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[May 31, 2007]

Heart failure or homicide?: A doctor thought Lilly Mae Harmon died of heart failure. Harmon's daughter suspected otherwise. When police wouldn't investigate, the daughter sought a second opinion.

(Fresno Bee (CA) (KRT) Via Thomson Dialog NewsEdge) May 31--Betty Harmon thought her elderly mother's death was suspicious.

The mysterious withdrawals from her mother's bank account in Fresno and the strange leg ulcers and discolored feet made Harmon think her mother was the victim of murder.

But nearly every government agency she asked to investigate declined. "Nobody was believing me," Harmon said, "so I had to prove it."

First, she hired a private investigator to find out who took money from 85-year-old Lilly Mae Harmon before and after she died in December 2004. Then she spent more than $12,000 to exhume her mother's body and fly it out of state for a private autopsy.

Two months ago, the results came back: Lilly Mae Harmon died from arsenic poisoning, suggesting a homicide, according to the autopsy report.

"This is exactly what I told them -- that she was killed," Harmon said. "Why did the coroner refuse me? Why did no one help me?"

An official with the Fresno County Coroner's Office, which twice declined to delve into Lilly Mae Harmon's death, now admits his office made a mistake.

"There is a degree of egg on your face when someone calls you and says, 'Actually we did get an autopsy and it does show this,' " said pathologist Michael Chambliss, who advised the then-coroner not to investigate the death. "We made a bad judgment call."

On the strength of the evidence Betty Harmon obtained, Fresno County law enforcement agencies are now taking a closer look at her mother's death.

Blackened feet

Lilly Mae Harmon, a widow who attended college in her mid-50s to become a teacher, had been having heart problems for years, and in the year leading up to her death she was hospitalized three times, her daughter said.

Her last trip to Community Regional Medical Center fell on Nov. 21, 2004. Betty Harmon, who flew to Fresno to visit her ailing mother, found her weak and frail, with leg ulcers and blackened feet.

After two weeks in the hospital, she was transferred to Beverly Living Center-Fresno and died on Dec. 6, 2004.

Her attending physician, Dr. Kevin Nguyen, concluded she died of congestive heart failure.

Nguyen could not be reached for comment, and a spokeswoman for the nursing facility, Debi Witt, declined to comment, citing medical privacy law.

Natural deaths at medical facilities like nursing homes do not have to be reported to the Coroner's Office, and this one wasn't.

Betty Harmon, a computer programmer living in Minnesota at the time, said she doesn't have a clear understanding of her mother's medical history. But she did not believe her mother's death was natural, and says she asked the nursing home staff to request an autopsy.

They didn't.

Without a second look, Lilly Mae Harmon's body went into a grave at Odd Fellows Cemetery along Belmont Avenue.

Soon after, Betty Harmon discovered thousands of dollars in automatic teller withdrawals from her mother's bank account before and just after Lilly Mae Harmon's death.

She was suspicious of her mother's neighbor, Theresa Centeno, who had been acting as Lilly Mae Harmon's informal caretaker for several years.

On her deathbed, Lilly Mae Harmon would not talk to Centeno, the daughter said.

After her mother died, Betty Harmon pressed local law enforcement to look into the withdrawals.

For weeks, as she delayed her return to her home in the suburbs of St. Paul, Minn., she got bounced between law enforcement agencies.

The Sheriff's Department initially took the case because Lilly Mae Harmon lived in the county's jurisdiction on West Beran Way southwest of Fresno -- her home for decades. But the bank transactions occurred in the city of Fresno, so Fresno police detectives -- after refusing the case at first -- said they would take it over.

The detective who was assigned the case, Henry Monreal, says he believed the Police Department was only going to assist the Sheriff's Department and only did basic fact-finding.

In the end, no arrests were made.

Harmon grew weary of the inaction. In early January, she hired a private investigator, Jeffrey Pearce of Fresno, to find out who took her mother's money.

Pearce got an answer in less than two weeks: Centeno. He says that Centeno, in a face-to-face interview, confessed to taking the money, so Pearce passed on his findings to Fresno police. Still, nothing happened.

Frustrated, Harmon contacted the state attorney general's elder abuse unit, which agreed to investigate the thefts. Fearing she would be considered crazy, she did not mention her suspicions of homicide.

A state investigator found at least eight withdrawals amounting to $7,000, including some while Lilly Mae Harmon was hospitalized and after she died.

The state investigator referred the findings to the Fresno County District Attorney's Office, which in May 2005 charged Centeno with three crimes.

On Sept. 21, 2005, she pleaded no contest to one of them: theft from an elder or dependent adult by a caretaker. The other two charges -- grand theft and using an access card unlawfully -- were dropped. She was sentenced to 90 days in jail and five years of probation, according to court records.

But Betty Harmon wasn't through.

Urging an investigation

With the theft resolved, she urged prosecutor Tim Donovan to investigate her mother's death. He told her the District Attorney's Office's homicide unit would look into it. She said she heard nothing back.

Convinced local authorities were doing nothing, Betty Harmon contacted the state attorney general's elder abuse unit again in November 2005.

This time, she didn't hold back.

"Theresa Centeno consciously lied and covered up the money she was stealing from my mother," Harmon wrote in one of two letters to the agency.

