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Wyborcza’s journalists uncovered the emergency room scandal in 2002. The prosecutor's office opened an investigation, and an ambulance driver, a witness, came to "Gazeta Wyborcza" after the story’s first publication. He told us about a former paramedic Andrzej N. - There was a man who killed people. Openly, in front of others - he said. He recounted one of the crimes in detail - killing a mentally ill man in an ambulance by injecting him with pavulon.

In June 2003, CBŚ (Central Bureau of Investigation) officers knocked on N.'s door (a year earlier, he had been fired from the ambulance service for drinking on the job). When interrogated, he admitted to killing patients with pavulon stolen from the emergency room pharmacy using forged prescriptions. He spoke of his victims (at least a dozen, and while in custody, he boasted to fellow inmates that he had "taken out" at least 50 people). But the details were fading in his memory - only four crimes were reconstructed enough for him to identify the victims. In court, he renounced his earlier testimony, but the judge had given him a life sentence anyway.

Another paramedic, Karol B., was sentenced to 25 years in prison. He was convicted of one murder and aiding and assisting a murder committed by N. Two former E.R. physicians accused of endangering the lives of 14 patients (they did not save them or acted improperly - all the patients died) were sentenced to five and six years in prison respectively.

The authors of "Hide Hunters" were the winners of the very first edition of the Kurt Schork Awards in International Journalism, awarded since 2002 by Reuters, the Schork Foundation, and Columbia University. The feature was also awarded the "Grand Press" prize for best article in "investigative journalism".

***

A doctor calls our editorial office. We spoke to him a few months earlier, looking for the connections between funeral homes and the ambulance service, but he didn’t want to say much then. Now we hear, "I’ve thought it all over--I’ll talk to you about the hides."

Why did he change his mind?

"It’s gone too far," is all he replies. He’s obviously nervous. He asks us to come to his home in the evening: "At a bar someone who knows me might come in, at your office someone might see me too, and make the connection later. And I’m afraid--I myself don’t know what could come of this."

He hasn’t done well for himself at the ambulance service. For someone who’s been a doctor for a long time he lives modestly. In one small room there’s a wardrobe, a sofa, and vinyl armchairs.

The doctor has a sad face. "Of course you know what a "hide" is?" he asks.

By now we know the answer: "A dead patient, whom the crew of an ambulance and the dispatcher sell to a funeral home."

"But did you know that you can make a hide?"

How a body becomes a hide

We were searching for Włodzimierz Sumera for weeks. A few years ago, he made a fortune on funerals. Now he’s got problems. He has no place of his own, he’s staying with relatives. He was shot at a few months ago, he takes side streets, avoids strangers.

A sculptor by training. About forty, but he looks like a student. He wears tinted glasses. "Why did I agree to talk to you? Not because I’m a good guy. This should have been cleared up long ago--maybe you can do it. I don’t have much of an excuse, just that I didn’t imagine how it would turn out. But I should have guessed."

Sumera knows almost everything about the hide trade. "After all I was the one who thought up the deal with the ambulance service taking the hides."

As the nineties began he was moonlighting in the Lodz ambulance service as an orderly. "The families of the deceased would wait at home for hours for the municipal van to come and take the bodies to the morgue. But times were changing, and I thought to myself, there’s room here for me to start a business."

He left the ambulance service in 1991, and he and a friend founded a firm. "I bought a Nyska [translator’s note: a type of commercial van commonly used in Poland] and handed out business cards at the ambulance service. I said they should call me when there was a pick-up to be made.  I found myself in over my head--we couldn’t even keep up with the orders.  At the beginning they called me up just like they’d call a colleague. I showed my gratitude. At first not with money."

"With coffee? Cognac?"

"Vodka. I brought cases of vodka to the ambulance service. The firm began to bring in money. We tried to use our money wisely, to develop our business. And there were so many bodies that we went further and were doing funerals. We hired people, dressed them nicely. We were the first to buy cars that looked classy, at least for those days. My dream was to make that firm into what I would call a showpiece. And I almost did."

But then Sumera’s old colleagues from the ambulance service stopped being colleagues. Once big money appeared they entered the business themselves.

Today Sumera swears, "We weren’t the first to pay. When the competition started paying, I told the boys I’d buy them something for the ambulance service: a television, some kind of couch, blankets. They said, ‘Cash only.’  So I outbid the competition. And bodies quickly became hides, that is, goods for sale. Attractive goods that were very easy to sell.

Dialing 999: Help!

How do you get from an ambulance call to the sale of a hide?

