On the morning of Jan. 5, eight officers in wide-brimmed military hats stood prepared to do whatever was necessary to guard against the vices of sloth and disobedience at a Panama City juvenile boot camp.
Nurse Kristin Anne Schmidt had a different task. Clad in a white lab coat, Schmidt's job was to guard against other dangerous threats: fatigue, dehydration and hidden ailments that can lead to physical distress among youths engaged in rigorous exercise at the camp.
That morning, in what were certainly the most fateful moments of Schmidt's medical career, the eight officers punched and kneed 14-year-old Martin Lee Anderson while Schmidt stood a short distance away looking on. Minutes later, after Schmidt examined him with a stethoscope, the teen left the boot camp on a stretcher, unconscious and not breathing. Within hours, he was dead.
Medical ethicists say Schmidt's actions that day are the most telling example, since the 2003 appendicitis death of a teen at the Miami juvenile lockup, of how the decisions of healthcare workers in jails or prisons are fraught with danger if they conflate the ethics of a penal system with those of their own profession.
"When judgment calls have to be made, you must err on the side of protection, " said Arthur Caplan, chairman of the medical ethics department at the University of Pennsylvania School of Medicine. "She was there as a nurse. She was not there as a guard."
'A REAL RISK'
In penal settings, Caplan added, "There's a real risk that nurses and doctors will grow a pair of handcuffs, or grow a baton."
Schmidt, 52, may face trouble on two fronts: a special prosecutor, who is investigating the circumstances of Martin's death, and the state Board of Nursing, which oversees the profession. Both Benjamin Crump, the attorney for Martin's family, and an unidentified Florida nurse have filed complaints against Schmidt with the state.
There is precedent for charging healthcare workers with a crime when prosecutors feel they failed to help juveniles in distress.
In Miami, a grand jury indicted two nurses on charges of second-degree murder and manslaughter in the death of 17-year-old Omar Paisley. The youth died of a ruptured appendix at the Miami-Dade juvenile lockup after medical staff allegedly ignored his pleas for help.
The nurses are awaiting trial. The prosecution, which is extremely rare, will not be easy - essentially trying to prove something should have been done and wasn't - said Miami-Dade State Attorney Katherine Fernandez Rundle.
"We had a lot of lawyers with different opinions about the case, " Rundle said. "But I'm a parent. And you just think of a child treated in this way, and it's heart-wrenching. It is intolerable in a civilized nation like ours. It is unspeakable that these things happen here."
Schmidt, a registered nurse, has declined requests for an interview. She has worked at the Panama City boot camp, which operates under a contract with the state Department of Juvenile Justice, since it opened in 1994. Unlike the guards involved in the incident that day, who have been placed in positions where they have no contact with the youths at the camp, there was no change in Schmidt's status.
Schmidt attended Alfred University School of Nursing in New York, from 1977 to '79, according to her Florida Board of Nursing application.
From 1984 to 1986, records show Schmidt worked at the Anneewakee Hospital, a treatment center and wilderness camp for about 150 troubled boys in Carrabelle, in the Panhandle. The treatment center was closed in 1986 amid allegations of widespread abuse and molestation of children. The Herald has found no evidence Schmidt was involved in any incident.
Following Anneewakee's closure, Schmidt went to work at Florida State Hospital, a 1,100-bed locked mental hospital in Chattahoochee, where she was a senior registered nurse coordinator.
In 1991, Schmidt worked at the Rivendell Psychiatric Center in Panama City. In August 1992, while at the mental hospital, state medical regulators charged Schmidt with failing to keep proper records of how she dispensed tranquilizers. Schmidt was reprimanded and fined $250, records show. Between 1992 and 1994, Schmidt worked for a nursing home, a home health agency and the American Red Cross.
Since going to work at the Bay Boot Camp, she has earned consistently high marks on her performance evaluations. Schmidt, who is paid $38,155 a year, was praised in her June 2005 evaluation as "a longtime employee that does her job well, " as "consistent and dependable" and who "works in the best interest of all involved."
As for her observation of "established rules and regulations, " Capt. Mike Thompson wrote that Schmidt "does things by the book."
Shortly after Martin Anderson's death, Schmidt told a Juvenile Justice official that her role in the boot camp's exercise yard "was to monitor the entire group [of new inmates] for labored breathing, irregular movements [and] any form of physical distress during the exercise drills."
Schmidt made the comments to Dr. Shairi R. Turner, the department's chief medical director, who wrote a report on the teen's death.
Schmidt first noticed Martin while he was "against the wall" with "drill instructors on either side of him to 'maintain control, ' " Turner's report said. "He was noted at times to be on his feet and then laying down during the 'use of force techniques.' "
'COULD NOT BREATHE'
While Schmidt was checking Martin's heart rate, he told her "he could not breathe, " Turner wrote.
But the nurse took no action, saying "he appeared comfortable and in no respiratory distress."
That was Schmidt's first mistake, said Nancy Hamilton, chief executive officer of St. Petersburg's Operation PAR drug treatment program and president of the Florida Juvenile Justice Association.
"In our world, your obligation is first to the client, " Hamilton said. "I don't care if the client is faking it. You call 911 and get him to the hospital. Then you deal with him faking it later on. You never take a chance when someone says, 'I can't breathe.' "
"I would rather deal with the expense of a hospital visit than a dead child any day, " Hamilton added.
A videotape of the incident shows that 15 to 20 minutes elapsed between Schmidt's first contact with Martin and the next time she examined him.
Schmidt spent most of that time observing officers as they punched, kneed and applied pressure points to Martin as he remained limp.
Schmidt "stayed by the youth and watched for 'any distress, ' " Turner wrote of her debriefing of the nurse. "When she noted the youth stopped 'fully complying' with the officers, she went inside to retrieve [the sergeant] to make him aware of the situation, " Turner wrote. "When they returned to the youth, he stated that 'he could not see and he could not breathe, ' " Turner added.
Paramedics arrived within four minutes , the report said. On the tape, Martin is lifted onto a stretcher, his arm dangling from the side. Kenneth Goodman, who heads the University of Miami's bioethics program, calls Schmidt's behavior a cautionary tale for medical professionals who work in corrections programs: "In environments like this, all bets are off because you're not merely doing healthcare.
"You're in a highly charged situation, and I would imagine the pressure on her is to accommodate her law enforcement colleagues." Click on today's extras to view video of the Boot Camp Beating incident