Last Dance, Last Chance

garden; it would have made her happy to see them, but it made us cry. Dan never lived there again, but his sister, Paula, did—until he could sell it.”
    “Everyone kept telling me to sue,” Dan recalled. “But it wasn’t going to bring Sarah back. My goal was only to be sure that people knew there were doctors like Pignataro out there. I didn’t even push to have him go to prison for the maximum time because I knew he had two kids at home. I didn’t want to take him away from his family. I thought if he just lost his license and couldn’t practice, we’d have one really bad doctor out of the system.”
     
    For a time, at least, that wouldn’t be a concern. On August 29, 1997, Anthony Pignataro’s license to practice medicine was suspended by the New York State Department of Health. He had been correct in assuming he wouldn’t be able to continue operating on patients when he rushed to increase his income before that happened.
    His malpractice insurance made a settlement with Dan Smith, and Dan put it in a fund for his and Sarah’s children.

Part Five
Last Dance

11
    W hat had happened to Sarah Smith to cause her brain to die? The answers weren’t easy, and it would take the combined efforts of medical investigators, skilled detectives, and clever prosecutors to find them. They could not bring Sarah back, but they wanted to know whether she had died because of some undetected prior medical condition or through an outrageous instance of medical malpractice.
    The first of the investigators were the local police. Captain Florian Jablonski and Detective Robert Fiscus of the West Seneca Police Department visited Anthony Pignataro in his office at 531 Center Road in their town on August 29, 1997, two days before Sarah was declared dead. At ten that Friday morning, they were ushered into the doctor’s office. He told them that his attorney had advised him not to talk to anyone about Sarah Smith. But then he smiled and said that since Jablonski and Fiscus were detectives, he would be glad to talk with them.
    Asked who was present during Sarah’s surgery, he said that Janie Krauss, the LPN who worked for him, was there and that his wife, Deborah, had acted as a gofer to get the instruments as he needed them. He explained Sarah’s operation to the two detectives, saying that he had given her a local anesthetic and then something that allowed her to drift in and out of consciousness.
    Pignataro gave them a description of the TUBA procedure. But somehow, he said, something had gone wrong, and he detailed how carefully he had given emergency aid to Sarah Smith when she went into cardiac arrest.
    Doing breast surgery through the belly button sounded very peculiar to the two detectives from West Seneca, but Anthony Pignataro assured them that it was common in California and that it would soon be “very popular” in New York State.
    When his patient had suddenly stopped breathing, he had administered immediate resuscitation efforts, of course, and instructed his office personnel to call for help. During this interview, four days after Sarah Smith went into a coma, Anthony assured the investigators that his prime concern had been for his patient and her recovery. But now, he said, he had to apologize to them because he had patients to see, and he could give them no more of his time.
    Two days later, Sarah Smith was dead.
     
    Frank Clark, the district attorney of Erie County, New York, oversaw an office with numerous assistant district attorneys to handle the different divisions. Like any city, Buffalo had its felonies and misdemeanors, domestic abuse, sexual assaults, arson, robberies, drug violations, and, of course, homicides.
    Although there were ongoing investigations into the medical skill—or lack of it—of Anthony Pignataro, M.D., before September 1, those had been under the aegis of the New York State Department of Health. With the death of Sarah Smith, the Erie County D.A.’s office was drawn into the case of a doctor who had a disturbing history of patient care. While the Department of Health works with local law enforcement departments, the Buffalo-based D.A.’s office has sixteen of its own special investigators, most of them seasoned detectives with years of experience in other agencies. Jonathan Coughlan, Chief of the Special Investigations/Prosecution Bureau at the time, called two of the D.A.’s prime investigators and asked them to look into Sarah Smith’s death.
    Pat Finnerty and Chuck