A dispatcher answers a 999 call. On the basis of that conversation the dispatcher must decide how serious the patient’s state is, and thus whether to send an ambulance and what kind of ambulance to send: a transport ambulance (with only a driver and an orderly, to transport the sick person to the the emergency room or to provide first aid on the spot), an emergency ambulance (with a doctor, a driver, and an orderly), or an "R," (for life-and-death situations, with the same crew and a nurse as well).. There are a lot of ambulances, waiting in various parts of the city. The dispatcher’s job is to pick the right kind and the one that will get to the patient the fastest.

If the patient dies, the doctor is supposed to record the death and fill out the paperwork--the information card and the death certificate--and return to the ambulance. And the family is left with a problem--the health code prohibits keeping a corpse in your house. The body has to be taken to a morgue, where it will wait until the day of the funeral.

We have a free market, so it’s up to the family which funeral home picks up the body and then takes care of the funeral and the burial itself. The family calls the firm of its choice, and the body goes into their morgue.

Almost no one is financially prepared for the loss of a loved one, so it’s important for the funeral home to write up its bill quickly. With that bill you can go to ZUS [translator’s note:the Social Insurance Institution, the state agency that administers almost all social benefits in Poland]

for a funeral allowance--today over 4 thousand zloty--and with that money you can arrange all the rest with the funeral home and the cemetery.

And that’s all.

So where then is there any room for selling hides? In the details. No one keeps the phone numbers of funeral homes at their fingertips. No one who has just lost a loved one has a head for business--no one wants to compare prices, to ask about the quality of the services. A lot of people don’t have the slightest idea what to do next. But the bodies have to be taken somewhere. The ambulance team hasn’t left the apartment yet, and already there’s an appeal from the family: help us! The doctor (or the orderly or the driver) is supposed to explain the procedure. But, and here’s the key, they could also give a number for a funeral home. They could even call them up on the spot.

The price for ten hides

Wlodzimierz Sumera assures us that the first sum he paid an ambulance team wasn’t much. "Something like 50 thousand zloty per hide. That was old zloties of course, so it would be 5 new zloty. Cigarette money. But right away funeral homes started bidding for the bodies. In 1995 I was already paying 500 zloty for a hide."

Selling hides quickly became a good business, and some ambulance crews didn’t wait for families to ask them for help.

Dispatchers also wanted their share. They made informal agreements with particular emergency teams: "I’ll be the first to hear about a death--I’ll send your ambulance for the hide, you’ll cut me in for a share."

But you still have to settle up accounts.

Sumera: "There are any number of ways. Sometimes, for convenience, I paid the ambulance service in advance, for ten hides. When they met their quota, the dispatcher called me up, asking for another envelope. How they divided it up later--that was their business."

Two solemn gentlemen with papers

Witold Skrzydlewski, a Lodz councilman, whose family owns the largest chain of florists and funeral homes in the region, tells us how an ambulance team hunts for hides. "A professional doesn’t tell the family that funeral home X is coming to pick up the corpse, because the family could say, ‘We don’t want that one.’ He says, ‘A transport team is on the way and will take the deceased to a morgue.’ For the average senior citizen that’s just another part of the same institution as the ambulance team. The doctor, the orderly, or the driver walk out and make a phone call. And then two solemn gentlemen arrive. They don’t introduce themselves; instead they just say, ‘Please sign these papers.’ Believe me, there’s no one who would read the papers at a time like that. They sign. It’ll be the next day when they finally look at the papers to see where they have to go to take care of the rest of the formalities. And then they see that it’s not the ambulance service, but a funeral home."

It’s an extremely common practice for ZUS to pay the burial allowance directly to the funeral home on the basis of an authorization signed by the next of kin. And that’s one of those documents that the relatives sign for those two solemn gentlemen.

Councilman Skrzydlewski tells what happens next: "At the funeral home, the family is already up against the wall, since that firm has already done all the paperwork and--most importantly--has already got the funeral allowance from ZUS. At the time they didn’t realize that they were signing an agreement for the funeral, and that if they cancelled, they’ll have to pay a certain penalty. And people don’t want to quarrel about this, because after all--there’s the deceased, it’s a tragedy--you know how it is."

Skrzydlewski says that this is a hard conversation for him--he’s paid the ambulance service himself. He assures us, "When the prices went very high, we stopped. We felt that it was already becoming dangerous and that the line between saving someone’s life and pretending to try and save it could get blurred."

