Last Dance, Last Chance

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    Whatever the source of Debbie’s massive poisoning, treatment had to begin at once. The preferred method of getting arsenic out of her system is chelation therapy. Debbie would be given capsules of Succimer (DMSA), an agent that would bind with the heavy metal of the arsenic in her bloodstream and render it weaker and weaker as it left her body, but she had so much arsenic in her body that they wondered if it wasn’t too late. It would take nineteen days of chelation therapy to go through the whole course of Succimer treatment.
    Somehow, Debbie had been poisoned with one of the most infamous poisons known to man—and yet, for the moment, she was alive. It would take a while to see how much permanent damage had been done to her liver, kidney, and heart functions.
    Anthony doubted the diagnosis, and he didn’t tell anyone about it. Instead, he demanded that Debbie have surgery to take out her gallbladder. That, he insisted, was her real problem. Until that happened, he was convinced that she wouldn’t get well.
    And her doctors looked at him, amazed. For her to undergo any kind of surgery in her condition would be akin to signing her death warrant. She probably wouldn’t live long enough to waken from surgery. They stonewalled his demands.
     
    With the diagnosis of arsenic poisoning by some unknown cause, it was mandatory for the Erie County District Attorney’s office to be notified. Frank Sedita, Chuck Craven, and Pat Finnerty were not really surprised that they were hearing about Anthony Pignataro and a patient in critical condition only eight months after his release from prison. All kinds of possibilities came to mind. The wild card was that the patient was Pignataro’s own wife—the same wife who had stood beside him with unflinching loyalty when he was investigated for Sarah Smith’s death.
    One of Sedita’s strongest memories was a phone call from the Poison Control Center. “They asked me when the patient’s funeral was,” he recalled. “And I said, ‘There is no funeral—she’s alive.’ They couldn’t believe it. It was unheard of that anyone could have more than 29,000 micrograms per liter of arsenic in them and be alive. But Debbie Pignataro was.”
    Debbie had both disliked and feared Frank Sedita when he cross-examined her in the grand jury after Sarah Smith’s death, but now he was on her side—although she didn’t know that yet.
    And so were Chuck Craven and Pat Finnerty. The two D.A.’s investigators had great expertise in any number of areas, but they had never worked on an arsenic poisoning case before.
    “Both of us are interested in finding out new ways to investigate,” Craven recalled, “and we learn wherever we can. We’re always watching shows like Justice Files and the Discovery channel documentaries on television. And we found a lot of information on the Internet. We played catch-up fast on arsenic.”
    There was a great deal of information on the Internet about poisons. Sedita, Craven, and Finnerty read everything they could find about arsenic poisoning. They learned that it is tasteless and odorless and that its crystals look like sugar. Absorption occurs primarily through the digestive tract, although some arsenic can be taken up through the skin. Once arsenic is in the body, it binds to hemoglobin, plasma proteins, and white blood cells and is then carried to the liver, kidneys, lungs, spleen, and intestines. After a few weeks, arsenic deposits can be found in the skin, hair, nails, bone, muscles, and even the nervous tissues. Ingestion of arsenic often leaves white marks on the fingernails, called “Mees’ lines.”
    “We learned how to check for arsenic deposits by watching one of the Justice Files shows,” Craven said. “You can find it by taking hair cuttings, fingernail cuttings, and urine samples. You can almost date the times the victim was given arsenic—particularly when they’ve been given large amounts.”
    Although they couldn’t really question Debbie at the moment—she was fighting for her life—they would have heard answers that rang true for arsenic poisoning. Those with acute exposure suffer from nausea, vomiting, and diarrhea. They have low blood pressure and a rapid heart rate, and they may complain of a metallic taste in their mouths. Some have a garlic odor on the breath.
     
    An armed guard was placed outside Debbie’s room in Buffalo Mercy Hospital, and her visitors were carefully monitored. Anthony was her most faithful