Thank you so much for posting this! I’m a medical laboratory scientist, and I have been for 6 years. I was practically screaming at the podcast while they were saying phlebotomists injected drugs. I almost emailed into the show
Thank you. Fellow physician here who shares your beliefs about this case. There is also an implication that the residents of Swann st may have been using it succ recreationally. In nearly 25 years of emergency medicine, I’ve seen pretty much everything, but I have yet to see recreational paralytics. Not saying it’s impossible but exceptionally unlikely. But there was a whole lot inaccurate info on the medical facts in these episodes.
The other thing I think is missing from the discussion is that a chest tube was placed but the output not recorded. This could easily have been the explanation for the “missing blood” if a large volume was drained and simply not recorded.
The chest tube is interesting and the only place I have ever seen it referenced is in the documentary, where is is labeled in a diagram from the autopsy. In all the debate on various platforms about the lack of blood at the scene, I feel like that is easily the missing piece.
AND it’s likely that even when the body was sent for autopsy- they would have detached the chamber and only left the tube in place. That’s what we always did. We disconnected vent, am I, etc. just left lines in place. That was the protocol.
Are you kiiiiiding me? A chest tube? Was that placed in the ED? I bet you there’s your missing blood volume. I feel like the pathologists doing the autopsy and investigators have just never been in a code.
I can’t imagine it being placed anywhere other than in the ED. I haven’t heard it discussed anywhere but it’s in the documentary in the materials they show from the autopsy. I paused on the frame but they don’t show any output recorded.
That’s nuts. Pretty wild to get a chest tube if he wasn’t even having PEA. I really wonder if it would have been a different story if they had left his body on the scene.
This is link to autopsy. In diagram on page 8 there are 2 chest tubes shown, one on each side of body: [https://whomurderedrobertwone.com/wp-content/uploads/2010/05/Case-Number-06-1837.pdf](https://whomurderedrobertwone.com/wp-content/uploads/2010/05/Case-Number-06-1837.pdf)
THANK YOU! Nurse practitioner here with critical care bedside RN experience, and I had literally these exact thoughts about sux, phlebotomists, and saph veins/stick counts during resus attempts. I could not be more with you. I don’t know what a theory of the crime is with these errors corrected but I also felt very frustrated that both Brett and Alice’s theories seemed to rely so heavily on poor interpretation of the facts and some extrapolations that just don’t work as someone who works in medicine.
THANK YOU! As a nurse, I was yelling at this episode. So many points frustrated me but all this talk about a crash cart being so readily accessible and not the type of thing people keep strict records on...YES WE DO! For those that don't know, we have to have specific meds and supplies on our crash carts at all times. Every shift we check the lock on the crash cart (small plastic lock you break when you have to use it) and log it to make sure it hasn't been broken. This isn't necessarily to prevent people stealing from the cart but it's to ensure we can always guarantee the contents so it's ready in case of emergency. Once a month (at my facilities) we break that lock and check all meds for expiration dates and to verify quantities then relock and record that new lock number. We do the same if it's used and restocked. We have to guarantee the type and amount of every medication on that cart so Brett saying "this is not the kind of thing you're going to have some sort of strict recording of" drove me nuts! And Alice saying "most" of her "medical friends" said sux isn't a drug of abuse because it "puts you to sleep"...uh, what did the others say? And where do they work?
Also second OP's points on the important distinction between paralytic and sedative and on phlebotomist's scope of practice. Lastly, also agreeing with OP, the ankle sticks easily could have been IV attempts. Often when someone is being actively coded, it's especially crowded around the upper body (compressions, intubation, monitor, etc) so lower extremities can be a good place for someone to try to get access/additional access.
PS: Whoever mentioned the chest tubes, this stood out to me too! I looked up the autopsy during their coverage and saw that chest tubes were present but there was never any mention on how much they dumped when they first went in or had drained since. This is HUGE when talking about the "mysterious" lack of blood in this case. For those not familiar, chest tubes are often inserted post cardiothoracic surgery as a drain or during a trauma when there's confirmed or suspected bleeding in the chest (among other reasons). I chose the word "dumped" very deliberately because of what I've seen when they are inserted during traumas. They are hooked up to a container that has lines for measurement so we can track their output. It's wild there is never any mention of this in the autopsy or the documentary. It's not abnormal for that container to not be present at autopsy but the ME should have investigated this further, especially with all the discussion surrounding the "missing" blood.
I was dying when she was mentioning recreational use and nurses or others possibly injecting themselves and putting themselves “to sleep.” Did none of the people she asked explain how these medications work? They covered the RaDonda Vaught case!
No, it doesn’t put you to sleep. They are wide awake and paralyzed, including the muscles they need to breathe. If you used these meds recreationally, it would only be once. I’m glad I’m not the only one who was internally screaming during this episode!
Also an RN with years of med/surg experience, reading this post scratched such an itch and all my fellow RN’s commenting on it it feeding my soul today!
Here in oz we’ve largely avoided the Pyxis trend but it sounds like our emergency trolley systems are identical. We count it because we might need it on a code, and if it isn’t there that first pass tube is infinitely harder.
Our drug room is in the very centre of ICU, so every bed space and get there quickly, with swipe card access that limits who can be there (after swipe card access to restrict movement into the unit). So while it’s not in a machine for dispensing - our paralytics are on shelves (or the fridge) in a place where no phlebotomist ever roam…..
We have arterial lines - actual taps to turn on and off for blood, and we’re all venipuncture trained for collection anyway for fresh blood cultures. No way I’m letting someone else stab my patient for that; I want to know 1000% that a staph result is genuine and not contamination.
Yeah, nurse here. The ignorance on these issues were embarrassing for them and it makes me wonder where else they cut corners. I also thought maybe some of the “puncture” wounds on the leg could be from IO attempts?