We know that the Skrzydlewski family firm hasn’t been paying the ambulance service for a few years. It can afford not to--it’s a powerhouse on the Lodz market.

1800 for a hide--who’ll pay more?

The price competition for a hide continues.

Wlodzimierz Sumera: "I was still paying for hides in 1998. But by then I was only doing it to drive up the price. I went up from 800 to 1000 zloty for a hide. I thought that if I push the price up high enough, the funeral homes will stop making money on it and the market will dry up."

Remember, a funeral home gets 4000 per funeral from ZUS (as of 2001). The more it pays the ambulance service for the body, the smaller the profit.

So why has the price of a hide kept going up and up? Because as the money paid to the ambulance service has increased, the funeral homes have raised the prices of the funerals.

Skrzydlewski: "The funeral homes got an idea kind of like that in the film, "Killer," in which Siara-Rewinski and Englert split their take like this--two gold bars for me, one for you. The relative arrives, and they give him a little bit of that funeral allowance too. The relative grumbles that there’s so little left, but he leaves satisfied. But that’s only because he doesn’t know what’s still in store for him. Next he goes to the cemetery and finds out that he still has to pay so much for the plot, so much for the priest. So he’s already paying more out of his pocket for this, in spite of the fact that the funeral allowance really should cover an average funeral including a cemetery plot and a priest. But these funeral homes do it as cheaply as they can, taking the entire allowance themselves and providing the cheapest casket. Because they’ve got to pay off the gang.

How do funeral homes conceal the bribes for the hides from a tax audit? They don’t have to keep complete account books, because they pay their taxes in advance in a lump sum. As for the clients, they almost never demand a detailed bill after the funeral (if they do, they’ll find a "surcharge for the casket").

The bidding for hides keeps going, because new players are entering the game.

Skrzydlewski: "There’s one firm that pays only 1200 zloty, but they provide other services for the ambulance crews. For example they take them on holidays to Spain. Others pay 1600."

One of the latter is funeral home P. Only half a year ago it wasn’t paying the ambulance crews, and it was putting on only a handful of funerals a month. Now it’s doing about 150 funerals monthly.

Since our conversation with Skrzydlewski (two weeks ago) the price has gone up again. The CZA funeral home is paying 1800 zloty a hide.

The colonel is planning a murder

Skrzydlewski continues: "Anyone can open a funeral home--you don’t need any qualifications. You don’t even have to have money. There are a lot of casket-makers, and they’re glad to sell caskets on credit; you present the family with a few bills; and the next day you have their funeral benefit. So you don’t have to have any capital to enter the market. Nobody checks to see if someone who starts up a business like that has a criminal record. Funeral homes have been opened up by nurses, by the secretaries of hospital directors, by orderlies from the ambulance service. It’s an outlaw market."

One of our informants was Jacek T, a well-known figure in Lodz funeral circles. For years he’s been an employee of the human anatomy department of the Army Medical Academy hospital; he was also a co-worker of Sumera’s, and the first teacher of Skrzdlewski (who at the beginning of the 90s was still only a florist, just entering the funeral market).

Jacek T. not only worked washing and dressing the corpses, but also was a shareholder in a funeral home and an expert in getting hides from the ambulance crews.

"If he had thought ahead he’d be a rich man today,"remembers Sumera, but he squandered money as easily as he earned it. When the Colonel--that was his nickname--was partying in Kaskada (during the People’s Poland era the most elegant nightspot in Lodz, but now the symbol of a past epoch--editor’s note), he stood drinks for everyone. Jacek’s 40th birthday was celebrated by everybody from the funeral industry and half the ambulance service.

In 1998 Jacek T. came into conflict with some of the competing funeral homes. A few others were on his side.

One year later Jacek T.’s new Renault Megane was blown up--someone had placed a bomb underneath it. He accused the competition of the bombing, as well as of a death threat on the phone. But the culprits were never found, and the prosecutor dropped both cases.

In a few meetings in 2001 Jacek T. told us details of how funeral homes work with the ambulance crews. But he didn’t make it to the next scheduled meeting. It turned out that while he was talking to us he was planning a murder. In September he was arrested next to one of the Lodz giant supermarkets, where he was paying 25,000 zloty to a hitman. That was the deposit, the hitman was to get the rest after killing Skrzydlewski. When interrogated Jacek T. admitted his guilt, and is now awaiting trial.

The death certificate is the trump card

Large sums of money are at stake. Let’s count--in Lodz alone the ambulance service reports 400 deaths per month. How many hides are the ambulance crews selling to the funeral homes? Let’s remember that when the P funeral home started to pay the teams, it gained more than 140 funerals a month. And after all it wasn’t the only one paying the ambulance crews.

