- Female narrator: He was a dedicated plastic surgeon
Who gave his patients new hope and confidence.
- Mark: He had a great reputation.
There are a number of plastic surgeons in the area.
And I would certainly say he is in the top 10%.
- Sandy: He was a good doctor and friendly.
You could just tell when you met him that he wanted to help you.
- Narrator: But tragedy suddenly strikes,
When this revered doctor
Is viciously murdered at his own practice.
- Our whole building was surrounded by police officers.
We didn't know what was going on.
- Danny: I saw blood splatter on the floor
And some blood splatter on the wall.
- Patrick: It was a very brazen crime.
Somebody came in, in broad daylight.
- Debra: It was just very surreal.
How can that happen at his own office?
- Narrator: As homicide investigators begin to dig in,
They uncover a life riddled with deep wounds that never healed.
- She was, in her mind, horribly disfigured.
- It was very clear from her demeanor
That she was not stable.
- She was just angry at so many people.
- And that was the beginning of this thing,
Which just went from bad to worse.
- Virginia: She wasn't insane.
She was just evil.
- ♪
- Narrator: July 3, 1997. Petaluma, california.
At 8 a.M., business owners and their employees begin arriving
At the medical complex on lynch creek way.
- Debra: It was a Thursday morning, we started our day.
We work at a physical therapy facility,
So we had patients coming in.
And me and two other therapists heard some popping noises.
This was July 3, so we just assumed it was firecrackers.
We didn't really think anything of it.
- Narrator: Minutes later, petaluma police receive
A frantic 911 call from a woman named deborah tavis.
She says there has been a shooting
In her husband's office.
- Debra: Dr. Mike tavis ran a plastic surgery office.
He worked with his wife, deborah tavis,
And their building was right next door
To our physical therapy facility.
- Danny: When a potential "shots fired" call happens in petaluma,
It's not ordinary.
So, typically, all available officers
Will respond to that area.
- [siren wailing]
- The police, uh, arrive at these medical offices
And they come with the full cavalry, so to speak.
- Debra: Our receptionist noticed that there were officers
Outside with their guns drawn,
That our whole building was surrounded by police officers.
We didn't know what was going on.
- Narrator: According to deborah tavis,
There are at least two people inside: Her husband,
53-year-old dr. Michael tavis,
And his office manager, 59-year-old kay carter.
- Officers could tell from talking to her
That she was scared,
She was frantic about her husband's safety
Because her husband had not exited the building.
Based on the circumstances,
The decision was made to enter the building.
- Patrick: We have to be careful.
We don't know if there's still a shooter in the building.
Two things we're doing is looking for the injured and
We're looking for the suspect.
- Danny: As the team entered the rear of the building,
You enter a kitchen area
And then you make a turn down a hallway.
And as I came around the corner, I immediately saw feet
And the parts of a man's legs laying on the ground.
I saw blood splatter on the floor
And some blood splatter on the wall.
And I immediately called out to the rest of the team
That I had somebody down.
- Clark: They found two people laying on the floor.
They were almost right next to each other.
- Danny: We immediately could identify
Dr. Tavis and kay carter laying on the ground,
Because there was a picture of them in the reception area
With deborah as the group that worked in the office.
- Narrator: The scene is violent,
But there is still hope that the injuries,
While life threatening, are not yet fatal.
- Danny: His office manager, kay carter, appeared to have
Sustained a single gunshot wound to the head.
She was not moving, but she was making sound, moaning.
Dr. Tavis was laying on his back
With multiple gunshot wounds.
- Narrator: Outside, police speak with deborah tavis to
Piece together how the tragic scene unfolded.
- When we first come into contact with deborah
At the scene, she's clearly distraught.
She's clearly upset.
- Narrator: Deborah tells police she and her husband arrived late
For an appointment with a patient.
- Clark: Deborah tavis and her husband arrived at the back door
And, uh, went inside.
And deborah tavis stopped in the back there to apply her makeup
While her husband went towards the front.
And she then heard a conversation between
Her husband--between dr. Michael tavis and a woman.
- The last thing that she heard was the voice of her husband
And then she heard shots from within that office.
- [two gunshots]
- She became frightened when the gunfire stopped
And ran out of the building.
- Patrick: Deborah was in great fear for her safety
And the safety of her husband.
She ran next door to another office.
She called 911.
- Narrator: Inside, police and paramedics desperately try to
Save the lives of the victims.
- Danny: The medical staff from the fire department entered
The building the minute we told them
That we had cleared it and that we needed help.
The paramedics transported kay carter to memorial hospital.
And they pronounced dr. Tavis dead at the scene.
- ♪
- Narrator: Michael james tavis was born on April 14, 1944,
In los angeles county, california.
He grew up in the city of orange and attended orange high school
Where he played football, ran track, and loved racing.
His classmates nicknamed him "racer brown."
- Clark: He graduated from high school down there,
And he was kind of trying to find his way,
Like any young man does.