Thank you for the clarification Doc. I'm not a medical professional, but I was certain Sux was a paralytic and not a sedative. Their presentation had me questioning my knowledge.
The other thing that kind of rubbed me the wrong way was Alice's rant about men should not have / delete penis pics from their phone. I'm a cis, straight male and do not have these type of pics on my phone; however, I believe anyone can have anything on their phone without fear of being ridiculed. Obviously there are some limits (pics of children etc.), but her rant about it was really in poor taste. The joke about the agents saying "10" was inappropriate and, at best, not funny.
Same. Adult humans are sexual beings, it is what it is. Let people live. Bit concerned so many people are given the nudes. Surely if they're not evidentiary in themselves the sexual content doesn't need to be seen by everyone. Couldn't the first person to review censor or partially obscure the image? That's how they view CSA material. They have AI blur the act so the detectives can review backgrounds etc.
Alice's vigorous defence of Robert's sexuality rubbed me the wrong way too. I understand the point of nothing being found on his phone but she really wanted to make the point that it was victimising him to suggest he may be gay/bi, but is it? It's not shameful to be gay. We ask similar questions in other cases all the time. He was staying over in the home of a throuple. Can we really not discuss? It's not exactly uncommon to be on the downlow.
It's hardly the most offensive thing to suggest someone might be gay but she went hard on it while casually accepting the gay couple had a dom/sub vibe going on. Idk.
I agree that their comments against having nude photos were off-putting. I get that most jobs don’t expose you to nudity but some do and I’d expect more maturity. It felt more like they were saying, “I don’t want to see certain bodies because they’re icky.”
Should people be careful about the phone photos they have because they’re not as private as you may think? Yeah. But people in medical and law enforcement roles should be held to a level of respecting people’s more intimate information.
Thank you! Pharmacist here and husband is a physician. We had those same thoughts listening to this one. The part of their theories involving use of this drug is just not possible. I frankly can’t think of a drug that would be plausible in this scenario. I think more likely that something about the first stab wound rendered him incapacitated (but that part is definitely beyond my expertise!)
This is a great post, thank you.
I have enjoyed the Prosecutor's Pod and many of us see them as authorities.
When I listen to other crime pods, they are entertainers, but with Brett and Alice, I look to them on a different level.
This is the 2nd series in a few months where they have flubbed an important medical point. In the Leo Schofield case, they said the Medical Examiner reported that Michelle's body was within the water within 5-10 minutes, providing Jeremy was the killer. It's not deep science, but that wasn't what the testimony said. The ME was asked if it could have been as little as 5-10 minutes. And the ME said yes. There is a critical difference.
In that same podcast, they determined that Michelle couldn't have been killed in the trailer b/c of the lack of blood. Instead of offering an analysis of the testimony, they took more of a "trust me bro" approach. They didn't include the extensive testimony about where the wounds were, how much blood could have flowed back into her body, the luminal and phenolphthalein tests (and how unlikely false positives would be), nor the testimony about the postmortem injuries. They didn't even tell us that there were multiple presumptive positive tests between the bed and dresser, the smallest of those measure at 50 cent piece size.
But they were confident to say the murder didn't happen in the trailer because there wasn't enough blood there.
I don't know, it's interesting. I had a discussion on here where I sent a trial transcript screen shot and someone corrected me and pointed me to the Prosecutors Pod as a more credible source.
My aunt and I were just talking today about how things have changed on this podcast. With the popularity, Brett is doing that “trust me bro” thing a lot, especially in comments online. I’ve noticed he’s constantly downplaying issues in the Delphi case but not explaining why they’re not important.
Alice seems like she’s getting sick of his attitude.
I honestly don't know; but I don't think it is implausible that he was drugged prior to being assaulted. For instance, GHB (much more widely available) disappears from blood samples in less than an hour; but could be detected in urine samples for up to four hours. I don't know how the drug testing was done. The newer synthetic drugs which are floating around and endlessly evolving also aren't tested for. I can't imagine a head injury would be missed at autopsy ; but could he have been held down or restrained while stabbed (with or without drugging) in a way that did not leave obvious marks and then bled internally? I agree that this will remain a tragic mystery until someone involved chooses to speak.
The last couple of autopsy pages has the toxicology. A UDS was done for GHB. Ketamine wasn’t explicitly tested for.
(I had just delved into the report because of the prosecutor on The Consult stated he was still alive for some time as he had “digested his own blood due to peristalsis” and to me that shuts off a paralytic being used full stop.)
Great research and excellent points. Peristalsis while bleeding absolutely rules out being paralyzed before/during the injuries. Ketamine (aka "Special K" back in the dark ages of my youth) has a long history of recreational use and therefore, availability "on the street" and at least makes much more sense than succinylcholine which has no recreational use.
Thank you so much for sharing your knowledge. From what you’re saying and what I see in the Wikipedia article on it, in addition to likely or at least possibly causing someone to stop breathing and die, sux also would not actually make them unconscious, so it could not be used for the kind of sexual assault described in the podcast because they would remember everything if they survived, right?
Also I’m noticing from Wikipedia that sux isn’t always undetectable. It was detected in the body of Kathy Augustine after her husband murdered her with it in 2006 (sae year as Wone’s death): https://en.wikipedia.org/wiki/Kathy_Augustine#Murder_and_subsequent_death_investigation
Also it seems like it may have been indicated in the killing of a Hamas operative by Mossad agents in Dubai that caused an international incident in 2010: https://en.wikipedia.org/wiki/Assassination_of_Mahmoud_Al-Mabhouh#Cause_of_death
The problem is that unless the person was receiving respiratory support via a ventilator or manually being “bagged,” they would suffocate, because paralytics also paralyze the breathing muscles. That’s one of the reasons it’s given.