"I believe Theresa Centeno became desperate and she chose to kill my mother," she wrote in the second letter.

Centeno, 45, denies that she poisoned Lilly Mae Harmon.

"I had nothing to do with Miss Harmon that way. I would never hurt her like that," she said in an interview last week. "I even took her to the doctor. She would tell the doctors that I was her daughter."

She also said that Betty Harmon likely believes she is responsible for the death "because I've been in trouble." Centeno, who has since moved to a different neighborhood, suggested that one of Lilly Mae Harmon's relatives poisoned her.

Centeno acknowledged taking money from Harmon's account but said she did it to pay Harmon's bills. She said she pleaded no contest to the crime because, if she hadn't, she was facing a lengthy prison term.

A no-contest plea is not an admission of guilt but is treated as such for sentencing.

State authorities, who had not previously heard Harmon's suspicions about murder, agreed in December 2005 to look into the death. But the case did not stay open for long.

Prompted by an inquiry from the state, the Fresno County Coroner's Office -- which had previously decided not to investigate the death -- agreed to take a second look. Using medical records and photos of her body, coroner's officials concluded that the discoloring of her feet and the ulcers on her legs were the result of her medical problems, not signs of poisoning as Harmon suggested. They decided there was no need to exhume her body.

With the coroner's analysis in hand, the Attorney General's Office closed the case in February 2006 due to "lack of sufficient corroborating evidence."

"Our decision was based on the coroner's report at the time," said David Kravets, spokesman for the Attorney General's Office.

The news hit Harmon hard. She was out of work and had spent the past year shuttling between Fresno and her home in Minnesota.

"I was depressed. I was so upset," she said. "I had no money. I didn't know what to do."

She did not give up, though.

Through the Internet, Harmon got in touch with a business named Expert Witness, which links forensic consultants or experts in other fields with lawyers, businesses and private parties. The company helped set up the autopsy with a forensic pathologist in Lincoln, Neb.

To pay for it, Harmon took out a loan on her mother's house, which she inherited, and borrowed money from friends.

Then, in September 2006, she got a permit from the county health department to exhume the body.

'We missed it'

The autopsy was performed in September 2006, by Dr. Matthias I. Okoye of the Nebraska Forensic Medical Sciences. The most critical part -- the toxicology tests -- were done at the St. Louis University School of Medicine.

The autopsy's conclusion: "The manner of death is consistent wtih (sic) homicide. The toxicologic analysis shows recent acute and chronic arsenic poisoning."

In a phone interview, Okoye described the conclusion in layman's terms: Lilly Mae Harmon was given a dose of arsenic within several hours of her death, but had also been exposed to the poisonous element for a period of time prior to that.

Betty Harmon got the autopsy results in March. She sent the paperwork to the District Attorney's Office, which referred the case last week back to Fresno police.

Chambliss, with the Fresno County Coroner's Office, concedes now that the office should have brought the body in for examination.

He says Harmon's age and extensive medical history played a role in its decision to label the death natural, adding that arsenic poisoning can disguise itself as other health conditions, including congestive heart failure. Leg ulcers and discolored skin are two symptoms of arsenic poisoning, as are stomach pains, vomiting, diarrhea and cramps, according to the federal Centers for Disease Control and Prevention.

"At the time, there was nothing I saw that should have warned us to bring the case over here to do an autopsy," he said.

Bob Hensel, a retired chief deputy coroner, said the photos of Harmon did not show the wartlike growths that are an indication of chronic arsenic poisoning. They also didn't see white lines in her nails -- another red flag, according to Hensel.

"The pictures of her legs didn't look anything like that," Hensel said.

He also said the discoloration in Harmon's feet was no different than what he's seen in thousands of elderly people who had poor circulation when they died.

But, if the death is confirmed as a homicide, "we missed it and they found it," Hensel said.

Fresno police have opened a suspicious death investigation but have not yet assigned a homicide detective to the case, Lt. Mark Salazar said this week. He said they want to talk to Okoye, the Nebraska doctor, and determine whether the death is a homicide.

Harmon is pleased that her mother's death is getting attention, but her feelings are bittersweet. She's angry that it took so long for authorities to listen to her. And she doesn't want Fresno police involved; she wants the Attorney General's Office to do the investigation.

"I'm concerned they're not going to do a thorough job," she said of Fresno police. "I definitely lost trust in them."

Harmon says she's shopping for a lawyer to pursue a lawsuit against the departments or agencies she believes failed her. And a local civil rights activist, the Rev. Floyd Harris Jr., sent a letter asking federal authorities to investigate the "inappropriate behavior" of those agencies.

Harmon plans to stay in Fresno until the case is resolved and isn't sure she'll return to her former hometown of Maplewood, Minn.

And she also wants closure for her and her mother. Sunday evening, Harmon held a vigil at Lilly Mae Harmon's grave to memorialize her mother.

She's hoping it will allow her to mourn her mother's passing, now that she's done all she can to ensure her mother's death will not be forgotten.

"I really haven't had time to grieve," she said. "Maybe this will be the beginning."

The reporter can be reached at teberly@fresnobee.com or (559) 441-6465.

To see more of The Fresno Bee, or to subscribe to the newspaper, go to http://www.fresnobee.com
Copyright (c) 2007, The Fresno Bee, Calif.
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