Calculating conservatively ambulance crews are getting paid for 200 to 250 hides a month. Figuring the average price (ranging from 1200 to 1800 zloty) at 1500 zloty, we get 300 to 375 thousand zloty per month, and 3.6 to 4.5 million zloty per year. Tax-free.

We obtained four written statements from family members induced to use the services of particular firms just in the past month. (Our editorial office is keeping the full names confidential.)

December 23, 2001- Wieslawa W.: "The doctor recommended funeral home W."

December 25 - Maria K.: "The doctor recommended funeral home CZ."

December 29 - Halina M.: "The doctor recommended funeral home P."

January 3, 2002 - Slawomir B.: "The doctor called funeral home CZ--without my permission."

Some hide-sellers take it even further. If the family doesn’t want to agree to the proposed firm, they’ll be coerced into it.

The family’s in a bad position, because the doctor holds the trump card--the death certificate. This states the cause of death: "natural causes" or "suspicious circumstances." In the latter case everything becomes snarled up in red tape, the family can’t get the body to bury, there’ll be an autopsy, and the funeral will be delayed from a few days to over a week. For example:

October 2001. A ambulance doctor is summoned to declare dead a resident of Widzew (a district of Lodz). She suggests funeral home A to the deceased’s son-in-law. Bad luck--the son-in-law is a physician and knows the procedure perfectly. He protests. Right in front of him the irritated doctor tears up the death certificate stating "natural causes" and quickly fills out another: "suspicious circumstances."‘

January 5, 2002 in Gorna (a district of Lodz): a doctor does the same when a woman doesn’t agree that funeral home CZ be called to pick up her dead sister.

Dispatchers suggest, " she’s probably dead"

The dealing dispatchers are also fighting for hides. They have their technique for sending their chosen ambulance team (for example, an "R") to pick up a hide.

For example, a family member calls and says, "Please come. Grandmother died." Since she’s dead, the ambulance doesn’t have to hurry; the death can be officially declared just as well an hour later. But the dispatcher wants his chosen team to get the hide as fast as possible. So he leads the conversation so that he can write down "probably dead"on the documents instead of "dead." "Have you checked the pulse? Are you sure that your grandmother can’t be helped? Are you a doctor that you can be so sure?" Finally, the dispatcher hears his desired "probably" and sends his chosen "R" out on the call.

And so those who are dying and really in need of fast help get not the closest ambulance but the "convenient" one. We managed to establish that three ambulance teams went out significantly more often to pick up hides than others--over twice as often.

In December 1999 a man collapsed on Pabianicka street. Two ambulances were parked 500 meters away, but the dispatcher sent a team from the other end of the district. They arrived too late and couldn’t resuscitate him. The crowd of onlookers jeered the ambulance team.

The ambulance is going to McDonald’s

An employee of one of the Lodz funeral homes: "I’ve been working here for a few years, I transport the corpses from their homes to our morgue. I’ve heard about various cases in which the team didn’t hurry to the call because there was a chance that the death would occur before they arrived."

Sumera: "In the business they call it ‘going to McDonald’s’ --that is, "let’s not hurry, we can stop for a hamburger on the way."

We obtained a fire department report: January 21, 2001, fire in an apartment on Wolczanska street. The firefighters carry out two people suffering from smoke inhalation. They work on resuscitating them. They call an ambulance at 3:25 am. At 3:36 they call a second time. Again at 3:39. The ambulance is there at 3:46. It took 21 minutes. From its station to the place of the fire was 2200 meters; there’s no traffic on the streets in the middle of the night.

That’s not all. One ambulance team orders them to stop the resuscitation of the female patient and carry her to the ambulance. The firefighters shift the unconscious woman onto the ambulance’s stretcher. The ambulance team starts to take her and drops her; she falls one meter to the ground, and her face hits the concrete. The orderly and the driver throw her back on the stretcher and run to the ambulance. Meanwhile the second ambulance team has the male victim taken to their ambulance. At 4 am the doctors of both teams tell the firefighters that their patients died.

One more example. We found out that in November 2000 one dispatcher had received a call about a man with a possible heart attack. But after the call the emergency doctor was still drinking coffee in the next room, knowing nothing about it. The family, upset by the lack of an ambulance, kept calling the ambulance service. The dispatcher said the ambulance was already there. He lied, he only sent it 20 minutes after the call. There was no hide--by a miracle the patient lived.

