Case file
Genene Jones: the nurse behind San Antonio's “Death Shift”
Children kept dying on one shift in one intensive care unit. The hospital changed its staffing and said nothing. It took a clinic in a small town, a paralytic drug and, forty years later, a prison release date to bring the case to court.
- Born13 July 1950, Texas; adopted as an infant
- ProfessionLicensed vocational nurse (LVN), licensed 1977
- Worked atBexar County Medical Center Hospital, San Antonio, pediatric ICU (1978–1982); a pediatric clinic in Kerrville (1982)
- Convicted ofMurder of Chelsea McClellan (1984); murder of Joshua Sawyer (2020)
- Sentences99 years (1984); 60 years, concurrent (1984); life (2020)
- StatusIn prison in Texas; first parole eligibility in 2037, at 87
Genene Jones was a pediatric nurse in Texas who has been convicted of murdering two children, one in 1982 and one in 1981, and is suspected by prosecutors in many more deaths. The convictions came thirty-six years apart. The story in between is partly about her, and partly about how long it took anyone in authority to act on what the numbers were showing.
Estimates of how many children she killed have been reported as high as sixty. That figure is a suspicion, not a finding, and it is treated that way below. What is established is the pattern at the hospital, which was measured by the Centers for Disease Control, and the two convictions.
The nurse on the evening shift
Jones was born on 13 July 1950 and adopted as a baby. She qualified as a licensed vocational nurse, a grade below a registered nurse, in 1977. In October 1978 she started work in the pediatric intensive care unit of Bexar County Medical Center Hospital, San Antonio's public teaching hospital.
Over the next three years children on the unit kept going into sudden cardiac arrest and other unexplained emergencies, and dying, disproportionately on the evening shift, 3 to 11 p.m., that Jones worked. Staff took to calling it the Death Shift. In March 1982 the hospital replaced the licensed vocational nurses in the unit, Jones among them, with registered nurses. According to ProPublica's reporting, it did not refer the deaths to police.
What the numbers showed
The CDC investigation was later written up in the New England Journal of Medicine (Istre and colleagues, July 1985). Its figures are stark. Between April 1981 and June 1982, 34 of the 42 deaths in the unit happened on the evening shift. In the four years before, the evening shift had accounted for 36 of 106. The authors found that the presence of one particular nurse carried a relative risk of 10.7 for a child's death and 25.5 for cardiopulmonary arrest.
The paper does not name the nurse. Later reporting, including ProPublica's, identifies her as Jones. The statistics pointed at a person. On their own they could not prove what had happened to any one child, and that gap runs through the rest of the case.
Kerrville, 1982
In August 1982 Jones went to work for Dr. Kathleen Holland, who was opening a pediatric practice in Kerrville, in the Hill Country northwest of San Antonio. Within weeks, children at the clinic began to stop breathing. Six were rushed to Sid Peterson Hospital in the space of about a month.
Chelsea McClellan, fifteen months old, was one of them. She was given injections at the clinic and died on 17 September 1982. The drug found to have killed her was succinylcholine, a paralytic used in surgery that stops the muscles, including the ones that breathe.
Two convictions in 1984
The trial was moved from Kerrville to Georgetown, Texas. In February 1984 a jury convicted Jones of Chelsea McClellan's murder, and on 14 May 1984 she was sentenced to 99 years. Later that year she was convicted over a heparin overdose given to an infant, Rolando Santos, and received 60 years to run concurrently.
Those were the only charges brought for most of the next three decades. The other deaths on the Death Shift were never tried in the 1980s.
The release date that forced a new case
Jones was sentenced under a 1977 Texas law, passed to relieve prison overcrowding, that gave inmates mandatory credit for good behaviour. The law was later changed, but not retroactively. Applied to her 99-year sentence, it produced a mandatory release date in March 2018.
According to ProPublica, she had told a parole officer in 1998 that she really did kill those babies. With the release date approaching, Bexar County District Attorney Nico LaHood's office reopened the hospital deaths. In 2017 grand juries returned five new murder indictments, for Joshua Sawyer, Rosemary Vega, Richard Nelson, Patrick Zavala and Paul Edward Villareal. She was held in custody on the new charges, and the 2018 release never happened.
The 2020 plea
On 16 January 2020, in the 399th District Court in San Antonio, Jones pleaded guilty to the murder of Joshua Sawyer, eleven months old, who died on 12 December 1981 after an overdose of anti-seizure medication in the pediatric ICU. The other four murder charges were dismissed as part of the plea agreement.
Judge Frank Castro sentenced her to life in prison. She becomes eligible for parole in 2037, when she will be 87. Addressing her in court, the judge said she had taken “God's most precious gift, babies, defenseless babies.”