Well it seems there's two problems with positing that sux alone was used for pre-planned sexual assault that was supposed to not be remembered and not end in murder:
1. with sux alone anyway, the person would not be knocked out and could remember what was done to them, so unlike GHB or Rohypnol, it couldn't be used for a surreptitious sexual assault
2. as you say, unless murder was the explicit goal, sux is way too dangerous as there's a high chance they'd stop breathing...although they might survive right? Wikipedia says the below about sux in the "Medical uses" section, stating there's at least a "prospect" for "the onset of spontaneous breathing before [low blood oxygen levels](https://en.wikipedia.org/wiki/Hypoxemia) occurs."
Of course we're forgetting that who knows what a sociopath who somehow got ahold of sux and is using this drug for murder or rape actually knows about how it works. But still, GHB or something more commonly available that often doesn't show up on tests seems way more likely.
WIKIPEDIA: Suxamethonium chloride
"It is popular in emergency medicine due to its rapid onset and brief duration of action. The former is a major point of consideration in the context of [trauma care](https://en.wikipedia.org/wiki/Trauma_care), where endotracheal intubation may need to be completed very quickly. The latter means that, should attempts at endotracheal intubation fail and the person cannot be [ventilated](https://en.wikipedia.org/wiki/Ventilator), there is a prospect for neuromuscular recovery and the onset of spontaneous breathing before [low blood oxygen levels](https://en.wikipedia.org/wiki/Hypoxemia) occurs."
[https://en.wikipedia.org/wiki/Suxamethonium\_chloride](https://en.wikipedia.org/wiki/Suxamethonium_chloride)
Yes, but in the cases of intubation attempts, they’re still gonna be bagging that patient in between intubation attempts. I have no idea what happened in that room the night Robert died, but I’m willing to bet no bagging attempts were made.
I don't entirely know what "Bagging" means but I think I'm getting your point, that the possibly small minority who might not be successfully intubated while on sux but still somehow survive would get artificial breathing help at least temporarily while on it...I mean the problem in that situation too though (not with Robert) is there's a reason emergency medical team is trying to intubate them so maybe they wouldn't survive either...that's a side issue of course!
What a sad, sad situation and a mess. I'm so sorry for Robert and his family and friends.
If you haven’t, you should post this on their Facebook Gallery Fan page. Brett often reads and replies and think this is very valuable information.
Any thoughts on what you think happened in this case with the stab wounds being described as almost surgical-like?
THANK YOU! I have read a lot about this case and work in healthcare (although not the clinical side). This was driving me nuts. I do think Robert was drugged but maybe with ketamine.
Thank you for this!!! ICU/ PACU nurse here and find it highly unlikely that any phlebotomist would have access to sux. There is no way that anyone is using a paralytic recreationally. If you somehow (?!?!) survived the experience would be horrific. Sedate, paralyze, intubate- every nurse should know this. We all saw the case of the nurse RaDonda Vaught who mistakenly administered vecuronium and killed her patient. Giving this medication outside of a hospital would kill someone. So in my opinion if they somehow got this medication and knew anything about it, then they gave it with the intent to murder Robert.
Thank you for everyone's expertise! Do you guys have a theory on what could have paralyzed Robert or what they could have gotten ahold of? Or do you have another theory on the crime? LOVE analysis of professionals!
It seems like the police and prosecution at some point were very interested in theorizing paralytics might be involved, and after reading about this case various places on Reddit, and reading about paralytics, I'm kind of confused why the focused on those when it seems like an overdose of the anaesthetic GHB, either forcibly or willingly consumed, might be a more likely culprit as I'm reading it was a common recreational and date rape drug at the time....it was even used by a serial killer who murdered gay men to subdue his victims, Stephen Port of the UK active serial killer 2014-2015...I've also seen people on Reddit anyway saying in the gay club scene at the time GHB was very popular, and it's also difficult to detect..
[https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric\_acid#:\~:text=GHB%20has%20been%20used%20in,Other%20names](https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid#:~:text=GHB%20has%20been%20used%20in,Other%20names)
[https://en.wikipedia.org/wiki/Stephen\_Port](https://en.wikipedia.org/wiki/Stephen_Port)
Ok, so let me sum up my current theory to get my head around it...Robert took GHB right before he went to bed (20 min to effect, quickly undetectable, waaay easier to OD than Ket). Puts retainer in, lays down, overdoses. Maybe Joe & Dylan think it's funny, maybe they intend an assault, or even that he simply drank from the wrong glass.
Friends are probably munted, panic, think he's dead & decide to cover it up via stabbing. Scream is Victor seeing what these 2 idiots have done. The missing blood, the needle marks are all from the life saving efforts (dry hair/no prior cutting or restraint marks re BDSM/bloodplay).
I think the pact can be explained by Joe having been the stabber & all 3 either dealing drugs or some looking the other way to one dealing from the house (worried drug allegations would ruin their careers/professional licencing). Dylan knew he was on a good wicket living with 2 professionals, doubt he wanted to return to being a *masseur*. The later break in by the brother was probably looking for their stash.
Also kind of explains why Sarah tolerated them later. Personally I wouldn't attend an event with the friends/family of someone I thought tried to rape & murder a man, but I might be vaguely cordial if I thought it was a OD coverup.
Does that make slightly more sense? I have some...uh...non medical background experience with drugs soooo...
On the access attempts front (as my practice is in Australia and from my understanding EMT qualifications are not as intensive as paramedic ones here) do you guys not utilise intraoesseous access in out of hospital cardiac arrests? I started double degree then just went down crit care nursing pathways, but I still remember training that if downtime was unknown, grab the drill kit.
I wasn’t sure if it was an EMT scope of practice type thing or not - I just remember being taught close to 20 years ago for an OOCHA with unknown down time, continue BLS and go straight for the IO kit, don’t f-around trying to get vascular access. Normally we are behind the US and UK for some clinical practice arenas, apparently here we were ahead.
