454:. One witness in the affidavit said they saw Dr. Pou request additional syringes filled with saline. According to Kristy Johnson, LifeCare's director of physical medicine, Pou told these patients that she was administering drugs to make them "feel better." The drugs injected are usually given for pain purposes, but not at the levels found in subsequent toxicology reports. Attorneys for the three accused deny any wrongdoing, and say their clients performed heroic acts under unimaginable conditions.
41:
361:, Pou was alleged to have administered a lethal cocktail of drugs to Everett with the intent of ending his life. One person present during the event stated that Everett only died after having his face smothered with a towel. Everett was a paraplegic and weighed approximately 380 pounds (170 kg); for these reasons, according to staff who participated in the discussion, Pou allegedly didn't think the staff could reasonably assist him in the evacuation.
238:
326:
investigation, so the files should remain secret. The following year, Orleans Parish
District Attorney Leon Cannizzaro testified in the same case that "human beings were killed as a result of actions by doctors" at Memorial after Hurricane Katrina. However, he explained that he did not plan to prosecute anyone. "Whether or not there was a homicide and whether or not there is a case that can be brought are different matters."
224:
212:
509:
with the
Memorial case, rather than the dozens to hundreds grand juries normally hear; prosecutors stated it could hear testimony for months. The unusual moves prompted legal observers to speculate that the district attorney considered the evidence ambiguous and wanted to be able to assure the public of a thorough investigation if he decided to drop the case without bringing formal charges.
370:
following weeks, it was reported that staff had discussed euthanizing patients. Some reports went further; Bryant King, an internist at
Memorial, told CNN that he believed "the discussion of euthanasia was more than talk." LifeCare told the state Attorney General's office that nine of their patients might "have been given lethal doses of medicines by a Memorial doctor and nurses."
347:
evacuate the hospital by authorities. Patients on upper floors had to be carried down the stairs, and those evacuated by helicopter had to be carried up more stairs to the helipad on a separate building; several patients died while being moved. By Friday, about 2,000 patients, families and staff had been evacuated "under incredibly difficult circumstances".
484:
questionable after
Minyard announced that he had classified the patient deaths at Memorial as "undetermined," which means that on available evidence he could not classify the deaths as due to homicide or natural causes. Minyard told the media that he had retained some of the nation's leading experts as consultants in the case.
427:
Investigators believed up to two dozen patient deaths might have been homicides, but stated that they had difficulty acquiring the medical records needed to document the patients' conditions. Tenet
Healthcare said it turned over all the patient records it had on the case. Investigators believed that
410:
also wrote in his expert report that all nine of the deaths constituted active euthanasia; the administration of the drugs was "not consistent with the ethical standards of palliative care that prevail in the United States," precisely in that the death of a patient must not be the goal of a doctor's
350:
The seventh floor at
Memorial was leased to LifeCare Hospitals of New Orleans. LifeCare provides long-term acute care for severely ill patients, aiming to improve their health to the point that they no longer need hospital care. Many of LifeCare's patients at Memorial were especially affected by the
513:
Law
Professor Dane Ciolono told the media, "Doing it this way certainly speaks to the ambiguity of the evidence and the prosecutor's deliberation as to whether to seek an indictment. . . . Or it could be that he's made up his mind that he does not want to bring charges and wants the
508:
The grand jury was sworn in on March 6, 2007, and prosecutors took the unusual step of having its meetings at an undisclosed location (i.e. away from the courthouse), in order to prevent the media from observing the identity of witnesses coming and going. The grand jury was selected to deal solely
423:
continued: "Karch flew to New
Orleans, examined the evidence and concluded that it was absurd to try to determine causes of death in bodies that had sat at 100 °F (38 °C) for 10 days. In all of the cases, he advised, the medical cause of death should remain undetermined." Having received
354:
One patient in particular, Emmett
Everett, was alert and in the hospital awaiting surgery to relieve a chronic bowel obstruction, a condition not acutely life-threatening. He had fed himself breakfast that morning and asked the staff, "Are we ready to rock and roll?". One of his nurses later told
499:
Assistant
District Attorney Michael Morales said in 2009 that he and District Attorney Jordan "weren't gung-ho" about prosecuting the case, in part due to negative public reaction. In March 2007, a state grand jury was sworn in to consider the Memorial case. Unlike a typical grand jury, this one
483:
