Michael Bromwich, the independent investigator charged with analyzing problems at the HPD crime lab and property room, issued a damning final report (pdf) of Phase I of his investigation today.
The report is highly critical of leadership with regard to the HPD crime lab dating back more than a decade, citing leadership problems within the lab itself as well as HPD.
Having read the seven-page Executive Summary and the 68-page report itself, I have to recommend that interested parties at least read the Executive Summary (but preferably read the entire report at some point). Bromwich and his crew bring impressive credentials to the task, and the written report reflects work that seems to be extremely well-documented, organized, meticulous, and extensive. Because the report is lengthy and complex, I would suggest that media accounts (or blog posts) are no substitute for reading the report itself.
That said, KHOU-11’s Doug Miller gives a good, brief summary. KHOU is cited in the report for its previous reporting on the crime lab.
Former Chief Bradford makes a number of appearances that don’t exactly reflect well on his leadership, and even former Chief Lee P. Brown makes an appearance (yes, the problems date back that far). The report also documents the extensive efforts of the office of the Harris County District Attorney to analyze all cases where the HPD crime lab’s treatment of evidence might have affected cases. Phase II of Bromwich’s investigation will also analyze a sampling of such cases.
I plan on updating this post at some point with interesting excerpts from the report, but I don’t have an easy way of converting the PDF file to text at the moment, so that will have to wait.
Incidentally, it is worth noting the Houston Chronicle‘s hit piece on Harris County District Attorney and Chronicle editorial board “bad guy” Chuck Rosenthal today. However much certain people at 801 Texas Avenue seem to dislike the Harris County District Attorney, the fact remains that Bromwich’s report is highly critical of HPD and City of Houston leadership with regard to the crime lab, not Rosenthal or the Harris County District Attorney’s office. The timing of the hit piece on Rosenthal is curious, since that’s what Chronicle readers got to see this morning before Bromwich’s highly critical report on the crime lab took over the news cycle later in the day, not-so-subtly connecting Rosenthal to a crime lab fiasco that Bromwich’s report clearly identifies as an HPD/City of Houston fiasco.
That’s another reason why there is no substitute for reading those reports, and why the technology that makes them available to anyone with an internet connection changes everything about media.
UPDATE (07-01-2005): Selected excerpts from the report follow below. In all instances, the excerpts have come from the main report (not the executive summary). The page(s) are identified above. Some footnotes have been omitted.
By 1987, there were already hints of the personnel problems that would become even more distracting and debilitating in the DNA/Serology Section throughout the 1990s and early 2000s. In a memorandum to Chief of Police Lee P. Brown dated November 13, 1987 and entitled “Serology Section Work Load Increase,” Mr. Bolding complained that “the loss of trained staff and the increase in paperwork has had a devastating effect on sectional proficiency.” Mr. Bolding stated that workload problems in the Serology Section were “exacerbated by disgruntled employees” and that “[a]ccusations of incompetence and personal prejudice are part of my daily schedule.”
Dr. Sharma also made a serious error in a serology case in May 1995. While Dr. Sharma was training a new serology analyst, Mr. Bolding asked Dr. Sharma to determine whether semen was present in a dried fluid stain. Rather than test for the presence of semen using a P-30 or acid phosphatase test, Dr. Sharma simply viewed the sample under a stereo microscope and reported it negative for semen. Later, while attempting to remove fibers from the sample for analysis, a trace evidence examiner discovered that no chemical analysis for semen had been performed. Upon learning of the error, Mr. Bolding directed that a chemical test be performed on the sample, and this test indicated the presence of semen. Dr. Sharma received no significant discipline as a result of this error.
 By the time Dr. Sharma’s error was discovered, the Assistant District Attorney involved in the case already had agreed to a lesser-charge plea bargain based on Dr. Sharma’s original assessment that no sperm was present in the sample.
On October 20, 1999, a group of line analysts from the DNA/Serology Section met with Chief Bradford to discuss their request that the position of Criminalist III in the DNA/Serology Section be restored, as well as other issues related to equipment and training for the Section.
There is an important issue relating to whether Chief Bradford received and read the September 14, 1999 memorandum before, during, or after the October 20, 1999 meeting. Because Mr. Krueger was opposed to the memorandum being sent to Chief Bradford, presumably because the complaints of the DNA/Serology Section analysts reflected poorly on his stewardship of the Crime Lab, the analysts did not send the memorandum through the normal chain of command. This means that the memorandum was not transmitted through either Assistant Chief Milton Simmons or Executive Assistant Chief Storemski. HPD procedures require that each official who receives a piece of correspondence sign his name to reflect his review of the document. Neither Assistant Chief Simmons nor Executive Assistant Chief Storemski signed the document, and both of them deny they saw the document in 1999.