They call them: the Angel of Death, the Hide-trapper, Dr. Mengele, Dr.Potasik

Wlodzimierz Sumera, former owner of a funeral home: "An ambulance doctor arrived at my firm with a dying patient. The man gasped his last breath, and the doctor calmly wrote the death certificate."

Our next informant, Janusz Pietraszkiewicz, was an ambulance driver. He admitted to us that he’s also taken money for hides a few times. He left his job--he says--"because I didn’t want to be part of it any longer. But the doctors were in on it. I can give names: X, Y, Z [Pietraszkiewicz gives first and last names of doctors], and the Angel of Death..."

"Why the Angel of Death?" we ask.

"They called him that because he did people in."

"How?"

"He would arrive, take a look, and say ‘oh, there’s no point resuscitating this one.’ He’d take the pulse, and then it was good-bye. And the patients could have been saved."

"How do you know that?"

There was a case like that in Dabrowa (a neighborhood in Lodz) in the night. He went up to a woman lying next to a couch, took her pulse, and said that was it. There was an orderly with us, and he said, "But after all there’s still a pulse--we have to resuscitate her!" But the Angel of Death replied: "Who are you to tell me that?" Because he’d already written out the death certificate. Our colleague the idealist, who never took his share for a hide, wouldn’t give up and got that woman breathing again. She got up and went to bed.

"Why did the Angel of Death do that?"

"For the money and nothing else. Let’s take another example. If a patient died on the Angel of Death in the ambulance, he would order me to drive to funeral home C immediately. And there the bodies were sold."

Pietraszkiewicz has a seriously ill 99-year-old grandmother. "Recently the ambulance doctor was here again. As he was leaving, he wanted to give me a phone number. He said, "When she dies, please call so that the same team will come."

"Did he say why it should be the same team?"

"No, but it was obvious. To get the hide."

Sumera and Pietraszkiewicz talk about other nicknames of members of the teams: Dr. Mengele, the Hide-trapper, Dr. Potasik (because potassium slows the heart, and giving too large a dose or giving a correct dose too quickly can kill).

Pavulon - the death drug

We tell all this to the doctor who has invited us to his home. He listens without emotion, nodding his head sadly. What follow is his story:

"Halfway through 2001 a new vice director, Janusz Morawski, started work at the Lodz ambulance service. He started looking through the records, including the use of medicines. He’s an anesthesiologist, so it wasn’t strange that he noticed the name pavulon.

"I’ve been working over ten years, and I’ve used pavulon only once,"the doctor continues. "I could do without it, using instead a weaker paralyzing agent, scolina, the effects of which last for about 3 minutes. Well, the new vice director, looking at the records, noticed that there had been a huge use of pavulon. Because of the chaos in the records there was no way of telling when it had been used--which patient had gotten an injection and how much. That unusually dangerous medicine had been supplied on the basis of ordinary collective prescriptions, the ones doctors write for refilling the ambulance supply. Or rather--most often--it was added onto those prescriptions, in a different handwriting. The vice director went to the director of the ambulance service, who immediately ordered that pavulon should be dispensed only on the basis of individual prescriptions, and that each dose had to be accounted for, with an exact description of  why it was used, in what circumstances, and for which patient. And suddenly the need for pavulon fell to zero."

Pavulon, given intravenously, is an unusually strong drug paralyzing the skeletal muscles. A synthetic derivative of curare. Used mainly in anesthesiology for paralyzing the muscles during an operation. Its effects last 30 to 45 minutes. It can only be used when the patient is on a respirator. Its effects include the paralysis of the diaphragm, and as a result the almost immediate cessation of breathing.

Professor Wojciech Gaszynski, director of the anesthesiology department at the Lodz Medical Academy and a national consultant on anesthesiology and intensive care: You cannot give that medicine without a lot of experience. Formally, only certified anesthesiologists have the right to do so. Pavulon should be used only in the operating room, ambulance teams should not be using it. In the US only specially certified doctors can use that type of medicine. Furthermore the credentials to use it are given only for limited periods and with certain conditions. For example, if a doctor hasn’t done a certain number of respirator procedures with that medicine within a certain amount of time, he loses his certification and has to undergo training again.

We suggest that perhaps the medicine was stolen from the ambulance service to be sold on the black market. But Dr. Gaszynski doesn’t know what good pavulon would be to anyone.

In some countries similar drugs are used for executions, after the patient has already been put to sleep, for example by barbituates.