In February 2007, seven months after Pou's arrest, Minyard spoke with the media about the deaths of the LifeCare patients. He had not yet issued a determination of cause of death in any of the cases, leaving them classified as "undetermined". The case against Pou and the two nurses appeared more
401:
and midazolam constituted homicide in many of the deaths on the seventh floor. Wecht thought eight of the nine deaths on the LifeCare floor could conclusively be ruled homicides, and Baden thought all nine constituted homicide. Young stated, "All these patients survived the adverse events of the
547:
Tenet Healthcare, while claiming no admission of liability, ultimately settled the case after jury selection began at a trial in 2011. The company set up a $ 25 million substantial settlement fund for all non-Tenet employees, patients and visitors who were trapped at Memorial during Katrina. To
532:
that every case "should have been declared undetermined, because it is impossible to do a scientific analysis of a cadaver that has been in the sun for 10 days." Karch said after he reached this conclusion, the attorney general's office told him not to submit further reports. Foti lost the 2007
369:
On September 11, mortuary workers recovered 45 bodies from the hospital. Toxicology tests were performed on 41 bodies, and 23 tested positive for one or both of morphine and the fast-acting sedative midazolam (Versed), although few of these patients had been prescribed morphine for pain. In the
325:
in support of the position taken by lawyers for Pou and other doctors and nurses from Memorial, who were fighting to keep the state's investigative records in the case sealed from public view. He said, "the case against Dr. Pou is probably over," but that new information could lead to a renewed
346:
from before Katrina's landfall on Monday, August 29 until Thursday, September 1. By Wednesday, the hospital was surrounded by floodwaters, without sanitation, running out of food, experiencing indoor temperatures up to 110 °F (43 °C), and had no electricity. The staff was ordered to
289:
struck the Gulf Coast on August 29, 2005. In the aftermath of the storm, while the building had no electricity and went through catastrophic flooding after the levees failed, Dr. Anna Pou, along with other doctors and nurses, attempted to continue caring for patients. On Wednesday, August 31,
373:
King publicly charged that one or more health care workers had killed patients, based on conversations with other health care workers. King told CNN that when he believed a doctor was about to kill patients, he boarded a boat and left the hospital. King explained his actions in terms of his
402:
previous days, and for every patient on a floor to have died in one three-and-a-half-hour period with drug toxicity is beyond coincidence." One of the experts, an internist, wrote that Everett was "in stable medical status with no clear evidence that death was imminent or impending".
431:
On July 17, 2006, Pou was arrested and charged with four counts of second-degree murder in connection with the deaths of four LifeCare patients; nurses Lori Budo and Cheri Landry were arrested and charged, but charges were dropped in exchange for their testimony. In a statement,
301:
On September 11, 45 bodies were recovered from Memorial Medical Center, about five of whom had died before the disaster (originally thought to be eleven). Out of an estimated 215 bodies found in nursing homes and hospitals in New Orleans, Memorial had the largest number.
414:
Having received these six reports indicating that at least eight of the nine deaths under investigation were homicides, Minyard sought the opinion of another expert, Steven Karch, who specializes in disputing drug toxicology tests performed after death. According to the
544:, Civil District Court No. 2005-11701 c/w 2006–8861, Division "A", alleged a number of failures by Tenet Corporation, ranging from a failed evacuation policy to the improper location of generators in the basement of the facility, which led to the loss of power.
436:, who owns the medical center, said "Euthanasia is repugnant to everything we believe as ethical health-care providers, and it violates every precept of ethical behavior and the law. It is never permissible under any circumstances." State Attorney General
440:
announced the arrests the next day, at a widely televised news conference. He stated: "This is not euthanasia; this is plain and simple homicide". Foti said he had probable cause to make the arrests based on eyewitness testimony, which was outlined in an
562:
In the four years following Katrina, Pou helped write and pass three laws in Louisiana offering immunity to health care workers from most civil lawsuits (except in cases of intentional misconduct) for their efforts in future mass casualty situations.
305:
In July 2006, a Louisiana judge found probable cause to order the arrest of Pou and two nurses for second degree murder in the deaths of several of the patients, following a nearly year-long investigation by the office of Louisiana Attorney General
1360:
504:
investigator who had spent a year on the case and amassed 50,000 pages of evidence. The two nurses who had been arrested with Pou testified in her defense, after being compelled to testify in return for not being charged themselves.
