't believe
that someone with this level was still alive debbie's hair established a timeline of
the poisonings [Music] in march of 1999 when tony and debbie were living separately
debbie had no poison in resistance the couple reconciled in may and in debbie's hair grown that month
were the first signs of arsenic poisoning the largest dose of arsenic was administered in july this coincided with
debbie's hospital visit in which tony recommended removing his wife's gallbladder a procedure medical experts
say debbie would not have survived when questioned by police the couple's daughter lauren remembered something
around this time she saw her father setting small traps around their home when we asked her
can you tell us what that bait was she said she didn't know what it was except that it was little round tins
that he set out on the floor only one manufacturer made insect repellent in small round tins
the president of the company revealed their product contained arsenic he told me that two of those hand stacks
which would contain four tins would be enough to be fatally toxic to a 150 pound man
investigators found this brand of insecticide in a store not far from the pignotaro's home
you don't want to believe it you don't want to believe that someone you loved and
lived with could actually do this to you there's no there's no answer i don't know
a check into tony's background provided a possible motive he became associated with a few
cons in prison and was able to get involved with heroin and he kept in contact with one
particular person who would supply him with his narcotics after he got released from prison
and investigators discovered tony was having an affair with another woman after he was released from prison
friends say tony feared his mother's reaction his mother was against divorce and
if he had divorced debbie he would have been cut out of any will in his family but money wasn't the only motive in the
pignotaro's home detectives found a manuscript tony had written entitled md mass destruction
it was about tony losing his medical license and what was described as the conspiracy
against him it was a story about how he was wronged by the medical community and by the judicial
system and you know by everyone on earth the great wrong that they did to anthony
pignataro [Music] investigators believe this entire episode might have been a ploy for
pignotaro to get his medical license back he gave debbie poison she developed gastric symptoms
he then tried to convince her doctors to perform gallbladder surgery that she wouldn't survive
[Music] had debbie died during surgery tony could argue as he did in sarah smith's
case that people occasionally die in surgery and that he shouldn't have been singled out
and in tony's eyes that would have vindicated let's see my own wife died under a
doctor's care in a hospital while having surgery and that's what we felt was his prime
motivation but why didn't she die from the massive dose of arsenic [Music] medical experts say
this was miscalculation when tony gave his wife smaller doses of poison she developed a tolerance for it
so the higher doses later had less of an effect i'm sure he was thinking i can't believe she's
still alive i can't believe i gave her so much and she's still here i think he just got
panicky and it wasn't working so i think that's when he just figured i'm just going to give her a massive dose and be
over with apparently his daughter's ingestion of the arsenic was unintentional investigators believe
tony vandalized his own home to make debbie's illness appear to be retaliation for sarah smith's death
he deserves to be injected with as much arsenic as he gave me he deserves to go through the hell that
i went through and the pain that's what i feel he deserves when i asked tony if he tried to kill
his wife he looked down at the table and told me i can understand why some people might
think that but he never said yes and he never said no and they changed the subject and
continued to look me in the eye when faced with the scientific evidence tony pignataro confessed he pled guilty
to attempted first-degree assault and was sentenced to 15 years in prison pignotaro promised to tell where he
obtained the arsenic and how he administered it but he never honored that part of the
plea agreement although debbie survived massive doses of arsenic which were 80 times higher
than a lethal dose she will continue to suffer side effects for the rest of her life
the nerve damage and lack of fine motor skills are permanent i can't believe any human being would
do this to someone that they even cared about i mean maybe he didn't love me anymore but
there's other alternatives you don't you know do this to someone the mother of your
kids the hair on her head was the key evidence that pointed to again only one person could have done it
in the long run his arrogance is what got him convicted you know thinking he'd outsmart everyone he
outsmarted himself [Music] [Applause] [Music] you

A young woman suddenly becomes critically ill, eventually leaving her unable to walk. A bone marrow test reveals the cause: arsenic. Investigators must determine if the poisoning was caused by groundwater contamination or something more sinister.

Forensic Files is the longest-running true crime series in television history. Evidence and interviews with experts help solve real crimes, disease outbreaks and accidents around the world.

Brief Summary

Dr. Anthony Pignataro faces prison for poisoning his wife after a botched surgery led to a patient's death.

Key points

A Medical Tragedy Unfolds. Dr. Anthony Pignataro's negligence leads to the death of a patient, Sarah Smith.
The Aftermath of a Tragedy. Tony Pignataro struggles with the consequences of his actions after prison.
A Shocking Diagnosis. Debbie Pignataro is diagnosed with arsenic poisoning, raising questions about her health.
The Hair Analysis Reveals All. Forensic analysis of Debbie's hair uncovers a timeline of arsenic poisoning.
A Dark Motive Uncovered. Investigators find evidence suggesting Tony had a motive for poisoning Debbie.

Episode highlights

Episode quotes

All hell broke loose.

The moment Sarah Smith's condition deteriorated.

2:38WatchJan 1, 2022

Tension

85/ 100High tension

More from Forensic Files

Solve the Crime

Read a real case one clue at a time, then see how your call held up against the investigators.