Dr. Ryszard Golanski, also an anesthesiologist, the deputy head of the Regional Physicians’ Council in Lodz: "Paralyzing drugs are to eliminate the breathing of the patient in the operating room, where a machine does the breathing for him. So that his own breathing won’t "interfere" with the work of the machine. Giving pavulon to a conscious person without connecting him to a respirator would be one of the cruellest deaths on earth. The patient is fully conscious but can’t breathe. Because of the paralysis of his muscles his eyelids droop. He can’t say anything, he can’t even lift a finger. He suffocates, he dies in agony. I know what I’m talking about: I’ve spoken with a patient who was accidentally injected with pavulon in the hospital. Fortunately we saved him. Working in the Regional Physicians’ Council, I’ve met with cases of various drugs disappearing, for example, dolargan or morphine, which are used by drug addicts. But what do you need pavulon for?"

We ask the doctor who invited us to his home straightforwardly: Could the mysterious consumption of pavulon have something to do with the hide trade?

"I’m afraid it does. Lately in the service there’s appeared a new term: ‘suspicious deaths.’ I heard about one of these: a mentally ill woman, the doctor walked away for a minute. He came back and saw the orderly injecting something in her vein. ‘What are you giving her?’ he asked. ‘The same as usual,’ came the reply. A few minutes later she was dead. The moment I found out about the pavulon I remembered various strange conversations, events, hints, nicknames. For example, some teams give their patients undiluted eufilina, a terribly strong drug lowering the blood pressure. Today I can’t escape the thought that someone’s death may have resulted from that. Giving the medicine in that way is a simple way to stop the heart."

"What kind of nicknames did you hear?"

"I used to think they were bad jokes: Dr. Mengele, Dr. Potasik, the Angel of Death."

Ignacy Baumberg, an anesthesiologist, rode with an ambulance for a few years. "I’ve also heard that undiluted eufilina was used. Often those watching saw a connection between this and the patient’s suddenly getting worse. By the beginning of the 90s the ambulance workers and the funeral homes had created a system in which a patient’s death was more valuable than his life."

In October 2001 the ambulance service got a new director, for the first time in 12 years. The new director, Boguslaw Tyka, is an economist, not a physician; earlier he ran a hospital, also in Lodz. While collecting information for this story on the hide trade, we asked him to let us see the records, especially on the ambulance calls. He admitted that he had heard a lot about the "necrobusiness," but said he had to look over the records himself first.

Director Tyka calls the police

By now we know that in late fall Director Tyka found out about the suspect consumption of pavulon from the new vice director Morawski. With a group of trusted physicians he examined the service’s records, and a few weeks after our conversation with him, he had a conversation with the deputy head of the Central Investigative Bureau in Lodz.

For almost two weeks we had been asking Director Tyka for an interview on the topic of pavulon, suspicious deaths, and the hide trade. He didn’t want to talk. Finally when he decided that we knew about the matter anyway, he made an appointment to talk to us with vice director Morawski present.

Director Tyka is very nervous. He speaks in a stilted manner, as if he were reading; he stammers; and he weighs every word. "I want to close the book on this thing that’s called by the ugly name of the ‘hide trade,’ and in which ambulance teams among others were involved. For me it’s a criminal trade. I believe that since I’ve found out about this phenomenon its scale has decreased radically. By now we’re not heading out to every death that has to be declared. We do it only when it’s necessary on humanitarian grounds, to help families who find themselves with a corpse in their home after 5 pm. In other cases the death should be declared by a doctor who has treated the patient in the last 30 days. That’s what a regulation from 1956 says--it’s still in effect although it wasn’t being observed. Officially I know about 3 cases linked to the hide trade: in 2 of them the doctor refused to sign the death certificate, in another he wrote down ‘suspicious death.’ I issued an official reprimand, the case is going to the physicians’ ethics commission."

"You’re eliminating that trade?"

"Yes, of course. I’m certain."

We bring up the next catchphrase: "probably dead."

"There were many cases in which the dispatcher’s report of the call contains the phrase ‘probably dead.’ In a situation like that we can’t refuse to send out an ambulance. But now we have a computerized system of recording the phone calls, so that every call for an ambulance is archived. Our commission checks all of them to see if the dispatcher has led the caller to say ‘probably dead.’ We must radically eliminate such cases and get back to normal."

"You reported a crime to the police. What kind of crime?"

"We had a conversation with the Central Investigative Bureau. We had certain suspicions based on the medicine usage patterns and the need for odd medicines. We couldn’t ignore this. We told the appropriate authorites, who can check out our suspicions."