490:
reported in August 2009 that Minyard privately came to the conclusion that Pou was responsible for the deaths of four of the nine patients: "I strongly do not believe she planned to kill anybody, but it looks like she did."
148:
445:
that stated Pou and the nurses "intentionally (killed)" Emmett Everett Sr., 61; Hollis Alford, 66; Ireatha Watson, 89; and Rose Savoie, 90, by administering or causing to be administered lethal doses of
536:
Since then, the charges have been expunged, the State of Louisiana has agreed to pay Pou's legal fees of over $ 450,000, and several Louisiana lawmakers have apologized for the accusations against her.
500:
dealt with just one case, and functioned as an investigation instead of a review of evidence. The grand jury did not hear from Minyard's experts, some witnesses who had been present, or the
463:
reporter James Varney, they "ignited a furious debate in New Orleans and elsewhere about whether sharp ethical boundaries can be drawn around decisions on patient comfort made in a crisis."
108:
1535:
1339:
548:
receive a share of the money, the eligible had to submit notarized claim forms indicating whether they had suffered injuries. Pou opted in for a share of the settlement.
98:
554:
Three lawsuits (Alford, Everett, and Savoie) initially filed against Pou and other parties were settled; the families had to agree to keep silent about the terms.
419:, Karch "had staked his career on advancing the argument that the level of drugs found in a cadaver may have no relationship to the levels just before death." The
540:
A class action lawsuit was filed on behalf of non-Tenet employees, patients and relatives who were stranded at Memorial during the hurricane. The class action,
138:
128:
298:
reassured the public that 2,500 patients would be evacuated from hospitals in Orleans Parish, although it wasn't clear at first where they would be moved to.
1488:
133:
1570:
377:
At the request of the Louisiana AG's office, Orleans Parish Coroner Frank Minyard investigated the cause of the deaths. Experts reported abnormal levels of
1615:
428:
of the two dozen possible cases, they initially had the strongest case in the deaths of four of the patients who had died on the hospital's seventh floor.
1852:
374:
opposition to Pou's alleged actions, arguing "I'd rather be considered a person who abandoned patients than someone who aided in eliminating patients."
291:
1427:
143:
1802:
1664:
178:
113:
67:
118:
321:, Foti's successor, said, "This is a prosecution that should never have been brought" forward. In 2008, Caldwell testified before the
314:
refused to indict Pou on any of the counts. Eventually, the charges were expunged and the State of Louisiana paid Pou's legal fees.
1857:
1518:
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93:
1842:
1764:
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1262:
1231:
1200:
1075:
865:
738:
88:
1036:"Orleans DA testifies that he believes patients were killed at Memorial Medical Center after Katrina, but he can't prove it"
1548:
778:
Davis, Robert; Johnson, Kevin (17 October 2005). "La. looks into 215 Katrina deaths - Inquiry includes euthanasia report".
517:
After several months, the grand jury concluded its work by declining to indict any of the suspects on any of the charges.
501:
194:
103:
698:
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as consultants to assess autopsies and other medical information. One of them, Steven Karch, later testified before the
227:
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72:
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269:
173:
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911:
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937:
216:
606:
343:
282:
48:
510:
153:
62:
17:
1781:
1623:
987:
Foster, Mary (23 March 2009). "Consultants earned $ 80,000 on failed Katrina case, 1st Ld-Writethru, LA".
1171:
551:
LifeCare opted early on to pay undisclosed sums to family members of several deceased patients who sued.
529:
1435:
1817:
1812:
403:
355:
investigators he had said, "Cindy, don't let them leave me behind." According to witnesses speaking to
1806:
1549:"'Dark Cloud' Lifted From Pou, Attorney Says: Grand Jury Declines To Indict Doctor In Hospital Deaths"
1099:
479:
No, I did not murder those patients. Mr. Safer, I've spent my entire life taking care of patients.
