Emergency Room Doctor, Police Officer Testify in Stewart Trial
An emergency room doctor told jurors in the Robert Stewart murder trial Thursday how the ER was flooded with wounded and dying people from murderous rampage at Carthage nursing home two years ago.
Dr. Michael Harmody is one of a number of doctors who are partners in Pinehurst Emergency Physicians. Harmody, who was on duty that Sunday morning, saw both victims and Stewart He examined and treated the most critical, while other doctors helped with those whose wounds were not as bad, he testified.
Stewart is charged with eight counts of first-degree murder in the March 29, 2009, shooting deaths of seven elderly patients and a nurse at Pinelake nursing home. He faces the death penalty if convicted.
He has admitted that he killed eight people, but his attorneys say he does not remember anything that day and that he was not in control of his actions because of the prescription drugs he was taking.
Harmody told of examining Tessie Garner, who would die from a shotgun blast to her left upper abdomen, according to testimony.
“She was critical,” he said. “Her low blood pressure suggested major life-threatening injuries. She was very anxious as one might expect.”
Harmody said he couldn’t stay with Garner. He said he looked in on Jerry Avant, the nurse who later died, and spoke briefly with Stewart.
He said he also checked on Carthage police officer Justin Garner, who had some shotgun pellets in his leg. Garner, who ended the shooting rampage with a single shot, took the stand Wednesday.
Harmody said he saw Michael Cotton, the man Stewart shot in the nursing home parking lot. Both were released later, Harmody said.
He said he had noticed that Stewart was in handcuffs when brought into the ER and that law enforcement officers kept him under guard.
County Medical Examiner Max Muse also took the stand and told how there had been so many deaths, he had to call another county medical examiner for help.
He was his way to the First Presbyterian Church in Carthage that Sunday when he heard the radio call. A minute later his pager went off.
“I went in through the front door with the trama bag — anything you need to give first aid,” he said. “The first thing I saw was a very small, very frail female slumped over in a wheelchair with a large amount of blood. I checked for a long time for any sign of life and found none.”
Muse said he went down the hall and turned left toward the nurse’s station. He had been to Pinelake many times, but this was different.
“I could hear crying, shouting, alarms going off,” he said..
Muse found another woman slumped in a wheelchair with an abdominal wound, she was missing a thumb. Checking her pulse and finding none, he reported that person was deceased also.
“At that point, someone directed me to the nurse that had been injured,” he said. ”They took me to the nurse at the end of a hall by a door with windows that were broken out. He had been shot. It appeared to be multiple times. I noticed a broken femur — the largest bone in the body, from your hip down to your knee. He could not move.”
It was Avant, and he was conscious, could speak with Muse.
“I asked how he was breathing,” Muse testified. “He said ‘a little tough.’ (On the radio) I said I needed the next ambulance for this gentleman. His blood pressure was fair, 100 over 60.”
But it was dropping quickly, a bad sign Muse knew.
“I might have waited a minute or two, then it was down to 80 over 40,” he said. “He was going into shock, and he needed to be in the OR. Several members of our rescue team arrived.”
Muse knew Avant’s fiancé, Jill DeGarmo, because she had volunteered with the Carthage Rescue Squad.
“Jill came around the corner and was crying, talking to him,” Muse said..”They brought me an oxygen concentrator that plugs in the wall, but it only makes a low flow.”
That device could provid only a third of what Avant would need with a mask, and there was no place to plug it in, Muse said.
“Bullet holes, the blood was just coming out,” Muse said. “He said he knew he was going to die. Jill was at his side. They prayed together.
“He said he knew that he was dying and asked if Jill would pray with him. It was very eerie having him say that he was dying. He was in a great deal of pain. He was very stoic about it. He had multiple gunshot wounds, a fractured femur, blood loss.”
On Wednesday, Garner testified about how he entered the nursing home to confront the shotgun-wielding Stewart and end his carnage.
The most exciting two minutes of that young police officer's career started in the nursing home parking lot. Former Carthage officer Justin Garner, gun drawn, entered Pinelake responding to a radio call of shots fired, he testified Wednesday morning.
Garner is now a cadet completing his last six weeks of training for the state Highway Patrol. His replies to lawyers were crisp, near military in style.
“I opened the front door and proceeded in, sir,” Garner said, replying to Prosecutor Peter Strickland on direct examination. “When I opened the door, a lady came running out screaming there was somebody inside shooting. She continued running, shouting as she came running by. I proceeded through the hallway.”
