Ex-nurse pleads not guilty in patient deaths

Richard Allen Williams.

COLUMBIA, Missouri (CNN) -- A former nurse pleaded not guilty Tuesday to charges he murdered 10 hospital patients by injecting them with lethal doses of a muscle relaxant.

Richard Allen Williams appeared at the arraignment via closed-circuit television from the Columbia jail where he is being housed. He was without counsel at the hearing but has since hired two lawyers.

He was ordered held without bond.

Williams was charged with the murders Monday after authorities said they used newly available technology to find evidence in the 10-year-old case.

Authorities accuse Williams of giving the victims succinylcholine, a powerful muscle relaxant, while they were patients at Truman Memorial Veterans Hospital in Columbia in 1992 when he was a nurse there.

The investigation involved state officials, the FBI and agents from the federal Department of Veterans Affairs.

According to an affidavit outlining the state's case, 41 mysterious deaths occurred on Ward 4E of the hospital between May and August 1992 while Williams was on duty. It was determined that people under Williams' care were 20 times as likely to die as other patients on the ward.

In 1993, authorities obtained permission to exhume the bodies of 13 of those who died. Lab tests at the time failed to reveal a cause of death.

The affidavit says that in January 2001 health care inspectors and medical experts agreed the deaths suggested the patients were given a paralytic-type drug.

Based on the findings, Veterans Affairs Inspector General Richard Griffin recommended new tests using technology unavailable at the time. The new tests indicated that 10 of the 13 victims were given succinylcholine, which can cause muscle paralysis and death.

It is commonly used to induce temporary paralysis of skeletal muscles while breathing tubes are inserted into patients.

Authorities say succinylcholine was commonly present in the hospital in 1992 and that it was available to all registered nurses, including Williams. Authorities say Williams was the only hospital staff member who was on duty in ward 4E when all of the 10 victims died.

Nine of the tested victims were men 58 years old or older and one was a 69-year-old woman.

Boone County Prosecuting Attorney Kevin Crane said authorities have not forgotten the other suspicious deaths. "We do not consider this investigation to be over. It will continue throughout this process," he said.

Crane declined to discuss a possible motive, saying the state does not have to prove a motive in this case.

Griffin credited the persistence of the investigators. "It was never a cold case as far as our organization and the FBI were concerned. We never gave up on the case," he said.