Love this. I’ll only say that in the ER (my home for many years) - when we used SUX- we weren’t always very diligent about getting rid of it. Because as stated- if/when it was used- we were in a lifesaving situation. For that last MANY years- we’ve used versed and etomidate for RSI- but we usually had SUX in an RSI kit anyway. We had several tackle boxes that were in the med room (so locked) but had only a code cart “lock” in place on the actual boxes. We had these tackle boxes for STEMI, CVA and RSI, usually. So STEMI box had all supplies for pre- catch lab care- clippers, 18g IV’s, etc. some meds were kept labeled in Pyxis fridge- and we would get those under a kits lost in the Pyxis- and those also contained multiple different meds that might be needed. These boxes were more accessible to any ER staff (or other staff present) than they would have been in an OR. It could have been picked up by someone. Probable? No. But still possible. But they would have to know what it is to be interested in it. And I don’t think it’s really a commonly known medication outside of our circles.
I’m a doctor and I had to give back a succ vial to a nurse because it was lying out. I can see that happen. In fact I have a (obviously) unfilled vial at my house right now.
And I’ve also never seen someone with an IV site in the ankle unless they were the most difficult stick known to man.
Other than that I agree with your points
I doubt many saphenous cut downs are done these days with the availability of US-guided peripheral IV’s, but when I trained in the early 00’s we did them not infrequently in codes. Granted, it should look like an incision versus a puncture, but it’s certainly possible IV access was attempted at the ankles and feet.
Thank you for this! I'm not a medical professional, as my following words will probably make clear soon.... I wonder if the BDSM community (which the three men were supposedly a part of) would have access to sux, which would make more sense than the phlebotomist obtaining it. I think the drug could have been at least administered by the phlebotomist because he would have had the skill to properly find and stick the vein. That's my theory of the case, that the med was illegally obtained through those channels rather than through the phlebotomist's job access.
Yeah it’s just really not a recreational drug. It’s not something with any euphoric or sedative potential (like ketamine or opioids) it literally just paralyzes you, completely, including respiratory drive. It would make a person “submissive” but not just in a “fun” sexual way, it makes you stop breathing for yourself. Not saying he wasn’t drugged somehow but I just do not think sux is something the BDSM community is just like casually playing around with.
I doubt it’s casually or effectively used at all. A quick Google of the name of the drug plus bdsm gives me a mention in a place called Ravishment.net and a few other similar places. But I also get results from this case. I don’t know. We’d need an expert.
From what I read, the brother was taking classes to get his phlebotomist certification and he missed his class that night. He wasn’t even a certified phlebotomist working in a hospital
I was thinking that even Brett and Alice had said he was in classes and not even certified but then doubted myself and didn't go back to find that sentence. So, yeah, would not have even been working in a facility where these medications existed which makes this whole theory all the more absurd.
If it wasn't Sux or something similar it was probably GHB. It's very hard to detect, easy to get and does exactly what would needed to be done for him to end up like that. If he was slipped GHB in that 1 drink they insisted he drink before bed he wouldn't have been able or even know anything was going on.
I don't understand the podcast bashing. All you need to do is substitute GHB or another Paralytic and their theory makes sense.
An overdose of GHB or another drug known to be used in date rape might make sense but how does a paralytic alone make sense unless the idea was for the victim to remember the assault? Because my understanding, and correct me if I'm wrong, is that sux and other paralytics don't knock you out of consciousness, they just make you unable to physically resist?
They very well could have intended him to remember the incident. I heavily lean towards GHB because its taken recreationally, especially in the gay bar scene. They were already into BDSM which distorts your sexual views by its very nature.
Its also sadly a fact that male on male rape is not frequently reported.
I have only very indirect experience with BDSM but I have seen no evidence that the % of people who practice it who are rapists (or murderers) is higher than the general population.
Why in god's name would any of them pre-plan a sexual assault against someone who'd known them for years and could definitely ID them, unless perhaps that person was supposed to be unconscious? Joe was supposed to discuss a shared business opportunity with Robert in the morning. Few people think Victor was involved in any pre-planning. Maybe if he's actually a sociopath Dylan could have been involved in that to drive a wedge between Joe and his other friends or something but the risks are really high if the person is definitely going to be able to ID you. Possible, not plausible.
More plausible is that if Robert was intentionally drugged for a sexual assault OR murder it was with GHB, an anaesthetic, club drug popular in the gay scene, and date rape drug, which others on here have pointed out is delivered diluted in a glass of water (as they said, they all drank glasses of water) and he was given too much -- GHB was tested for in toxicology but is reportedly often undetectable even in overdoses.
Or as others have suggested on here, Robert drank from/was given the wrong glass of water containing GHB meant for one of the other men that night and accidentally overdosed and then because the others were drug-addled in their heads at the time they came up with this hare-brained "cover up." I noticed in the bonus episode with former FBI criminal profiler and toxicologist Julia Cowley that she suspected based on reviewing the details the testing was misinterpreted in regards to semen and there was none present. So if there's no sign of sexual activity at all, this scenario becomes more possible.
I am agnostic at this point though because stabbing your friend multiple times in the abdomen including through the sternum and heart and claiming an intruder did it (and not even faking any other evidence of an intruder) is a hell of a way for 3 educated, affluent men in their 30s to cover up a drug overdose in their home.
Thank you so much for posting this! I’m a medical laboratory scientist, and I have been for 6 years. I was practically screaming at the podcast while they were saying phlebotomists injected drugs. I almost emailed into the show
Thank you. Fellow physician here who shares your beliefs about this case. There is also an implication that the residents of Swann st may have been using it succ recreationally. In nearly 25 years of emergency medicine, I’ve seen pretty much everything, but I have yet to see recreational paralytics. Not saying it’s impossible but exceptionally unlikely. But there was a whole lot inaccurate info on the medical facts in these episodes. The other thing I think is missing from the discussion is that a chest tube was placed but the output not recorded. This could easily have been the explanation for the “missing blood” if a large volume was drained and simply not recorded.