And his uncle had a club up in south tahoe.
He went up there and worked, uh, parking cars for a while.
And then at some point,
He decided he wanted to become a doctor.
He went to school at ucla.
- Narrator: Michael became a licensed physician in 1975 and
Built up a private practice as a reconstructive surgeon.
In 1978, he also started a family.
- Michael tavis married a well-respected attorney
In sonoma county.
And they were kind of a power couple.
- Narrator: The couple had two children
And settled on a ranch in petaluma.
For a while, they seemed to have it all.
But the marriage didn't last.
The couple divorced in 1995,
And michael had to readjust to life as a single man.
- Clark: I know that he wanted to be an artist
In his other life.
He liked to do still painting.
He enrolled in a pottery class
And he happened to meet this woman
Who would become his future wife.
- Narrator: When michael met deborah siegmund,
He knew he had found the woman of his dreams.
- Deborah, was recently divorced and raising a child of her own.
Deborah was extremely outgoing and exuberant, good-looking.
And she loved him, and they were happy.
- They had been married in paris,
With a kind of a lavish ceremony.
- Narrator: After their wedding in 1996,
Michael and deborah tavis
Formed a powerful partnership back in california.
- Dr. Tavis ran that office with his wife, deborah,
And they work together there.
- Danny: Deborah's job in the office, uh,
Was best categorized as a consultant.
She would oftentimes consult with dr. Tavis's patients to
Discuss aftercare,
Psychological effects of plastic surgery,
Um, the reasons to have it and to not have it.
- Narrator: With deborah by his side--
And in a decade where plastic surgery
Was becoming all the rage--
Michael's business flourished.
- Mark: He did abdominoplasties, liposuction, facelifts,
Brow lifts, rhinoplasties, breast augmentations.
He had a great reputation.
There are a number of plastic surgeons in the area.
And I would certainly say he is in the top 10%.
- Sandy: He was a good doctor and friendly.
You could just tell when you met him, that he wanted to help you.
It wasn't just like, "sign here, you know, pay the money,
I'm done."
And also his wife, deborah, was extremely nice.
- He had a steady growing clientele.
And he also lived in a very nice home.
There was a big swimming pool, so he had all the accouterments
Of a, you know, comfortable lifestyle.
- Narrator: In the summer of 1997,
The newlyweds were thriving.
- Mark: They seemed to get along quite well, very playful,
Very collegial and respectful.
I think that he really valued her judgment
And her participation with his patients.
- Narrator: But on July 3, 1997, the couple's successful practice
Has become the scene of a violent attack.
Dr. Michael tavis has been pronounced dead on the scene
And officer manager kay carter, is left fighting for her life.
- We were able to immediately determine that
This was not a murder-suicide, because there was no weapon.
The weapon that was used to shoot kay carter
And kill dr. Tavis left the scene with the suspect.
- [siren wailing]
- Narrator: As kay carter is rushed to an area hospital,
Police lock down the surrounding area in search of the shooter.
- It was a very brazen crime.
Somebody came in in broad daylight.
So, this received some immediate media attention.
- Next thing you know, there's a helicopter overhead.
We're getting all these phone calls.
People are calling in to tell us what's going on--
That someone was at large.
- Clark: They basically told everybody to stay inside.
So, it was really a tense situation of not knowing exactly
What they were dealing with and whether that person
Who had done this was still armed and dangerous.
- Narrator: Coming up...
As detectives race to find a killer,
Deborah tavis reveals a short list of dissatisfied clients.
- Deborah provided five names of recent patients
That were angry with dr. Tavis.
- She heard her husband say, "I'm sorry, I care."
And then the gunfire erupted. - [gunshot]
- Narrator: And police find a piece of evidence that suggests
This is only the beginning.
- Danny: It definitely gives you the idea that this notebook that
She was carrying was a hit list.
- They didn't know if someone was just going around
Shooting doctors.
- ♪
- Narrator: July 3, 1997.
Police officers in petaluma, california,
Have an office complex on lockdown
After a shooting claimed the life of
53-year-old plastic surgeon michael tavis.
- Dr. Tavis has been murdered in his petaluma office
And his office assistant kay carter has been transported to
Memorial hospital, gravely injured.
- We're all just very nervous.
None of us, the patients or employees,
Were allowed to leave.
It was hard to believe that it was dr. Tavis who was murdered
Because he was such a well-liked doctor.
It was just very surreal.
How can that happen at his own office?
- Narrator: With the assailant still at large,
Lead investigator danny fish assigns officers to search
The area, knowing every second counts.
- Danny: We went from office to office,
They were either closed and locked up completely and secured
Or the owners of the businesses were there and were able to
Easily tell us, "no, nobody's come in here."
The area where the doctor's office complex
Is called lynch creek,
Because there's a small creek that runs
Parallel to the office complex near the parking lot.