"What kind of suspicions?"

"I don’t want to talk about them now. I’m not a doctor. I could be mistaken. The use of certain medicines in conjunction with unsuccessful resuscitations led us to certain suspicions."

"About the deaths of patients?"

"Yes."

Director Tyka asserts that after the introduction of the new rules on pavulon its use fell to zero. He adds that there’s none in the ambulance service right now.

Dr. Morawski has been silent. Asked directly, he says only: "I can’t give any information. I promised the investigators."

The ex-director didn’t take bribes, others did

We go to Glowno, outside of Lodz. Ryszard Lewandowski just became director of the hospital there. Previously he was director of the Lodz ambulance service for 12 years.

While he was director of the Lodz service, he dismissed all questions about the hide trade.

"There’s nothing going on like that--show me some proof," he said. "I’ve never found a case of ambulance services working with funeral homes. If I’ve heard anything it was just a rumor, slander." That’s a quote from October of last year, just before he was dismissed from his position. (The dismissal was for economic reasons--the ambulance service had huge debts.)

Lewandowski doesn’t like the term "hide." He corrects us: "Selling information about a recent death."

And for the first time he admits: "I have to honestly admit that I wasn’t able to get rid of it. I was ineffective. In spite of efforts made many times to eliminate this trade or at least to limit it to civilized proportions, I was ineffective. It is incredibly hard to prove. On the one hand we have a family with a complaint, on the other hand there’s no one who could, who would want to confirm it. I heard, I knew, complaints came to me, but I never caught anyone red-handed.

"Furthermore, the institutions which should have--it seemed to us--been interested in this, in fact were not. At the beginning of the 90s we informed, for example, the Office of State Protection, the police, the treasury agencies. There were meetings with representatives of the prosecutor’s office, judges. None of those people were interested in eliminating this trade.

"Now I know that it’s a universal phenomenon and that there are people participating in it whom I never would have suspected. People who are in a certain position in the hierarchy of the ambulance service, and should be able to do more, should be better, wiser, more moral. It turns out that they’re not."

"What positions are you talking about?"

"I myself never took any bribe. But in positions underneath me it happened. I didn’t know that those people were taking bribes. I only found out about it recently. If someone, who for example is responsible for supervising an ambulance station, is so badly flawed, he can’t do his job properly."

"You never had any suspicions that for the sake of money someone could, for example, fail to give assistance?"

"If I had suspected a crime, I would have had to report it to the appropriate body. I didn’t have reason to suspect such a thing. That would have gone against the very reason for the existence of the institution."

We ask about the use of paralyzing drugs:

"I can imagine what lies behind your question. I don’t know what happened to those medicines, I didn’t use them. But I wouldn’t want your speculations to go ... somehow further."

Dr. Ryszard Golanski from the Regional Physicians’ Council: "The suspicion that physicians, or other members of the teams, killed their patients is horrifying. As a physician I can’t imagine it. I’ll believe it only when a judge pronounces a guilty verdict."

Witold Skrzydlewski, whose family has a chain of funeral homes, has heard about suspicious deaths, but doesn’t want to talk about them. "Maybe some day I’ll need help and I’ll want the ambulance to save me. I tell friends that if someone in their home collapses they should offer 2000 zloty to the ambulance team that comes. Then there’s a guarantee they’ll be saved."

 Will the prosecutor order an exhumation?

Can cases of suspicious death be examined, to see if the patient got an injection of pavulon? This is a problem. This medicine is breaks down unusually quickly in the body. It’s even said that pavulon could theoretically be used for the "perfect murder."

Professor Andrzej Kulig, director of the pathology department of the Polish Mother’s Memorial Hospital Research Institute, disagrees: "There’s no such thing as a perfect murder. The murderer always leaves traces. Some are easy to spot, others take serious investigation. You can look for the compound itself or its metabolic by-product, what the body makes of it. A lot of drugs damage tissues, others--working quickly--don’t leave such obvious symptoms. And then toxicological testing is necessary. And those techniques are getting better and better."

From unofficial sources we hear that the investigators have ordered the exhumation of the bodies of ambulance patients whose deaths are suspicious.

We ask Kazimierz Olejnik, appellate prosecutor in Lodz, if he’s carrying out an investigation into the "suspicious deaths," including the unsuccessful resuscitations of patients in conjunction with the unsupervised use of medicines such as pavulon, and the trade in corpses.

"I can confirm that we are carrying out an appropriate investigation into this matter. At this point I can’t give any other information."

