On the morning of April 28, 2008, Kimberly Saenz arrived for her shift at the DaVita dialysis clinic in Lufkin, Texas, and was told she would be working as a patient-care nurse that day. She became teary-eyed. She preferred the job of preparing medications, which kept her further from the patients. From her chair on the dialysis floor a patient named Lurlene Hamilton watched Saenz pour bleach into a container; another patient, Hall, watched too. Both said they then saw her draw bleach into syringes and inject it into the lines of two patients undergoing treatment. They reported it that day. It was the end of a month in which the clinic had seen an unheard-of run of patients collapsing in their chairs.
She had been born Kimberly Fowler in Fall River, Massachusetts, and grew up in Pollok, a small community outside Lufkin, where she was a cheerleader at Central High School until she became pregnant by her high school boyfriend in her junior year and left school after her son was born. She later qualified as a licensed vocational nurse.
Dialysis clinics use diluted bleach to clean equipment, and in April 2008 Saenz was the one who mixed it. Between April 1 and April 28 five patients died and at least five others suffered sudden adverse episodes during treatment: Clara Strange, Thelma Metcalf, Garlin Kelley, Cora Bryant and Opal Few died, and Marva Rhone, Debra Oates and Marie Bradley were among the injured. She was fired after the rash of illnesses and deaths. The dialysis lines of all five dead patients were tested, and bleach was found in every one except Bryant's. Each of the five had at least one scientific finding consistent with bleach poisoning: bleach in a line or syringe, a positive test for the biomarker 3-chlorotyrosine, or an elevated level of lactate dehydrogenase. Testimony ruled out the city water supply and the clinic's filtered water as the source. The pathologist Dr. Schwartz concluded that each patient had been injured by bleach injected into the dialysis line. Saenz, the appeals court later noted, had been the first person to mention bleach as a possible cause. Before the grand jury she denied giving any patient medication, but said that she "was drawing up bleach to mix for her containers."
She was indicted on one count of capital murder covering all five deaths and five counts of aggravated assault. The trial in the 217th District Court of Angelina County lasted about a month. Saenz did not testify. Her lawyers argued that she was a scapegoat for sloppy procedures at a clinic where bleach was everywhere, and that drawing bleach into a syringe to prepare cleaning solution was common practice there. After four weeks of testimony and two days of deliberation, on March 30, 2012, the jury convicted her of capital murder and of aggravated assault on Rhone, Oates and Bradley, and acquitted her of the assaults on two other patients, Castañeda and Risinger. The same jury then weighed death against life in prison and, on April 2, 2012, chose life without parole. She also received three twenty-year terms for the assaults. She was thirty-eight.
The Fourth Court of Appeals in San Antonio affirmed the verdict on January 22, 2014, holding that the two eyewitness accounts, though slightly different, could be reconciled. The Texas Court of Criminal Appeals agreed that spring to review her claim that the jury had not been required to agree unanimously on which of the five deaths made up the capital murder, and sent the case back. In August 2015 the Fourth Court affirmed again, finding that the jury instruction had not caused her egregious harm; the court pointed to her access to the victims, her own statements about the bleach and the scientific evidence, and to the verdicts themselves, which acquitted her on the two assault counts where the evidence was weakest.