Chief Bradford also denies that he saw the memorandum at or about the time of the meeting. He advised us that, when the memorandum came to light in 2003, he and his staff conducted an exhaustive search for the memorandum but failed to locate it. Chief Bradford says that, in particular, he does not recall being informed, either in writing or orally, of the pressing need for a first-level supervisor in the DNA/Serology Section. Chief Bradford told us that, had he been aware of the urgent need, he would have taken action to fill the gap. By contrast, more than one of the DNA/Serology Section analysts specifically recall that the memorandum was provided to Chief Bradford at the outset of the meeting and that he was holding it during the meeting. Whether or not Chief Bradford received the memorandum, the notes of the meeting, taken by a [footnote omitted] member of Chief Bradford’s staff, reflect that the need for a Criminalist III was the first issue discussed at the meeting. Chief Bradford, on review of the notes, takes issue with whether he was made aware of whether it was a DNA supervisor that was needed.
Whether or not Chief Bradford saw the September 14, 1999 memorandum, accounts from numerous people whom we have interviewed and who were present at the October 20, 1999 meeting have described an extremely positive response from Chief Bradford. Indeed, the criminalists were euphoric after the meeting. They immediately convened a meeting with other personnel in the Crime Lab to report the reception from Chief Bradford, which they believed boded well for positive action on their requests. Building on their perceived success in getting Chief Bradford’s attention, two criminalists had a second meeting with him in late December 1999.
The criminalists’ optimism was short-lived. In an undated memorandum apparently issued after the second meeting, Chief Bradford responded that the “Criminalist III position has been put on hold until sufficient funding is acquired. Funds may be converted if future vacancies within Criminalist I or II classifications occur.” This memorandum from Chief Bradford effectively sentenced the DNA/Serology Section to continue functioning without a supervisor for the indefinite future. We have been told that the members of the DNA/Serology Section were devastated by this response from Chief Bradford. After receiving the Chief’s memorandum, Mr. Bolding, in particular, felt that the DNA/Serology Section’s “ship had sunk” and that major problems in the Section at that point were inevitable. Chief Bradford was not aware of the impact his memorandum had on Crime Lab personnel.
Ultimately, Mr. Krueger came to believe that accreditation was not a realistic possibility in light of the Crime Lab’s chronic manpower shortages and the conditions created in the Crime Lab by the chronic roof leaks at 1200 Travis. Assistant Chief Simmons believed that accreditation was not a priority for HPD because there were more pressing “structural problems” with the roof and obtaining equipment for the Lab. Nevertheless, in a draft letter, dated June 17, 2002, that Mr. Krueger prepared for Chief Bradford to send to Houston City Council Member Carol Alvarado, Mr. Krueger wrote that “[t]he laboratory staff has been working towards meeting all the guidelines necessary for accreditation. Approximately 80% of the documentation is complete.” Based on the findings of the 2002 DPS audit and the substantial work on the SOPs and in other areas that was necessary for the Crime Lab to achieve accreditation in May 2005, it is clear that Mr. Krueger’s assessment of the state of the Crime Lab was, at best, exceedingly optimistic.
On December 20, 1999, while performing a routine case review, a Criminalist III supervisor determined that, on October 14, 1999, Mr. Patel had misidentified three tablets as Diazepam. The supervisor recognized that tablets with the same markings had been analyzed in the past and determined to be Clonazepam. The supervisor retrieved the evidence and, in the presence of a second Criminalist III, re-analyzed the tablets and confirmed that they were, in fact, Clonazepam and that Mr. Patel’s identification of the tablets as Diazepam was false. The supervisors observed that the tablets had been scraped, as if they had been analyzed, but, because the analytical data supporting Mr. Patel’s identification of the tablets as Diazepam could not have been generated through testing those tablets, they concluded that the test results obtained by Mr. Patel must have been falsified. After being confronted by all three of the Controlled Substances Section supervisors with the misidentification, Mr. Patel charged each of the supervisors with harassment.37 Despite the supervisors’ conviction that the incident involved deliberate falsification of test results, the only discipline Mr. Patel received as a result of this incident was a written reprimand, which was the same discipline issued to one of the supervisors based on the harassment charge.