The first thing he saw was a dead body.
“There was a female in a wheelchair that apparently had been shot,” he said. “There was no time to check her. There was no movement, appeared to be no life about the woman.”
At the end of the entry hall, a woman was pointing to his left, Garner testified. He said he made the turn.
“I heard some gunshots," he said. "I knew about where they were coming from, to the right. It was roughly four shots. I proceeded to the location where I heard the shots.”
Down that short hall, Garner said he received more directions from a man in front of him standing on the other side of a nurse’s station and pointing down the hall to the right.
“He initially threw his hands up in the air, I guess signifying he was not a threat,” he said. “I then took a right into — I guess it was the 300 hallway – and observed a subject step out carrying a shotgun, a long gun. He had the shotgun over his left shoulder. He was reloading it.”
The man seemed to take no notice of a uniformed police officer pointing a gun at him, Garner testified.
”I already had my weapon out as I was going through the building,” Garner said. “As he came around the corner I drew down on him.”
Garner said he commanded the man to drop his shotgun.
“I instructed him to drop it three times, ” he said. “He was reloading. He had the stock up over his left shoulder and was putting rounds into it.”
Garner said he gave the order three times.
“I said ‘Drop your weapon! Drop your weapon! Drop your weapon!’ and he just continued moving forward,” he said. “He turned toward me and was lowering the shotgun down in my direction. I then fired my weapon, sir. I fired once.”
The shotgun went off, and Garner felt something strike his left leg. He stepped sideways into a nearby room for cover. Seconds later, when he looked out, he saw the man was down.
“I stepped back into the hallway and observed the subject on the floor laying face down, sir,” he said. “I ordered him to put his hands behind his back. He complied.”
Garner handcuffed the man.
“It took two sets of handcuffs in order to get them on him, but there was no difficulty,” he said. “The shotgun he was carrying was laying on the floor to the right of him. There was a revolver in a holster on his lower back attached to his belt. I immediately secured the gun, unloaded it. I unloaded the shotgun and leaned it up against the wall.”
Garner said he spotted a hospital-type lunch cart nearby and placed the revolver and all the bullets on its tray..
“Possibly five bullets," he said. "It was fully loaded. I then removed the subject’s ID and asked was there anybody else with him. He said no, he was by himself. He had a North Carolina driver’s license in his right rear pocket in a wallet. At the time, I couldn’t see the subject’s face. He had suspenders on, and some type of red shirt.”
Garner identified Stewart as the man he handcuffed.
“He kept saying ‘Kill me,’ ‘Kill me ‘’Just kill me,’" Garner testified.
Garner waited by his handcuffed prisoner as backup arrived. He had reported “on scene” at 10:03 and “suspect down” at 10:05 that Sunday morning — one minute, 42 seconds in all.
On Tuesdaym the jury had chilling testimony that described the last hours of the nurse who died in a murderous rampage in March 2009 at Pinelake nursing home in Carthage.
Jill DeGarmo is a nurse who worked with Alzheimer’s patients for more than 20 years. She was at Pinelake the morning Stewart killed eight people. Seven were elderly residents. One was another nurse, Jerry Avant, who was her fiancé.
Because of their relationship, DeGarmo and Avant worked in different areas, she in the Alzheimer’s area — called the TLC Unit, or just “the unit”— and he up front. They seldom saw each other at work.
She worked weekends so she could study weekdays, trying to complete the last academic work to get her R.N. Avant was further along, only two weeks away from his. They planned an August wedding.
The couple had been together for a number of years, living together in Carthage not far from the nursing home with her twin boys, now 17 years old.
“They loved him,” DeGarmo said. “To them, that was their dad. He bought my engagement ring in '07 and wedding ring in '08. I wanted to wait to settle some old bills, things I didn’t want to bring into our marriage.”
DeGarmo’s schedule meant 16 hour days in the TLC Unit caring for patients with Alzheimer’s. When she heard he had been shot, she had no thought other than getting to him as fast as possible.
“I ran out, looking for Jerry,” she said.
Just outside the unit she saw a badly wounded man.
“I remember seeing the hole in his back in the right side of his shoulder," she said. "He was still in his wheelchair.”
DeGarmo said she checked for a pulse. He was dead, so she hurried on.