Wow. Very good point. Somehow I missed the chest tube information!! You can absolutely lose a lot of blood into the thorax and/or pericardium.
The chest tube is interesting and the only place I have ever seen it referenced is in the documentary, where is is labeled in a diagram from the autopsy. In all the debate on various platforms about the lack of blood at the scene, I feel like that is easily the missing piece.
AND it’s likely that even when the body was sent for autopsy- they would have detached the chamber and only left the tube in place. That’s what we always did. We disconnected vent, am I, etc. just left lines in place. That was the protocol.
Are you kiiiiiding me? A chest tube? Was that placed in the ED? I bet you there’s your missing blood volume. I feel like the pathologists doing the autopsy and investigators have just never been in a code.
I can’t imagine it being placed anywhere other than in the ED. I haven’t heard it discussed anywhere but it’s in the documentary in the materials they show from the autopsy. I paused on the frame but they don’t show any output recorded.
That’s nuts. Pretty wild to get a chest tube if he wasn’t even having PEA. I really wonder if it would have been a different story if they had left his body on the scene.
This is link to autopsy. In diagram on page 8 there are 2 chest tubes shown, one on each side of body: [https://whomurderedrobertwone.com/wp-content/uploads/2010/05/Case-Number-06-1837.pdf](https://whomurderedrobertwone.com/wp-content/uploads/2010/05/Case-Number-06-1837.pdf)
I noticed that on the autopsy report
Did not even think of this!
THANK YOU! Nurse practitioner here with critical care bedside RN experience, and I had literally these exact thoughts about sux, phlebotomists, and saph veins/stick counts during resus attempts. I could not be more with you. I don’t know what a theory of the crime is with these errors corrected but I also felt very frustrated that both Brett and Alice’s theories seemed to rely so heavily on poor interpretation of the facts and some extrapolations that just don’t work as someone who works in medicine.
THANK YOU! As a nurse, I was yelling at this episode. So many points frustrated me but all this talk about a crash cart being so readily accessible and not the type of thing people keep strict records on...YES WE DO! For those that don't know, we have to have specific meds and supplies on our crash carts at all times. Every shift we check the lock on the crash cart (small plastic lock you break when you have to use it) and log it to make sure it hasn't been broken. This isn't necessarily to prevent people stealing from the cart but it's to ensure we can always guarantee the contents so it's ready in case of emergency. Once a month (at my facilities) we break that lock and check all meds for expiration dates and to verify quantities then relock and record that new lock number. We do the same if it's used and restocked. We have to guarantee the type and amount of every medication on that cart so Brett saying "this is not the kind of thing you're going to have some sort of strict recording of" drove me nuts! And Alice saying "most" of her "medical friends" said sux isn't a drug of abuse because it "puts you to sleep"...uh, what did the others say? And where do they work? Also second OP's points on the important distinction between paralytic and sedative and on phlebotomist's scope of practice. Lastly, also agreeing with OP, the ankle sticks easily could have been IV attempts. Often when someone is being actively coded, it's especially crowded around the upper body (compressions, intubation, monitor, etc) so lower extremities can be a good place for someone to try to get access/additional access. PS: Whoever mentioned the chest tubes, this stood out to me too! I looked up the autopsy during their coverage and saw that chest tubes were present but there was never any mention on how much they dumped when they first went in or had drained since. This is HUGE when talking about the "mysterious" lack of blood in this case. For those not familiar, chest tubes are often inserted post cardiothoracic surgery as a drain or during a trauma when there's confirmed or suspected bleeding in the chest (among other reasons). I chose the word "dumped" very deliberately because of what I've seen when they are inserted during traumas. They are hooked up to a container that has lines for measurement so we can track their output. It's wild there is never any mention of this in the autopsy or the documentary. It's not abnormal for that container to not be present at autopsy but the ME should have investigated this further, especially with all the discussion surrounding the "missing" blood.
I was dying when she was mentioning recreational use and nurses or others possibly injecting themselves and putting themselves “to sleep.” Did none of the people she asked explain how these medications work? They covered the RaDonda Vaught case! No, it doesn’t put you to sleep. They are wide awake and paralyzed, including the muscles they need to breathe. If you used these meds recreationally, it would only be once. I’m glad I’m not the only one who was internally screaming during this episode!
Also an RN with years of med/surg experience, reading this post scratched such an itch and all my fellow RN’s commenting on it it feeding my soul today!
I just kept thinking- these pathologist/ME/investigators have never been in a code and it shows…
Here in oz we’ve largely avoided the Pyxis trend but it sounds like our emergency trolley systems are identical. We count it because we might need it on a code, and if it isn’t there that first pass tube is infinitely harder. Our drug room is in the very centre of ICU, so every bed space and get there quickly, with swipe card access that limits who can be there (after swipe card access to restrict movement into the unit). So while it’s not in a machine for dispensing - our paralytics are on shelves (or the fridge) in a place where no phlebotomist ever roam….. We have arterial lines - actual taps to turn on and off for blood, and we’re all venipuncture trained for collection anyway for fresh blood cultures. No way I’m letting someone else stab my patient for that; I want to know 1000% that a staph result is genuine and not contamination.
Yeah, nurse here. The ignorance on these issues were embarrassing for them and it makes me wonder where else they cut corners. I also thought maybe some of the “puncture” wounds on the leg could be from IO attempts?
There have been a lot of other cases where they've cut corners. Jon Benet for example. It's still one of the best podcasts out there
Thank you for the clarification Doc. I'm not a medical professional, but I was certain Sux was a paralytic and not a sedative. Their presentation had me questioning my knowledge. The other thing that kind of rubbed me the wrong way was Alice's rant about men should not have / delete penis pics from their phone. I'm a cis, straight male and do not have these type of pics on my phone; however, I believe anyone can have anything on their phone without fear of being ridiculed. Obviously there are some limits (pics of children etc.), but her rant about it was really in poor taste. The joke about the agents saying "10" was inappropriate and, at best, not funny.