They’ll ask

The doctor who invited us to his home drinks up his coffee. "I know perfectly well how it’ll be. What someone who has called an ambulance to take care of a loved one will feel. How the honest doctors, my colleagues from the ambulance service who never dirtied their hands with that business, will suffer. There will be a certain look from people they know, silently asking, ‘Were you part of it?’ Denying it won’t do any good.’"

***

The horrifying results of a journalistic investigation into the Lodz ambulance service

Corpses are for sale in the Lodz ambulance service. Certain doctors, orderlies, ambulance drivers, and dispatchers are selling them. Funeral homes are buying them. The deceased is called a "hide." Reporters from Gazeta and Radio Lodz have found that patients may have been killed to get their hides.

This shameful trade has gone on for over ten years. Funeral homes fighting for the burial market have driven the price of a hide up to 1200 to 1800 zloty. The victims are the families of the deceased, who are made to choose a particular funeral home either through trickery or blackmail. The ambulance workers dealing in hides could be raking in a couple of million zloty each year.

In order to get that money, there’s one requirement--you’ve got to have a corpse, not a living patient. The employee of a Lodz funeral home: "I’ve heard of cases where the team didn’t hurry to the call because there was a chance that the death would occur before they arrived."

The evidence indicates that the race for "necromoney" may lead not only to failure to give assistance to patients but also to putting them to death. The means of death may be drugs that if used inappropriately become fatal--rapidly acting poisons, such as pavulon, a drug that paralyzes the muscles and stops respiration. Pavulon should be used only by experienced anesthesiologists and only in the operating room, where a machine "breathes" for the patient, whose own breath could interfere with the machine’s functioning. But in the Lodz ambulance service pavulon was used very frequently. Our informant tells us: a doctor saw an orderly injecting a patient with something. "What are you giving her?" he asked. "The usual," came the reply. In a few minutes she was dead.

How does pavulon kill, if used by accident or with criminal intent? Dr. Ryszard Golanski, deputy head of the Regional Physician’s Council in Lodz: "The patient is fully conscious, but because of the paralysis of his muscles he stops breathing. He can’t say anything, he can’t even lift a finger. He suffocates, he dies in agony. It’s one of the cruellest deaths on earth."

A former ambulance driver, who quit because he "didn’t want to be part of it": "One of the doctors used to come, take a look, and say, ‘Oh, there’s no point resuscitating this one.’ He would take the pulse and then it was good-bye. One patient was saved by a honest orderly in spite of this doctor. We called this doctor the Angel of Death, because he did people in. For the money and nothing else."

Our informants mention other nicknames of ambulance service employees involved in this criminal trade: Dr. Mengele, Dr. Potas, the Hide-trapper.

For twelve years Dr. Ryszard Lewandowski ran the Lodz ambulance service. All that time he denied that there was any trade in corpses in his institution. Today he says that he himself didn’t take any money for it, but he admits that others did, and that it was a common practice. He doesn’t like the term "hide." He corrects us, "Selling information about a recent death."

But he doesn’t want to believe that ambulance crews might cause patients’ deaths. And if they had? "That would have gone against the very reason for the existence of the institution," he says with hesitation.

After we had already researched this story, we found that an investigation was underway by the Central Investigative Bureau and the Lodz appellate prosecutor’s division for organized crime. The prosecutors and the police are considering exhuming the bodies of dozens of patients of the Lodz ambulance service, in order to see if there are traces of dangerously lethal drugs, such as pavulon.

Lodz councilman Witold Skrzydlewski, whose family has a chain of funeral homes, admits that he heard of suspicious deaths, but he doesn’t want to talk about this. "Maybe I’ll need help some day and want the ambulance to save me. I tell my friends that if someone in their home collapses they should offer 2000 zloty to the ambulance team that comes. Then there’s a guarantee they’ll be saved."

The new director of the ambulance service, Boguslaw Tyka, reported the trade to the police himself. He’s certain that under his management its scale has "radically diminished." "Will you eliminate the trade?" we ask. "Yes," he replied, "I’m sure of it."

***

Every day, 400 journalists at Gazeta Wyborcza write verified, fact-checked stories about Polish politics and society, keeping a critical eye on the ruling camp’s persistent assault on democratic values and the rule of law; the growing cultural tension between religious fundamentalism and human rights; and the ongoing COVID-19 epidemic. Our journalists are on the front lines in 25 Polish cities, reporting from the streets, hospitals, and courtrooms about issues that move public opinion.

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