An IAD investigator contacted the Assistant District Attorney responsible for prosecuting the underlying criminal case. The Assistant District Attorney reported that Mr. Patel’s erroneous identification did not meaningfully affect the case because the defendant was likely to accept a misdemeanor plea. The misidentification was disclosed at the time of the plea, and the court pleadings were corrected appropriately.
Mr. Patel’s punishment for this second drylabbing incident was a three-day suspension. Mr. Krueger also removed Mr. Patel from drug analysis and assigned him to the CER unit. After some period of time in the CER unit, Mr. Patel took advantage of Chief Bradford’s open door policy to complain that he was overqualified for his assignment to CER and asked the Chief to take action to have him reinstated as a drug analyst. While neither Chief Bradford nor Mr. Krueger claims to recall any conversation about returning Mr. Patel to an analyst’s role, Mr. Patel was reinstated to the Controlled Substances bench a short time after his visit with the Chief. For his part, Mr. Patel had no doubt that Chief Bradford’s intervention was the reason he was transferred back to the Controlled Substances Section. Neither HPD nor the Crime Lab performed a review of other cases handled by Mr. Patel to determine whether any of those cases were affected by similar misconduct.
At the time of our Second Report, Mr. Patel remained an analyst in the Controlled Substances Section. The Crime Lab responded to our discussion of Mr. Patel’s drylabbing incidents by once again taking him off the bench and reassigning him to the CER unit. On June 13, 2005, the Public Safety and Homeland Security Committee of the Houston City Council passed a resolution calling for Mr. Patel’s termination. That same day, Mr. Patel resigned from the Crime Lab.
In addition to focusing on issues relating to the internal operations of the Crime Lab — including examiner competence, training, and laboratory management — our investigation is also focusing on issues relating to resource allocation by the City and HPD to the Crime Lab. At this stage, one thing seems clear: the Crime Lab was never provided adequate financial support to hire and train the number of criminalists necessary to handle the Lab’s ever-increasing workload, pay the salaries required to attract and retain qualified forensic scientists, acquire much-needed equipment and supplies, and maintain and repair the Lab’s infrastructure.
Historically, many Crime Lab analysts worked second jobs. Even Mr. Krueger and Mr. Bolding had outside employment while they were senior managers in the Crime Lab — Mr. Krueger worked in an underwater photography store and Mr. Bolding ran an antique store. Indeed, the Crime Lab’s hours of operation — from approximately 7 a.m. to 3 p.m. — appear to be structured to permit analysts to have outside employment in the afternoons and evenings. While these hours may facilitate outside employment, they would seem to limit hours during which analysts are available to communicate with prosecutors, investigators, and others. Given the comparatively low salaries offered to Crime Lab personnel, it is easy to understand the strong attraction outside employment held — and continues to hold — for many analysts, but the prevalence of outside employment does not contribute to a culture that enshrines the importance of hard work in the Crime Lab.
The building at 1200 Travis Street, which became the headquarters for HPD in the fall of 1997, was built in the 1960s. In October 1994, the City purchased the building, and, in February 1995, it hired a contractor to begin renovations. The City and HPD were aware of problems with the building’s roof prior to moving into the facility. A memorandum to Chief Bradford dated May 9, 1997 reported that there was a “problem causing water to get under the new roofing materials and saturate the new roof from underneath.” In February 1998, repairs to the roof were discontinued, and for the next nearly five years — until January 2004 — the project to repair the roof was on hold while the City was experiencing a prolonged series of fits and starts in connection with its attempts to hire contractors to design and construct a new roof for the building.
In a June 18, 2001 status report, Mr. Krueger advised Chief Simmons that “[t]hirty-five Trace/Serology/DNA cases were damaged and segregated to begin drying.” In 2003, several Crime Lab employees told internal affairs investigators that this biological evidence had become so saturated with water that they observed bloody water dripping out of the boxes containing the evidence and pooling on the floor.
It is not clear to us at this point how the Crime Lab ultimately handled the evidence in the 34 or 35 cases damaged by roof leaks during Tropical Storm Allison. In 2003, Mr. Bolding told IAD investigators that he believed all of the evidence in those cases already had been analyzed and was awaiting return to the Property Room, which is inconsistent with the initial report Mr. Krueger provided to Assistant Chief Simmons in 2001. It also does not appear that the Crime Lab was able in 2003 to identify the specific cases associated with the evidence affected by the storm.
