MedCrimes: a Medical True Crime Podcast · Kate Macy and Devon Rebecca

Dr. Anthony Pignataro; part 2

·1 hr 6 min·4 clips

EMS found Anthony Pignataro trying to create an airway with a yellow coat hanger.

1. MedCrimes: a Medical True Crime Podcast part two centers on Dr. Anthony Pignataro and the August 25, 1997 surgery that became a homicide case. 2. Hosts Devin and Kate narrate the case together, and they cite author Ann Rule, detective Pat Finity, detective Chuck Craven, and patient Sarah Smith as key voices. 3. The episode asks how Pignataro kept operating a low-cost cosmetic practice in a basement with almost no safeguards. 4. Pignataro is described as born into privilege, failing out of multiple residency programs, and later marketing himself as a world-renowned plastic surgeon. 5. His prior case involving Terry Lamotti is revisited, including the liposuction perforation, infection, and the hospital confrontation at 2:00 in the morning. 6. The hosts explain that his office had no anesthesiologist, no trained surgery staff, and only a licensed practical nurse, his wife, and a 17-year-old high school intern. 7. They note that he deliberately kept overhead low so he could charge less than the market average. 8. Sarah Smith is introduced as a 26-year-old former cheerleader, married to her high school sweetheart, with two children under 10. 9. She wanted a breast augmentation because the transumbilical approach promised fewer visible scars than the traditional incision sites around the nipple or under the breast. 10. The hosts explain that Pignataro gave her little pre-op workup beyond some labs, even though anesthesia procedures normally involve more screening. 11. On the morning of the procedure, Dan Smith drove Sarah to the office for a 9:30 a.m. appointment and watched her become drowsy after oral sedation. 12. Pignataro repeatedly told Dan to leave and run errands, and he never gave him a clear estimate for how long the surgery would take. 13. The surgery room is described as a dingy West Seneca basement with only an SpO2 monitor and a blood-pressure cuff. 14. The transcript says there was no ventilator, no oxygen tank, no airway gear, and no crash cart in the room. 15. Debbie Pignataro said Sarah’s face was losing color, but Anthony kept working as the pulse oximeter started beeping. 16. When the EKG was finally hooked up, it showed asystole, and the teenage intern called 911. 17. EMS arrived to find Pignataro trying to create an airway with a yellow wire coat hanger. 18. The detectives later received statements from Debbie, the teen intern, and the 22-year-old LPN, and toxicology confirmed excessive sodium pentothal and other substances. 19. The tone is conversational and narrative, with the hosts interrupting the case to explain anesthesia terms, cosmetic procedures, and why the setup was unsafe. 20. Listeners who like medical true crime with specific procedural detail will likely stay engaged, while listeners avoiding disturbing surgical mishaps may skip it.

As heard by us

Blunt, clinical, and furious, with a case that only gets more unsettling as it goes.

Part two stays with a nightmare medical case that moves from frantic improvisation to coma. MedCrimes keeps the pace blunt and conversational, which suits the material: the hosts walk through the airway and resuscitation details in plain language, then sit with the disbelief as…

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Why you'd press play

A yellow wire coat hanger enters airway care and the whole room goes sideways.

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