Tuesday’s guilty plea by a former Veterans Affairs nursing assistant to seven counts of murder effectively closed the criminal investigation into a string of patients deaths at a West Virginia medical center in recent years, but the case is far from over.

Questions still linger over what share of blame hospital administrators shoulder for the deaths, what can be done to prevent future crimes and — perhaps most vexing for the families — what drove an Army veteran to kill elderly and infirm veterans who depended on her for protection.

In a district court hearing Tuesday afternoon, Reta Mays, who worked at the Louis A. Johnson Veterans Affairs Medical Center in Clarksburg for almost three years, pleaded guilty to seven counts of second-degree murder and one count of attempted murder in the deaths of eight patients in 2017 and 2018.

Federal prosecutors said Mays used her position as a night shift worker to secretly poison patients with insulin injections, triggering seizures, comas and eventual death.

The case has drawn national headlines for the last year as the number of victims and details of the crime have trickled out of the ongoing FBI investigation. Following the guilty plea on Tuesday — part of an agreement where attorneys are still recommending life in prison for Mays — prosecutors praised the move as a chance for the community to move on.

“Though we can’t bring these men back because of (Mays') evil acts, we hope the conclusion of the investigation and guilty plea helps ease the pain of the victims’ families,” said William Powell, U.S. Attorney for the Northern District of West Virginia.

At least 26 family members attended Tuesday’s hearing, filling the small West Virginia courtroom. Numerous others watched the proceedings via an internet stream made available because of the ongoing coronavirus pandemic. The victims were all more than 80 years old, and included individuals who served in the Vietnam War, the Korean War and World War II.

Mays, 45, spoke little during the hearing but tearfully acknowledged her guilt multiple times. She told the judge she is currently taking medication for post-traumatic stress disorder, but did not offer any more details of that diagnosis.

And she did not offer any motive for the crimes. Attorneys for Mays said they expect to spend the next few months working through the “substantial amount” of mitigating factors in her case, but did not elaborate what those were.

Similarly, officials from the VA Inspector General’s office said after the guilty pleas that they will resume their internal investigation into Mays’ actions — postponed because of the criminal investigation — and any security deficiencies within the medical centers’ protocols.

“The work of the VA is not finished,” VA Inspector General Michael Missal told reporters.

“Our inspection is going to be looking at a number of things, including medication management and communications among the staff. The scope may change as we get further into it.”

Powell acknowledged that the number of victims may be higher than eight, but the charges brought against Mays this week represented the strongest provable criminal cases.

Family members of victims have already filed several civil suits against the medical center. Tony O’Dell, an attorney with the law firm Tiano O’Dell that is representing several families, said he expects more to be filed in coming weeks.

“The families are very happy that the criminal case has been brought to a conclusion,” he said. “But they still want resolution in the rest of these questions.”

They include whether other hospital workers should have more quickly identified a pattern of medical crises among patients in Mays care, and how closely employees’ access to medical supplies are monitored.

“There was a window where these deaths could have been prevented,” he said.

Wesley Walls, spokesman for the Louis A. Johnson VA Medical Center, said hospital officials brought the potential criminal activity to law enforcement’s attention in 2018 and have cooperated with their investigations every step of the way. Mays was fired from her post in spring 2018 amid multiple concerns about her work.

“Our hearts go out to those affected by these tragic deaths,” he said in a statement. “We’re glad the Department of Justice stepped in to push this investigation across the finish line and hopeful our court system will deliver the justice Clarksburg-area veterans and families deserve.”

Court officials have not yet scheduled a sentencing date for Mays, who could face up to seven life sentences plus another 20 years in prison for her crimes. Attorneys are scheduled to meet again on Oct. 30 to determine when that hearing may occur.

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.

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