Although the chain of command above the Crime Lab was aware of the leaky roof and that the leaks had affected evidence, no relief was forthcoming. The Crime Lab was forced to continue operating under the most troubling of environmental and facility-related conditions. For example, on July 9, 2001, Mr. Bobzean requested Assistant Chief Simmons’ authorization to use an HPD purchasing card to purchase a wet/dry vacuum so Crime Lab employees would not have to “use mops to clean up after heavy rains.”
In March 2002, Mr. Bolding estimated that there were 19,500 sexual assault kits received by HPD that had never been processed, some dating as far back as 1980. During our tours of the Property Room, we were struck by the number of unprocessed rape kits currently being stored in the Property Room’s freezers. DNA analysis of sexual assault kits involving unknown suspects, and the loading of the results of these analyses into CODIS, are very significant issues. Because the Crime Lab has not yet restored its DNA analysis capability, those “cold case” rape kits must be outsourced to other laboratories along with evidence related to open investigations and the DNA cases selected for re-testing by the District Attorney’s Office. The storage and processing of sexual assault kits is an area that we will continue to pursue.
On June 4, 2002, Assistant Chief Simmons forwarded Ms. LaCoss’s resignation letter to Chief Bradford. In a cover memorandum, Chief Simmons outlined Ms. LaCoss’s concerns and added that the Crime Lab’s need for additional personnel and supplies had been “thoroughly documented.” Chief Bradford asked Assistant Chief Simmons to develop an action plan to address the issues raised by Ms. LaCoss. Assistant Chief Simmons responded with a very general one-page memorandum dated July 1, 2002. Chief Bradford told us that he considered the response from Assistant Chief Simmons totally inadequate.
Chief Bradford signed Assistant Chief Simmons’ memorandum with the notation “Reviewed!” According to Chief Bradford, that notation signified his dissatisfaction with the memorandum, which would have been well understood by other members of the HPD command staff.
In early 2003, the District Attorney’s Office and HPD began a process with the goal of re-testing all cases resulted in a conviction — whether at trial or through a guilty plea — in which DNA evidence analyzed by the Crime Lab may have played a role. The central purpose of the re-testing program has been to identify any cases in which the results of DNA analysis performed by the Crime Lab cannot be confirmed.
Ultimately, the District Attorney’s Office identified 407 cases to be re-tested. Four of these 407 cases identified for re-testing have subsequently been withdrawn from the re-test list because the District Attorney’s Office determined that they did not belong on the list, leaving 403 cases to be analyzed.
HPD has been responsible for sending the DNA evidence related to the 403 post-conviction re-test cases to one of the following three outside laboratories for re-testing: Identigene in Houston, Reliagene in New Orleans, and Orchid-Cellmark in Dallas. HPD reports that, as of June 13, 2005, re-testing has been completed on 333 of the 403 cases.
For obvious reasons, the optimal evidence for re-testing purposes is raw evidence, such as stains on clothing or bedding, that have not been processed by the Crime Lab. In cases where such raw evidence does not exist, the next best alternative is to test DNA that already has been extracted or already has undergone some form of processing. The bulk of the cases reviewed — 248 — have confirmed with raw evidence the original Crime Lab findings. Seventy-five cases have confirmed the Crime Lab’s findings with DNA extracted or processed evidence. In one case, there apparently was no remaining sample to be re-tested and only the Crime Lab’s case file was available for review. The results in eight cases have been confirmed by outside laboratories, but with significant differences in the statistics reported by the outside laboratories from those originally reported by the Crime Lab. In one case, involving Josiah Sutton, the Crime Lab’s findings were reversed by the outside laboratory.
Finally, the District Attorney’s Office has retained its own outside laboratory, Bode Technology Group of Springfield, Virginia, to review the analyses performed by the three laboratories originally involved with the post-conviction re-testing project. The Assistant District Attorney coordinating the re-testing for the prosecutor’s office told us that the purpose of Bode’s involvement is to serve as a second check on the cases and to assist the District Attorney’s Office in reviewing the reports generated by the outside laboratories involved in the re-testing program.
The Property Room lacks a comprehensive, updated set of SOPs available to all Property Room personnel. The procedures governing the Property Room’s operations are contained in various memoranda that lack revision dates, and some of those procedures do not reflect current practices.