322:
1451:"N.O. coroner finds no evidence of homicide: Memorial doctor still faces grand jury in 4 deaths"
825:
1378:
963:"HB341 2009, Regular Session, Appropriates funds for payment of legal expenses of Dr. Anna Pou"
1756:
1750:
1725:
1719:
1254:
1248:
1223:
1217:
1067:
1061:
857:
851:
730:
724:
1279:
1192:
1186:
1007:"High court considers making public records of Memorial Medical Center deaths during Katrina"
881:
572:
262:
1296:
962:
8:
335:
1693:
1638:
1397:
533:
election for state Attorney General after criticism for prosecuting Pou and the nurses.
1601:
1522:
1492:
1473:
1454:
1321:
1297:
Louisiana AG Orders Autopsies of 50 Memorial Medical Patients; Susan Polk Goes on Trial
525:
486:
459:
357:
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1258:
1227:
1196:
1071:
861:
794:
734:
286:
32:
1619:
1343:
433:
255:
1318:"Doctor's drug mix not ideal killer: Evidence in Memorial case called unreliable"
1694:"Class-Action Suit Filed After Katrina Hospital Deaths Settled for $ 25 Million"
1556:
605:
The Memorial Medical Center has since changed ownership, and is now called the
542:
Elmira Preston et al. vs. Tenet Health Systems, Memorial Medical Center, et al.
318:
1836:
407:
394:
1423:
521:
472:
437:
307:
295:
40:
630:
1827:
1665:"Lawsuit Against New Orleans Hospital Settles Shortly After Trial Begins"
764:
671:
390:
311:
471:
aired a report on the case in September 2006. In an interview, Pou told
1431:
1167:
467:
1639:"Trial to Open in Lawsuit Connected to Hospital Deaths After Katrina"
451:
442:
386:
382:
1379:"Three charged with second-degree murder in Katrina hospital deaths"
759:
447:
411:
treatment; and death, in his opinion, was the goal in these cases.
398:
378:
231:
237:
1752:
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital
1721:
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital
1250:
Five Days at Memorial: Life and Death at a Storm-Ravaged Hospital
1219:
Five Days at Memorial: Life and Death at a Storm-Ravaged Hospital
1188:
Five Days at Memorial: Life and Death at a Storm-Ravaged Hospital
1063:
Five Days at Memorial: Life and Death at a Storm-Ravaged Hospital
882:"State of Louisiana vs Anna M. Pou, Affidavit and Arrest Warrant"
853:
Five Days at Memorial: Life and Death at a Storm-Ravaged Hospital
726:
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital
574:
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital
223:
577:- Book about the hospital in the aftermath of Hurricane Katrina
991:. New Orleans, LA. Associated Press News Service. p. 02.
1100:"Staff at New Orleans hospital debated euthanizing patients"
660:. Associated Press News Service. 31 August 2005. p. A9.
1821:
1552:
389:
in several bodies. A number of forensic experts, including
1489:"Foti sued by doctor accused in Memorial Hospital deaths"
1421:
1103:
1782:"Strained by Katrina, a Hospital Faced Deadly Choices"
1164:"Strained by Katrina, a Hospital Faced Deadly Choices"
1813:
Testimonies and coroners' reports from Foti's office
397:, and James Young, agree that the administration of
938:"Panel Recommends Paying Dr. Anna Pou's Legal Fees"
672:"Nurse: 'It's like being in a Third World country'"
351:loss of electric power; seven were on ventilators.
285:in New Orleans, Louisiana was heavily damaged when
826:"Doctor and Nurses Charged in Post-Katrina Deaths"
424:this opinion, Minyard sought no further opinions.
631:"Doctor cleared in Katrina deaths recounts scene"
334:Pou, an associate professor in the Department of
1834:
1467:
1448:
457:The arrests were controversial. In the words of
1616:"Gov. Jindal Signs Bill To Reimburse Anna Pou"
1157:
1155:
1153:
1151:
1149:
1147:
1145:
1143:
1141:
1139:
1137:
1135:
1133:
795:"Hospital Settles Katrina Deaths Class Action"
1398:"Patient Deaths in New Orleans Bring Arrests"
1131:
1129:
1127:
1125:
1123:
1121:
1119:
1117:
1115:
1113:
263:
1470:"N.O. coroner finds no evidence of homicide"
1315:
1093:
1091:
1089:
1087:
980:
777:
755:"Euthanasia alleged at New Orleans hospital"
1595:
1486:
1340:"Grand Jury to investigate hospital deaths"
1337:
1333:
1331:
1311:
1309:
1307:
1305:
912:"Grand jury refuses to indict Dr. Anna Pou"
656:"Hurricane Katrina: Swath of Destruction".