The drugs named in the case
Three different drugs run through the charges, and each one works by turning something a hospital uses every day into a weapon. Succinylcholine, the drug in Chelsea McClellan's death, is a paralytic given before surgery so a patient can be put on a ventilator; without one, it stops the breathing muscles. Heparin, the drug in the Rolando Santos conviction, is a blood thinner; an overdose causes uncontrolled bleeding. And in Joshua Sawyer's case, the plea was to a fatal overdose of an anti-seizure medication. CBS News reported that prosecutors alleged she used Dilantin, an anti-seizure drug, in children's deaths.
All three are ordinary stock in an intensive care unit or a pediatric practice, which is part of why individual deaths were so hard to prove as murder years later.
Why the number is uncertain
The gap between two convictions and a suspected sixty is not only about proof. At the time, the deaths on the unit were not investigated as crimes; they were handled as a staffing problem. Children in intensive care are, by definition, very sick, so any single death could be explained medically. What made the case was the pattern, and a pattern is evidence of risk, not of a specific killing. The 2017 indictments were an attempt to go back to individual children. Four of the five ended when the plea was accepted.
The case is often described alongside other killings by medical staff, and one feature of it stands out: the statistical evidence was gathered, published in a major medical journal and sitting in the literature for decades while the nurse it described was serving a sentence for a different child.
Genene Jones timeline
- 13 July 1950Born in Texas; adopted as an infant.
- 1977Licensed as a vocational nurse.
- October 1978Starts work in the pediatric ICU at Bexar County Medical Center Hospital, San Antonio.
- 12 December 1981Joshua Sawyer, 11 months, dies in the unit after an overdose of anti-seizure medication. Jones will plead guilty to his murder 38 years later.
- March 1982The hospital replaces the unit's licensed vocational nurses, Jones among them, with registered nurses.
- August 1982Joins Dr. Kathleen Holland's new pediatric clinic in Kerrville.
- 17 September 1982Chelsea McClellan, 15 months, dies after injections at the clinic.
- February 1984Convicted in Georgetown, Texas, of Chelsea McClellan's murder.
- 14 May 1984Sentenced to 99 years.
- October 1984Sentenced to 60 years, concurrent, in the Rolando Santos heparin case.
- July 1985The CDC study of the San Antonio unit is published in the New England Journal of Medicine.
- 1998Tells a parole officer she killed babies, according to ProPublica.
- 2017Indicted on five new murder charges in Bexar County.
- March 2018The mandatory release date passes with her still in custody.
- 16 January 2020Pleads guilty to Joshua Sawyer's murder; sentenced to life.
- 2037First parole eligibility, at age 87.
Questions people ask
How many children did Genene Jones kill?
She has been convicted of two murders: Chelsea McClellan, who died in September 1982 in Kerrville, and Joshua Sawyer, who died in December 1981 in San Antonio. Prosecutors have said she may be responsible for as many as 60 children's deaths, but no court has found that.
Is Genene Jones still in prison?
Yes. On 16 January 2020 she was sentenced to life after pleading guilty to Joshua Sawyer's murder. She is first eligible for parole in 2037, at age 87.
What was the “Death Shift”?
The staff nickname for the 3-to-11 p.m. shift in the pediatric intensive care unit at Bexar County Medical Center Hospital in San Antonio, where Jones worked from 1978 to 1982. A CDC study found that 34 of 42 deaths on the unit between April 1981 and June 1982 occurred on that shift.
Why was Genene Jones almost released in 2018?
She was sentenced under a 1977 Texas good-conduct law that made release mandatory once time served plus credits reached the sentence. The law was later changed but not retroactively, so her release was set for March 2018. New murder indictments in 2017 kept her in custody.
What drug killed Chelsea McClellan?
Succinylcholine, a paralytic muscle relaxant used in surgery. It stops the muscles used for breathing.
The page this portrait comes from
The full page — Genene Jones at the size you color her, with the case details drawn in around the portrait — is in Bloody Alphabet. Twenty-three killers, one to a letter, each drawn as a full-page portrait with the objects and details of the case around it.
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Sources
Every date and name on this page was checked against at least two of the following. Where they disagree, the disagreement is stated in the text rather than resolved silently.
- Genene JonesWikipedia
- “I Really Did Kill Those Babies”ProPublica
- Prosecutors Race to Keep Notorious “Angel of Death” Behind BarsProPublica
- Istre GR et al., A mysterious cluster of deaths and cardiopulmonary arrests in a pediatric intensive care unitNew England Journal of Medicine, 1985 (PubMed)
- Killer nurse Genene Jones makes plea deal in court hearingKSAT, 16 January 2020
- Killer nurse expected to make deal in baby death caseKPRC Click2Houston, 16 January 2020
- Genene Jones, nurse suspected of killing dozens of infants, indicted againCBS News, 2017
- Former Bexar County nurse Genene Jones faces new charges for child murderTexas Public Radio, 2017
- Genene Jones pleads guilty to new murderTexas Monthly, 2020
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