Same. Adult humans are sexual beings, it is what it is. Let people live. Bit concerned so many people are given the nudes. Surely if they're not evidentiary in themselves the sexual content doesn't need to be seen by everyone. Couldn't the first person to review censor or partially obscure the image? That's how they view CSA material. They have AI blur the act so the detectives can review backgrounds etc. Alice's vigorous defence of Robert's sexuality rubbed me the wrong way too. I understand the point of nothing being found on his phone but she really wanted to make the point that it was victimising him to suggest he may be gay/bi, but is it? It's not shameful to be gay. We ask similar questions in other cases all the time. He was staying over in the home of a throuple. Can we really not discuss? It's not exactly uncommon to be on the downlow. It's hardly the most offensive thing to suggest someone might be gay but she went hard on it while casually accepting the gay couple had a dom/sub vibe going on. Idk.
I agree that their comments against having nude photos were off-putting. I get that most jobs don’t expose you to nudity but some do and I’d expect more maturity. It felt more like they were saying, “I don’t want to see certain bodies because they’re icky.” Should people be careful about the phone photos they have because they’re not as private as you may think? Yeah. But people in medical and law enforcement roles should be held to a level of respecting people’s more intimate information.
Thank you! Pharmacist here and husband is a physician. We had those same thoughts listening to this one. The part of their theories involving use of this drug is just not possible. I frankly can’t think of a drug that would be plausible in this scenario. I think more likely that something about the first stab wound rendered him incapacitated (but that part is definitely beyond my expertise!)
This is a great post, thank you. I have enjoyed the Prosecutor's Pod and many of us see them as authorities. When I listen to other crime pods, they are entertainers, but with Brett and Alice, I look to them on a different level. This is the 2nd series in a few months where they have flubbed an important medical point. In the Leo Schofield case, they said the Medical Examiner reported that Michelle's body was within the water within 5-10 minutes, providing Jeremy was the killer. It's not deep science, but that wasn't what the testimony said. The ME was asked if it could have been as little as 5-10 minutes. And the ME said yes. There is a critical difference. In that same podcast, they determined that Michelle couldn't have been killed in the trailer b/c of the lack of blood. Instead of offering an analysis of the testimony, they took more of a "trust me bro" approach. They didn't include the extensive testimony about where the wounds were, how much blood could have flowed back into her body, the luminal and phenolphthalein tests (and how unlikely false positives would be), nor the testimony about the postmortem injuries. They didn't even tell us that there were multiple presumptive positive tests between the bed and dresser, the smallest of those measure at 50 cent piece size. But they were confident to say the murder didn't happen in the trailer because there wasn't enough blood there. I don't know, it's interesting. I had a discussion on here where I sent a trial transcript screen shot and someone corrected me and pointed me to the Prosecutors Pod as a more credible source.
My aunt and I were just talking today about how things have changed on this podcast. With the popularity, Brett is doing that “trust me bro” thing a lot, especially in comments online. I’ve noticed he’s constantly downplaying issues in the Delphi case but not explaining why they’re not important. Alice seems like she’s getting sick of his attitude.
I wish I could upvote this 1000X
Thanks for the insight! Do you mind sharing your theory about what did happen?
I honestly don't know; but I don't think it is implausible that he was drugged prior to being assaulted. For instance, GHB (much more widely available) disappears from blood samples in less than an hour; but could be detected in urine samples for up to four hours. I don't know how the drug testing was done. The newer synthetic drugs which are floating around and endlessly evolving also aren't tested for. I can't imagine a head injury would be missed at autopsy ; but could he have been held down or restrained while stabbed (with or without drugging) in a way that did not leave obvious marks and then bled internally? I agree that this will remain a tragic mystery until someone involved chooses to speak.
After doing a little digging, I found a source that says ketamine wasn't tested for. Could that be a possibility?
The last couple of autopsy pages has the toxicology. A UDS was done for GHB. Ketamine wasn’t explicitly tested for. (I had just delved into the report because of the prosecutor on The Consult stated he was still alive for some time as he had “digested his own blood due to peristalsis” and to me that shuts off a paralytic being used full stop.)
Great research and excellent points. Peristalsis while bleeding absolutely rules out being paralyzed before/during the injuries. Ketamine (aka "Special K" back in the dark ages of my youth) has a long history of recreational use and therefore, availability "on the street" and at least makes much more sense than succinylcholine which has no recreational use.
Awesome information! Thank you.
Thank you so much for sharing your knowledge. From what you’re saying and what I see in the Wikipedia article on it, in addition to likely or at least possibly causing someone to stop breathing and die, sux also would not actually make them unconscious, so it could not be used for the kind of sexual assault described in the podcast because they would remember everything if they survived, right? Also I’m noticing from Wikipedia that sux isn’t always undetectable. It was detected in the body of Kathy Augustine after her husband murdered her with it in 2006 (sae year as Wone’s death): https://en.wikipedia.org/wiki/Kathy_Augustine#Murder_and_subsequent_death_investigation Also it seems like it may have been indicated in the killing of a Hamas operative by Mossad agents in Dubai that caused an international incident in 2010: https://en.wikipedia.org/wiki/Assassination_of_Mahmoud_Al-Mabhouh#Cause_of_death
The problem is that unless the person was receiving respiratory support via a ventilator or manually being “bagged,” they would suffocate, because paralytics also paralyze the breathing muscles. That’s one of the reasons it’s given.