“I wasn’t walking; I was running,” she told raptly attentive jurors. “I wanted to get to him immediately. As soon as I’d heard that Jerry had been shot, my main focus was Jerry only.”
She said she rounded the corner into the long 300 hall, where Stewart was handcuffed and surrounded by officers, and rushed left into the service hall, where Avant lay bloody and fading fast, his broken leg tucked beneath him at an angle.
“I was kind of upset, because I couldn’t figure out why he was by himself,” she said.
DeGarmo said she was cradling him and reassuring him.
“He was quiet, telling me he was dying," she said. "I kept telling him he was going to be OK. His right upper leg — his femur — was broken. It was bent back at an angle against his left lower leg. I knew it was broken in two. He asked me to move his leg. I didn’t want to tell him. I said I didn’t want to. I said, ‘Jerry I can’t move your leg.’ That’s when he knew his leg was broken.”
A co-worker was there with some explanations, helping DeGarmo fill in the blanks about the terror of that morning, according to testimony.
“My whole focus was Jerry,” she kept repeating. “I remember some small like pellets, like a BB, on the right side of his leg. I remember seeing those pellet wounds. I knew the femur was life-threatening, but I didn’t see any blood — no.”
Avant told her nothing of how he had been shot, only asking his fiancé for one thing.
“He asked me to pray with him” she said.
The two prayed silently, waiting.
“I could see Jerry was losing consciousness, didn’t think it was the blood at the time, just thought it was because of what he’d just gone through,” she said. “He didn’t complain of any pain, but I could see the pain in his face.”
Other help arrived and helped DeGarmo get oxygen for Avant.
“I remember running down the hall to get the oxygen tank for Jerry,” she said. “Some people were with me, but I tuned them out. Max Muse showed up — we used to run rescue calls together. Max was helping him, and I was keeping Jerry awake. He was losing consciousness, and I was trying to keep him awake.”
Paramedic vehicles were driving behind the building, and Muse asked her to go out and stop them. She could not get the door open, because broken glass from large side windows was keeping it from opening, according to her testimony.
“Another man helped me open the door and go out and stop the next EMS vehicle that came through,” she said. “Next one came through, they stopped. Max was looking for his scissors to cut away his pants to stabilize his leg.”
Avant was barely awake and his color not good, she testified.
“He was still losing consciousness,” she said. “I talked to him all the way until they were loading him up. I could see the color in his face going.”
He told her once or twice that that he was dying, but had one real plea.
“He just wanted me to pray with him,” she said. “That was the most important thing to him, just praying.”
DeGarmo didn’t go with Avant on the ambulance, ceding that space to EMS responders she knew would do everything they could to save him on the way.
“I needed the ones that could take care of him better to be with him,” she said.
After the ambulance left, DeGarmo ran down the hall to get her keys so she could follow the ambulance to the hospital. A deputy stopped her. Stewart was in the way.
“That’s when I saw Robert Stewart,” she said. “They were standing up, handcuffing him, and there was another deputy on the other side of him. He was probably about three or four feet from me. He was standing up. He was handcuffed.”
Finally, with her keys, she left through a side door and raced around the building. She said she never dreamed Avant would die. She only wanted to be with him at the hospital.
“You got to understand that not one minute, not one second, did I think anything was going to happen to him,” she said, now visibly shaken, but forcing herself to remain calm on the witness stand. The courtroom was silent.
DeGarmo said she raced home to pick up the twins and her older son Chris, now 23, but they were taking too long. They stalled, she said, as if they thought she was joking. DeGarmo told them she was leaving and went alone to the emergency room.
“I wanted to get to the hospital as quick as possible,” she said. “He was already in the operating room. I was in the waiting area, and I told the lady I needed to go back, needed to be with him.”
She was not allowed through. She said she noticed two other nurses come in.
“I was trying to take all this in — it was hard for me to accept all this,” she said. “A few minutes later, a lady came in and told me to contact the family. I looked through my cell, but it was dying. I called information and got his aunt’s number — told her Jerry had been shot, get there as quick as possible.”
Before the family showed up two doctors came in, scrub hats still on. They told DeGarmo that Avant’s heart had stopped, but they got it back and were going back in to work on him.
“It seemed I was there for hours,” she said. “I was there a long time. His father, his aunt, his sister and his grandmother showed up. There was a priest who wanted to sit down with me and pray with me. I do remember some family members of others came in. Some sat on the floor. I remember one lady was very upset, then was told her family member would be better.”