1853:Medical controversies in the United States
1571:"Consultants earned $ 80K on Katrina case"
1541:
1361:"3 Arrests in New Orleans Hospital Deaths"
1110:
771:
649:
270:
256:
39:
1536:Grand Jury to investigate hospital deaths
1519:"Grand jury starts work in Memorial case"
1084:
1029:
1027:
109:Effects in the Southeastern United States
1608:
1589:
1480:
1442:
1395:
1328:
1302:
1097:
1000:
998:
792:
310:. However, a year later a grand jury in
1687:
1685:
1098:Johnston, Kathleen (October 13, 2005).
856:. New York: Crown Publishers. pp.
520:The former Louisiana Attorney General,
292:United States Health and Human Services
14:
1835:
1755:. New York: Crown Publishers. p.
1724:. New York: Crown Publishers. p.
1253:. New York: Crown Publishers. p.
1222:. New York: Crown Publishers. p.
1191:. New York: Crown Publishers. p.
1066:. New York: Crown Publishers. p.
1033:
1024:
986:
935:
909:
729:. New York: Crown Publishers. p.
696:
1449:Jeffrey Meitrodt (February 1, 2007).
1415:
1355:
1353:
1004:
995:
819:
817:
815:
601:
599:
1779:
1748:
1717:
1691:
1682:
1662:
1636:
1277:
1246:
1215:
1184:
1161:
1059:
849:
823:
793:Canfield, Sabrina (March 24, 2011).
722:
211:
1428:"Katrina Doc Denies Mercy Killings"
697:Struck, Doug (September 13, 2005).
585:- Miniseries adaptation of the book
24:
1749:Fink, Sheri (September 10, 2013).
1718:Fink, Sheri (September 10, 2013).
1577:. Associated Press. March 23, 2009
1350:
1247:Fink, Sheri (September 10, 2013).
1216:Fink, Sheri (September 10, 2013).
1185:Fink, Sheri (September 10, 2013).
1060:Fink, Sheri (September 10, 2013).
850:Fink, Sheri (September 10, 2013).
812:
723:Fink, Sheri (September 10, 2013).
596:
514:grand jury to provide his cover."
25:
1869:
1796:
1005:Maggi, Laura (October 13, 2008).
699:"45 Bodies Found in La. Hospital"
658:Atlanta Journal-Constitution, The
329:
1396:Nossiter, Adam (July 19, 2006).
1280:"The Deadly Choices at Memorial"
364:
236:
222:
210:
99:Criticism of government response
1858:Political scandals in Louisiana
1773:
1742:
1711:
1656:
1630:
1563:
1555:. July 25, 2007. Archived from
1529:
1511:
1468:Jeffrey Meitrodt (2007-02-01).
1461:
1389:
1371:
1316:James Varney (August 6, 2006).
1290:
1271:
1240:
1209:
1178:
1162:Fink, Sheri (August 30, 2009).
1053:
955:
929:
910:Filosa, Gwenn (July 24, 2007).
903:
874:
843:
1780:Fink, Sheri (25 August 2009).
1663:Fink, Sheri (March 23, 2011).
1637:Fink, Sheri (March 20, 2011).
1622:. July 1, 2009. Archived from
1598:"Foti out as attorney general"
1538:Associated Press, 8 March 2007
1278:Fink, Sheri (25 August 2009).
1034:Kovacs, Peter (July 8, 2010).
936:Moller, Jan (March 18, 2009).
824:Kahn, Carrie (July 19, 2006).
786:
747:
716:
690:
664:
623:
607:Ochsner Baptist Medical Center
49:2005 Atlantic hurricane season
13:
1:
1692:Fink, Sheri (July 21, 2011).
1487:Gwen Filosa (July 16, 2007).
1338:Mary Foster (March 8, 2007).
616:
1843:Effects of Hurricane Katrina
557:
448:morphine sulphate (morphine)
7:
1172:The New York Times Magazine
967:Louisiana State Legislature
566:
530:Louisiana State Legislature
317:Louisiana Attorney General
10:
1874:
1596:Bill Barrow (2007-10-21).