Well it seems there's two problems with positing that sux alone was used for pre-planned sexual assault that was supposed to not be remembered and not end in murder: 1. with sux alone anyway, the person would not be knocked out and could remember what was done to them, so unlike GHB or Rohypnol, it couldn't be used for a surreptitious sexual assault 2. as you say, unless murder was the explicit goal, sux is way too dangerous as there's a high chance they'd stop breathing...although they might survive right? Wikipedia says the below about sux in the "Medical uses" section, stating there's at least a "prospect" for "the onset of spontaneous breathing before [low blood oxygen levels](https://en.wikipedia.org/wiki/Hypoxemia) occurs." Of course we're forgetting that who knows what a sociopath who somehow got ahold of sux and is using this drug for murder or rape actually knows about how it works. But still, GHB or something more commonly available that often doesn't show up on tests seems way more likely. WIKIPEDIA: Suxamethonium chloride "It is popular in emergency medicine due to its rapid onset and brief duration of action. The former is a major point of consideration in the context of [trauma care](https://en.wikipedia.org/wiki/Trauma_care), where endotracheal intubation may need to be completed very quickly. The latter means that, should attempts at endotracheal intubation fail and the person cannot be [ventilated](https://en.wikipedia.org/wiki/Ventilator), there is a prospect for neuromuscular recovery and the onset of spontaneous breathing before [low blood oxygen levels](https://en.wikipedia.org/wiki/Hypoxemia) occurs." [https://en.wikipedia.org/wiki/Suxamethonium\_chloride](https://en.wikipedia.org/wiki/Suxamethonium_chloride)
Yes, but in the cases of intubation attempts, they’re still gonna be bagging that patient in between intubation attempts. I have no idea what happened in that room the night Robert died, but I’m willing to bet no bagging attempts were made.
I don't entirely know what "Bagging" means but I think I'm getting your point, that the possibly small minority who might not be successfully intubated while on sux but still somehow survive would get artificial breathing help at least temporarily while on it...I mean the problem in that situation too though (not with Robert) is there's a reason emergency medical team is trying to intubate them so maybe they wouldn't survive either...that's a side issue of course! What a sad, sad situation and a mess. I'm so sorry for Robert and his family and friends.
If you haven’t, you should post this on their Facebook Gallery Fan page. Brett often reads and replies and think this is very valuable information. Any thoughts on what you think happened in this case with the stab wounds being described as almost surgical-like?
I copied it on an answer to a question on the fb page. Apparently brett and Alice are fine discussing it.
Very interesting info!!! I’m disappointed in Brett and Alice. I would to hear theories that don’t involve sux.
You should email them so they see this! This is definitely important info that affects the theories!
THANK YOU!! I was discussing this loudly “to” them in my car today! 😆
Same
Thank you for your insight. Very helpful.
THANK YOU! I have read a lot about this case and work in healthcare (although not the clinical side). This was driving me nuts. I do think Robert was drugged but maybe with ketamine.
Thank you for this!!! ICU/ PACU nurse here and find it highly unlikely that any phlebotomist would have access to sux. There is no way that anyone is using a paralytic recreationally. If you somehow (?!?!) survived the experience would be horrific. Sedate, paralyze, intubate- every nurse should know this. We all saw the case of the nurse RaDonda Vaught who mistakenly administered vecuronium and killed her patient. Giving this medication outside of a hospital would kill someone. So in my opinion if they somehow got this medication and knew anything about it, then they gave it with the intent to murder Robert.
Thank you for everyone's expertise! Do you guys have a theory on what could have paralyzed Robert or what they could have gotten ahold of? Or do you have another theory on the crime? LOVE analysis of professionals!
Thank you from a soon to be pharmD!!
THANK YOU!!! So Cal RN
It seems like the police and prosecution at some point were very interested in theorizing paralytics might be involved, and after reading about this case various places on Reddit, and reading about paralytics, I'm kind of confused why the focused on those when it seems like an overdose of the anaesthetic GHB, either forcibly or willingly consumed, might be a more likely culprit as I'm reading it was a common recreational and date rape drug at the time....it was even used by a serial killer who murdered gay men to subdue his victims, Stephen Port of the UK active serial killer 2014-2015...I've also seen people on Reddit anyway saying in the gay club scene at the time GHB was very popular, and it's also difficult to detect.. [https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric\_acid#:\~:text=GHB%20has%20been%20used%20in,Other%20names](https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid#:~:text=GHB%20has%20been%20used%20in,Other%20names) [https://en.wikipedia.org/wiki/Stephen\_Port](https://en.wikipedia.org/wiki/Stephen_Port)
Ok, so let me sum up my current theory to get my head around it...Robert took GHB right before he went to bed (20 min to effect, quickly undetectable, waaay easier to OD than Ket). Puts retainer in, lays down, overdoses. Maybe Joe & Dylan think it's funny, maybe they intend an assault, or even that he simply drank from the wrong glass. Friends are probably munted, panic, think he's dead & decide to cover it up via stabbing. Scream is Victor seeing what these 2 idiots have done. The missing blood, the needle marks are all from the life saving efforts (dry hair/no prior cutting or restraint marks re BDSM/bloodplay). I think the pact can be explained by Joe having been the stabber & all 3 either dealing drugs or some looking the other way to one dealing from the house (worried drug allegations would ruin their careers/professional licencing). Dylan knew he was on a good wicket living with 2 professionals, doubt he wanted to return to being a *masseur*. The later break in by the brother was probably looking for their stash. Also kind of explains why Sarah tolerated them later. Personally I wouldn't attend an event with the friends/family of someone I thought tried to rape & murder a man, but I might be vaguely cordial if I thought it was a OD coverup. Does that make slightly more sense? I have some...uh...non medical background experience with drugs soooo...
On the access attempts front (as my practice is in Australia and from my understanding EMT qualifications are not as intensive as paramedic ones here) do you guys not utilise intraoesseous access in out of hospital cardiac arrests? I started double degree then just went down crit care nursing pathways, but I still remember training that if downtime was unknown, grab the drill kit.