Moreover, and quite problematically, there has been no Criminalist III line supervisor over the Toxicology Section since 1992 and the line supervisor position in the DNA/Serology Section was vacant between August 1996 and December 2002, when DNA analysis at the Crime Lab was suspended. The issue was brought directly to the attention of Chief Bradford by analysts in the DNA Section in 1999, but, after providing an initially encouraging response, no action was taken to fill the position, with Chief Bradford claiming a lack of funding. Two years later, when funding was available as a result of a grant provided by the City Council to reduce the backlog of approximately 19,500 unanalyzed sexual assault kits, Chief Bradford rejected his command staff’s recommendation that a portion of the funds be devoted to hiring additional DNA criminalists, including a Criminalist III supervisor. Chief Bradford’s reason for doing so appeared to be an unwillingness to use grant money to create a position that eventually would have to be funded by the Department.
Shockingly, the City and HPD failed to repair the roof leaks that allowed water to pour into the Crime Lab for over six years. The City and HPD were aware of problems with the 1200 Travis building’s roof before the Crime Lab moved into the facility. In 2001, Tropical Storm Allison flooded the Crime Lab, and boxes containing biological evidence became soaked and the evidence likely contaminated. Yet the roof leaks continued unabated in a scientific laboratory charged with the enormous responsibility of processing sensitive biological evidence for use in criminal matters. The roof problem was not addressed until after the Crime Lab scandal erupted.
Finally, as illustrated by the drylabbing incidents involving Mr. Price and Mr. Patel, there appears to have been a lack of support within the Crime Lab and the chain of command for disciplining line analysts for serious misconduct. Although it appears that the Department was prepared to terminate Mr. Price after his second drylabbing incident, he received relatively light punishment after his first incident for scientific misconduct that at least one of his immediate supervisors believed should have resulted in termination. Mr. Patel was never severely disciplined for his incidents, and it appears that Chief Bradford intervened directly to have Mr. Patel reinstated as a bench analyst, which may have undermined the ability of lower level managers and supervisors to respond effectively to misconduct.
Although HPD and the City must be faulted for failing to provide the Crime Lab with the resources it needed, there appears also to have been a lack of strong and effective leadership within the Crime Lab.
Although we have not yet begun our Phase II reviews of the cases worked by the Crime Lab, based on the materials we have reviewed and our interviews, we are attuned to several potential problem areas. For example, several of the problematic cases processed by the DNA/Serology Section involved analysis of samples containing mixtures of body fluids and DNA from more than one person. Such cases involve complexities in performing the actual DNA analysis and calculating the statistics associated with the results. As the 2002 DPS audit found, Mr. Bolding, who had served as the technical lead of the DNA/Serology Section following Dr. Sharma’s removal from the Section in 1996, lacked sufficient training and education in statistics. Our preliminary reviews suggest that in several cases involving mixtures, the DNA analysts performed the statistical calculations incorrectly. We also already have encountered deficiencies in the documentation contained in analysts’ case files.
Major problems beset the DNA/Serology Section of the Crime Lab almost from its inception, but these problems were insufficiently recognized by Crime Lab management and the HPD command staff for many years. By the time of the 2002 DPS audit, the DNA Section was in shambles — plagued by a leaky roof, operating for years without a line supervisor, overseen by a technical leader who had no personal experience performing DNA analysis and who was lacking the qualifications required under the FBI standards, staffed by underpaid and undertrained analysts, and generating mistake-ridden and poorly documented casework. A critical component of the FBI standards, to which the Crime Lab agreed to abide when it registered to participate in CODIS in 1998, is a requirement for bi-annual reviews by outside agencies. Such a review, of course, never occurred until the fate of the Section already was sealed.
At the heart of our investigation is the review of a large number of cases analyzed by the Crime Lab in all disciplines in which the Lab did its work. We have now framed the context of those case reviews and understand much better the institution within which the work was done, but we do not yet know whether the well-publicized cases of the Crime Lab’s failures are isolated analytic breakdowns or only the tip of an iceberg of widespread analytic failures, incompetence, or worse. Our Phase II case reviews will show comprehensively, not anecdotally, the extent to which Crime Lab analysts did or did not do good work. Only then will we grasp the answers to the questions that have driven this investigation — most centrally, how did the work of the HPD Crime Lab facilitate or impair the proper functioning of the Harris County criminal justice system. And, to the extent there were widespread failures, what were the human consequences?