Death by Manicure: The Case of the Poison Polish. Dr. Robert T. Spalding Jr.
a pedicure.
Robert, a plumber by trade, had converted the van into a carrier for his wife’s wheelchair a few months ago, and he still had room to fit in all his tools. Katie was a paraplegic, a result of an unfortunate injury that had created permanent damage to her lower extremities. It had been hard on her as she had been a very active person who loved to get out and about. She was also keen, or had been, on playing a variety of different sports. But she seldom complained. It did no good, she reasoned, and she had not become bitter, as the injury had been nobody’s fault. It had just been one of those things.
After a 15-minute drive, Robert pulled the van over to a stop on MacArthur Drive, in the heart of Dallas. “How much time do you think you’ll need?” he turned around to ask his wife. He initially missed having her up front in the passenger seat, but was becoming accustomed to her place in the back.
“Well there’s the pedicure, then I need to go to the bakery to ask about the cake and then there’s a few other things I need to do … say two hours. Is that okay with you?” she asked, knowing full well that he had plenty of things to do in the mean time.
“Yes, that’s fine with me, I have a job on the east side of town, but I will be back in time. It’s only a leaking faucet,” he said checking his watch as he estimated the time and distance he needed to drive. “Okay, we’ll call it noon, then shall we? Then I’ll take you for lunch at that new Chinese place we tried once before.”
“Yes, the food there was good,” she agreed as she adjusted her purse on her lap and made ready for the short trip out of the van. “Okay, noon will be good for me; see ya later,” She added as she came to rest on the sidewalk and then prepared herself for the short trip to her appointment at KE Nails salon. She managed her chair just fine though she still had trouble with doors, but these women were great and would be on the dime to open it once they saw her coming.
Robert watched her wheel herself away. He knew he was lucky to have the kind of job where the pay was relatively high for the amount of time he actually had to spend on each individual job. He was just thankful that not everyone learned to do his or her own plumbing work. That would have tightened up his lucrative business. The other thing he had to be wary of was that, although not everyone could do it, he certainly wasn’t the only person in town who could do it, so he had to keep his prices at a level where he could compete with his rivals.
At lunch Katie was uncharacteristically quiet, Robert noted. Usually she was chatty about some of the universal gossip she had picked up during her appointment.
“A penny for ‘em,” said her husband, looking up from the menu.
“Huh … oh sorry, Hon.,” said Katie as she glanced at Robert and then returned her eyes to the menu.
“Is everything okay? Is it about the party?” he asked, a slight frown creasing his brow just the way it had since he was a baby.
“No, that’s all going to be fine I think. Something happened at the salon today. They cut my foot; they’ve always been so good in the past. It’s probably nothing to worry about, but it’s just that they made such a fuss afterwards,” She said, a small frown replacing her usually sunny, cheerful expression.
“I’m sure it will be fine,” Robert responded. In his line of work, a nick here and a cut there were just par for the course. And really, how bad could anything be with those little scissors or toenail trimmers he imagined them using?
“Yes, you’re probably right,” agreed Katie. The cut still stung a little, but in light of everything she had gone through, and with the party coming up, she decided to dismiss it.
But everything wasn’t fine. Seven months later Katie was dead. As a result of her unfortunate death, a major upheaval in Texas nail salon regulations descended statewide within two weeks. Those newly enacted regulations had broad implications affecting the nation’s state boards of cosmetology and nail salons across the United States.
As most people do, Katie had always looked forward to her regular visit to the nail salon. She went into the salon monthly to get relief from her painful foot and nail afflictions and never had any problems before that fateful day. Some paraplegics or others with neuropathy depend upon these services. They are unaware that certain foot and nail conditions can lead to amputations or life threatening infections. As she had done for several years, Katie had rolled her wheelchair up to the footbath. She then complied with the soaking process to soften her skin in the whirlpool bath, while seated in her wheelchair. Suddenly, they noticed that blood was on the pumice stone while her foot was in the water.
In follow up on the routine pedicure, it is unclear whether Katie was treated with a pumice stone prior to her soaking.
The combination of an alleged injury with a pumice stone on the typically frail, atrophied leg of a paraplegic, and bacteria from a potentially improperly maintained whirlpool is a perfect recipe for a disastrous infection. Unfortunately, improperly maintained whirlpools have been linked across the country to a frequent cause of bacterial outbreaks. And this case is no exception.
Looking into the case, medical records reveal that over the next seven months the JPS physician at a clinic treated Katie for the MRSA staphylococcal (staph) infection on her foot from the cut.
MRSA is an aggressive staph bacterium resistant to common antibiotics and is found sometimes in the water of salon foot spas that are not disinfected properly. The doctor put Katie on a cocktail of strong oral and intravenous antibiotics, but unfortunately, the 43 year old died in February, 2004, after seven long months of intensive medical treatment.
The JPS Health Network doctor who signed her death certificate listed the cause as a heart attack from a blood infection brought on by a staphylococcal infection on her foot.
After her death, the KE Nails Salon initially denied even serving Katie on the day in question. Its owner was even absent during the interview with the TV news reporter. He had gone out of town for a few days in the hope that it would all blow over. But a nail technician was available for interview, and she said that she had worked at the salon for two years. She then stated that nobody at the salon, including herself, could recall ever seeing Katie Johnson and claimed that they ran a sanitary salon where there was no risk of picking up any infections. It was whispered that her boss had given her orders to take that line to avoid any trouble, although it was very difficult to prove that this had been the case. Of course, it was highly unlikely that the salon was going to cave in easily. They would not just say, “It’s a fair cop. We are guilty. Our place is crawling with germs, and if you come here for any treatments they may be your last.” That sort of revelation just wasn’t done in the business world.
But it did seem a bit fishy to all of those concerned with what had happened to Katie. The likelihood that an employee who had been working for an establishment for 24 months had not noticed a highly visible paraplegic who had been getting a regular pedicure over a period of two years seemed a little dubious to any reasonable person, to say the least. But the cold, hard facts were indisputable. Katie's bank records showed that she last made a check card purchase at KE Nails on July 5, 2003, and while state records indicated that there were 20 salons named KE Nails in Texas, there was just one in Dallas, and it was located on MacArthur Drive.
March 17th 2004
An unshaven and disheveled Robert Johnson sat on the couch in his pajamas flicking through the mindless amount of daytime television. It was only 11 in the morning and he was on his second can of beer. The most important decision he would make today was whether to watch a game show or a soap opera and whether three cans of beer before noon might be overdoing it. Some mornings he had killed off the best part of a six-pack by 10:30 a.m.
It used to irritate him when his wife told him not to drink so much in the evenings. Now he could drink as much as he wanted at anytime, but he still missed her telling him to go easy. He missed lots of things about her. He was certainly not the first person to ever seek solace in a bottle after the loss of a loved one, and he sure as hell wouldn’t be the last. But anyone who knew Robert would most likely have said that his