News she had not dreamed possible was coming.
“There was a nurse that came in, still had scrub hat on, was going to take us to another room,” she said.
DeGarmo said she was preoccupied, in her mind already rearranging their house.
“He couldn’t go up stairs with his leg," she said. "She took me to this room, but whatever I said was upsetting her.”
The nurse told her Avant had died.
“She looked at me and said, ‘He didn’t make it,’" DeGarmo testified. "I said, ‘What are you talking about?’ I said, ‘You are lying. You are not telling the truth.’ I told her take me to him.”
The nurse, tears falling down her own face, took DeGarmo in.
“I remember the sheet being across him, over his face,” she said. “I remember pulling the sheet off his face. I remember the cuts they made trying to save him. I remember the moon-shaped cut over his heart.”
Nothing seemed real, she said.
“I could not believe this was really happening, that someone I loved and was going to spend the rest of my life with was taken from me for no reason. It has been over two years, and I still can’t believe it.”
The Avant family came in, and his father moved to the side of his son’s body, DeGarmo said.
“I remember his dad putting his thumb on Jerry’s forehead and saying there was a cut on Jerry’s head he got as a boy," she said. "I remember my daughter screaming, the horriblest screaming I’ve ever heard in my life. I think she thought it could have been me.
“The only reason they let my daughter through was she worked at Moore Regional Hospital, and the doctors knew her. They wouldn’t let his preacher through. They wouldn’t let my sons through.”
Avant had served in the Coast Guard for 10 years. Photos of him from that time had been in the home they shared. Assistant District Attorney Peter Strickland had DeGarmo identify a photo of Avant beside a plane he had worked on when in service.
“He was very loving, very caring,” DeGarmo said, looking at the picture. “He was the best nurse I’ve ever seen.”
In earlier testimony Tuesday, former Pinelake employee Wilean Fletcher said that Sunday morning "was the most scariest day of my life.”
Fletcher no longer works at Pinelake. In March 2009 she’d worked there about four years. On that Sunday, she heard a commotion in the front hall.
“It was quiet for a while,” she said. “I went out, closed all the doors to my assignment. I saw Jerry, and he told me a man was here and was chasing him with the gun. I told him I called 911. He said they aren’t coming fast enough, let me call him again.”
Avant took her blue U.S. Cellular phone to call, then looked up, she said.
“I turns around and saw Mr. Stewart at the beginning of the service hall, and he was aiming a gun,” she said. “It was a big white man with a beard, with a shotgun. He was aiming it! I ran into the laundry room, and Jerry ran to the back entrance.”
That door wasn’t an emergency exit. It required a code to operate the lock. Fletcher said she had the code, because she smoked cigarettes in those days.
“As long as you got a code,” she said. “That’s where we went out to smoke.”
Fletcher said was at the rear of the laundry room when the shotgun boomed in the hall outside.
“Immediately I heard a gunshot,” she said. “I ran behind a washing machine, and when I got behind, I heard another gunshot. They were in the service hall. A few minutes went by, not many, but seemed like forever to me. Then I heard more gunshots. They sounded farther away.”
Finally, she heard Debbie Gordon on the intercom saying all clear. She came out to find Avant on the floor.
“I seen Jerry laying on the ground, still alive,” she said. “I asked was he all right, and he said no, he’d been shot.”
A man who was at Pinelake to visit Annie Blue came over to where the nurse lay. Fletcher left him taking care of Avant and went to check on her assigned residents.
“I had closed all my doors,” she said. “So. They were fine. One started to ask a question, but I told them everything was OK and shut the door back.”
Near the main nurse’s station she saw Lillian Dunn.
“I saw her with a bullet hole in the chest,” she said. “I went down the 200 hall, saw two more residents dead. And I broke down. About then I lost it.”
A co-worker pulled Fletcher into one of the rooms, where she stayed a few minutes to collect herself. She went to the Alzheimer’s unit where Stewart’s wife, Wanda Neal, was working. Neal told her she feared the shooter might be her husband. Together, they went out into the hallways.
“I saw Robert Stewart laying on the floor on the 300 hall,” she said – the same man she’d seen with the gun. “She seen him laying there, and said, ‘That’s him! That’s him!’ and we went in 401. She was crying hysterically, and I was just there to console her.”
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