494:
404:University of Pennsylvania
340:LSU Health Sciences Center
1299:CNN.com, 14 October 2005
589:
1828:Memorial Hospital Truth
799:Courthouse News Service
344:Memorial Medical Center
323:Louisiana Supreme Court
283:Memorial Medical Center
124:Memorial Medical Center
1848:History of New Orleans
1809:on September 8th 2023.
1805:at LSU, archived from
1559:on September 27, 2011.
767:on September 28, 2021.
481:
179:International response
149:Infrastructure repairs
114:Effects in New Orleans
68:Meteorological history
1499:on September 30, 2011
830:National Public Radio
582:Five Days at Memorial
526:forensic pathologists
502:Department of Justice
477:
1438:on October 16, 2006.
219:at Wikimedia Commons
1626:on August 25, 2012.
1426:(August 15, 2007).
989:Times-Picayune, The
703:The Washington Post
336:Otorhinolaryngology
129:New Orleans Hornets
1803:Dr Pou's biography
1643:The New York Times
1602:The Times-Picayune
1523:The Times-Picayune
1493:The Times-Picayune
1474:The Times-Picayune
1455:The Times-Picayune
1402:The New York Times
1322:The Times-Picayune
1284:The New York Times
1040:The Times-Picayune
1011:The Times-Picayune
942:The Times-Picayune
916:The Times-Picayune
487:The New York Times
452:midazolam (Versed)
358:The New York Times
134:New Orleans Saints
1766:978-0-307-71896-9
1735:978-0-307-71896-9
1264:978-0-307-71896-9
1233:978-0-307-71896-9
1202:978-0-307-71896-9
1077:978-0-307-71896-9
867:978-0-307-71896-9
740:978-0-307-71896-9
678:. August 31, 2005
511:Loyola University
385:(Versed), and/or
287:Hurricane Katrina
280:
279:
241:Works related to
217:Hurricane Katrina
215:Media related to
144:Tulane University
94:Political effects
33:Hurricane Katrina
16:(Redirected from
1865:
1824:on May 8th 2011.
1820:, archived from
1818:Dr Pou's website
1790:
1789:
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1740:
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1679:
1677:
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1653:
1651:
1649:
1634:
1628:
1627:
1620:Associated Press
1612:
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1586:
1584:
1582:
1567:
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1545:
1539:
1533:
1527:
1526:
1525:. March 6, 2007.
1515:
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1504:
1495:. Archived from
1484:
1478:
1477:
1465:
1459:
1458:
1446:
1440:
1439:
1434:. Archived from
1419:
1413:
1412:
1410:
1408:
1393:
1387:
1386:
1385:. July 18, 2006.
1375:
1369:
1368:
1367:. July 19, 2006.
1357:
1348:
1347:
1344:Associated Press
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783:
782:. Arlington, VA.
775:
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763:. Archived from
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1575:The Reveille
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1497:the original
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1581:January 25,
682:January 25,
391:Cyril Wecht
1837:Categories
1698:ProPublica
1669:ProPublica
1432:60 Minutes
1168:ProPublica
617:References
468:60 Minutes
294:Secretary
1503:April 25,
921:April 30,
780:USA Today
558:Aftermath
443:affidavit
387:Lorazepam
383:midazolam
342:, was at
139:Superdome
1703:March 1,
1674:March 1,
1407:March 2,
1045:March 5,
1016:March 5,
972:March 1,
947:March 1,
895:March 1,
889:CBS News
835:March 3,
760:NBC News
708:March 3,
676:NBC News
641:March 5,
567:See also
524:, hired
399:morphine
379:morphine
232:Wikinews
187:Analysis
63:Timeline
1648:1 March
1383:CNN.com
858:338–339
804:4 March
495:Outcome
450:and/or
338:at the
55:General
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166:Relief
81:Impact
885:(PDF)
590:Notes
421:Times
1761:ISBN
1730:ISBN
1705:2014
1676:2014
1650:2014
1583:2022
1553:WDSU
1505:2008
1409:2014
1259:ISBN
1228:ISBN
1197:ISBN
1170:and
1072:ISBN
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735:ISBN
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684:2022
643:2014
1757:469
1726:451
1255:297
1224:313
1104:CNN
1068:243
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230:at
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