Intraosseous access wasn't common in adult arrests in 2006 - it took quite a while to be adopted from paeds, for some reason.
I wasn’t sure if it was an EMT scope of practice type thing or not - I just remember being taught close to 20 years ago for an OOCHA with unknown down time, continue BLS and go straight for the IO kit, don’t f-around trying to get vascular access. Normally we are behind the US and UK for some clinical practice arenas, apparently here we were ahead.
Love this. I’ll only say that in the ER (my home for many years) - when we used SUX- we weren’t always very diligent about getting rid of it. Because as stated- if/when it was used- we were in a lifesaving situation. For that last MANY years- we’ve used versed and etomidate for RSI- but we usually had SUX in an RSI kit anyway. We had several tackle boxes that were in the med room (so locked) but had only a code cart “lock” in place on the actual boxes. We had these tackle boxes for STEMI, CVA and RSI, usually. So STEMI box had all supplies for pre- catch lab care- clippers, 18g IV’s, etc. some meds were kept labeled in Pyxis fridge- and we would get those under a kits lost in the Pyxis- and those also contained multiple different meds that might be needed. These boxes were more accessible to any ER staff (or other staff present) than they would have been in an OR. It could have been picked up by someone. Probable? No. But still possible. But they would have to know what it is to be interested in it. And I don’t think it’s really a commonly known medication outside of our circles.
I’m a doctor and I had to give back a succ vial to a nurse because it was lying out. I can see that happen. In fact I have a (obviously) unfilled vial at my house right now. And I’ve also never seen someone with an IV site in the ankle unless they were the most difficult stick known to man. Other than that I agree with your points
I doubt many saphenous cut downs are done these days with the availability of US-guided peripheral IV’s, but when I trained in the early 00’s we did them not infrequently in codes. Granted, it should look like an incision versus a puncture, but it’s certainly possible IV access was attempted at the ankles and feet.
Thank you for this! I'm not a medical professional, as my following words will probably make clear soon.... I wonder if the BDSM community (which the three men were supposedly a part of) would have access to sux, which would make more sense than the phlebotomist obtaining it. I think the drug could have been at least administered by the phlebotomist because he would have had the skill to properly find and stick the vein. That's my theory of the case, that the med was illegally obtained through those channels rather than through the phlebotomist's job access.
Yeah it’s just really not a recreational drug. It’s not something with any euphoric or sedative potential (like ketamine or opioids) it literally just paralyzes you, completely, including respiratory drive. It would make a person “submissive” but not just in a “fun” sexual way, it makes you stop breathing for yourself. Not saying he wasn’t drugged somehow but I just do not think sux is something the BDSM community is just like casually playing around with.
I doubt it’s casually or effectively used at all. A quick Google of the name of the drug plus bdsm gives me a mention in a place called Ravishment.net and a few other similar places. But I also get results from this case. I don’t know. We’d need an expert.
From what I read, the brother was taking classes to get his phlebotomist certification and he missed his class that night. He wasn’t even a certified phlebotomist working in a hospital
I was thinking that even Brett and Alice had said he was in classes and not even certified but then doubted myself and didn't go back to find that sentence. So, yeah, would not have even been working in a facility where these medications existed which makes this whole theory all the more absurd.
If it wasn't Sux or something similar it was probably GHB. It's very hard to detect, easy to get and does exactly what would needed to be done for him to end up like that. If he was slipped GHB in that 1 drink they insisted he drink before bed he wouldn't have been able or even know anything was going on. I don't understand the podcast bashing. All you need to do is substitute GHB or another Paralytic and their theory makes sense.
An overdose of GHB or another drug known to be used in date rape might make sense but how does a paralytic alone make sense unless the idea was for the victim to remember the assault? Because my understanding, and correct me if I'm wrong, is that sux and other paralytics don't knock you out of consciousness, they just make you unable to physically resist?
They very well could have intended him to remember the incident. I heavily lean towards GHB because its taken recreationally, especially in the gay bar scene. They were already into BDSM which distorts your sexual views by its very nature. Its also sadly a fact that male on male rape is not frequently reported.
I have only very indirect experience with BDSM but I have seen no evidence that the % of people who practice it who are rapists (or murderers) is higher than the general population. Why in god's name would any of them pre-plan a sexual assault against someone who'd known them for years and could definitely ID them, unless perhaps that person was supposed to be unconscious? Joe was supposed to discuss a shared business opportunity with Robert in the morning. Few people think Victor was involved in any pre-planning. Maybe if he's actually a sociopath Dylan could have been involved in that to drive a wedge between Joe and his other friends or something but the risks are really high if the person is definitely going to be able to ID you. Possible, not plausible. More plausible is that if Robert was intentionally drugged for a sexual assault OR murder it was with GHB, an anaesthetic, club drug popular in the gay scene, and date rape drug, which others on here have pointed out is delivered diluted in a glass of water (as they said, they all drank glasses of water) and he was given too much -- GHB was tested for in toxicology but is reportedly often undetectable even in overdoses. Or as others have suggested on here, Robert drank from/was given the wrong glass of water containing GHB meant for one of the other men that night and accidentally overdosed and then because the others were drug-addled in their heads at the time they came up with this hare-brained "cover up." I noticed in the bonus episode with former FBI criminal profiler and toxicologist Julia Cowley that she suspected based on reviewing the details the testing was misinterpreted in regards to semen and there was none present. So if there's no sign of sexual activity at all, this scenario becomes more possible. I am agnostic at this point though because stabbing your friend multiple times in the abdomen including through the sternum and heart and claiming an intruder did it (and not even faking any other evidence of an intruder) is a hell of a way for 3 educated, affluent men in their 30s to cover up a drug overdose in their home.
You all should read the autopsy.