So, if somebody was to perhaps discard a weapon,
That would be a logical place for somebody to throw a gun.
It would also be a logical place for somebody to hide.
We did assign officers to check the entire creek pathway.
We were unsuccessful in locating any weapons,
And we were not successful in
Really gathering any kind of investigative leads
During the time that we were checking out the creek area.
- Patrick: We are getting with potential witnesses
In other offices, people who may have passed by,
People arriving to work all those folks had to be
Interviewed to see if they saw anything unusual,
If they heard anything unusual.
Any information that will lead us to a suspect.
- Narrator: Inside the office of dr. Michael tavis,
Homicide investigators survey the crime scene.
- Danny: We did not find any signs of a struggle anywhere.
For instance, we didn't find any chairs knocked over
In the waiting room
That would indicate maybe a scuffle had occurred.
- Patrick: There was no sign of forced entry.
No pry marks on the door, nothing unusual there.
- Narrator: Detective fish and his colleagues theorize
The shooter likely entered the rear employee entrance,
And that kay carter was shot first.
- Kay carter was found, uh, near her de--desk.
She was just shot in the face, uh, very deliberately, uh,
In a very brazen way.
- Based on the blood spatter evidence that we could see
At the time, it was readily apparent that dr. Tavis was
Confronted somewhere in the hallway.
Dr. Tavis was shot one time in the chest
And then one time in the side
As he turned to run, and as he ran towards
The waiting room area, shot two more times in the back.
- Narrator: The extent of dr. Tavis' injuries suggests
He may have been the primary target.
- Danny: In my opinion, shooting kay carter one time in the head
And then shooting dr. Tavis four times would be more of
The emotional type of reaction
To a person who really wanted dr. Tavis dead.
- Clark: It pointed to the fact
That this was not a random occurrence.
So, it certainly narrowed
The list of possible motives and suspects.
- Narrator: Investigators circle back to the victim's wife,
Deborah tavis, to get more insight.
- Danny: Deborah said they had an 8:30 appointment
On the books, but it had been unconfirmed.
And so, they were not sure if
That patient was showing up or had shown up.
And because they were running late,
They were trying to reach kay carter to find out
Of that patient was in fact coming to the appointment
Or whether that patient had arrived at the appointment.
- Narrator: Deborah says when they finally arrived at
The office that dr. Tavis walked towards the reception area,
While she stayed in the back to apply her makeup.
There was no indication of anything amiss...
Until she heard a voice speaking to her husband.
- Danny: At first, deborah believed that dr. Tavis
Was probably talking to kay carter.
But then when she listened more closely,
It sounded like a voice that she didn't recognize.
- She described the woman's voice as very calm,
Controlled, deliberate.
And she heard the woman say,
"I've seen 28 surgeons," or words to that effect.
She heard her husband say, "I'm sorry, I care,"
And then the gunfire erupted.
- [gunshot]
- Narrator: Detectives press deborah for anybody she could
Think of who might have wanted her husband dead.
- Danny: She was able to recall that there had been a number of
Patients who were unhappy with the surgical procedures
That they had received from dr. Tavis.
- Dr. Tavis had had, I think, about a dozen lawsuits
Over perhaps the same amount of years
That involved patients.
- Danny: She gave it some thought, and she's like,
"these are the top five people that were really the angriest
About things that I can think of."
Our very next step is to
Identify who these five people are,
Do background investigation on all of them and find out
Where they live, what their issue is.
At this particular point, deborah is not a suspect.
She was legitimately distraught, she was legitimately frantic.
She was what you see in a victim
Who has just had a traumatic thing happen
And is trying to grapple with the aftermath.
- Narrator: With a list of names to follow up on,
Police release deborah and shift gears to secure the scene.
- Danny: We had created the perimeter which kept people
Out of the immediate vicinity for their own safety.
We interviewed as many of the occupants of the offices
In this office complex as possible.
- Narrator: Investigators get a new lead when they speak
To a witness in a neighboring building.
- One of our officers was able to contact a witness
Who observed a small pickup truck
Backed into a parking stall
Facing the rear of dr. Tavis' office
On the morning of July 3.
- Debra: I arrived at work,
And I saw a woman in a truck.
And I thought it was odd because
Usually no one's back there at that time.
Something just struck me really strange about her.
Because exactly a week before,
I had left for my lunch break at about 1 o'clock
And came back and she was in the parking lot.
But what was really strange was by the end of the day,
At 5 o'clock, she was still there.
Same position and just staring out our building.
One week later--the day of the shooting--I get there early
In the morning, and here she is again.
- Narrator: Coming up...
Key details about dr. Tavis's life come to light.
- Dr. Tavis had at one point, uh,
Considered a restraining order.
- Narrator: And detectives discover the secret life of
A potential serial killer.
- She had taken great care to know exactly what
These potential victims were doing with their lives.
- ♪
- Narrator: July 3, 1997.
Petaluma police officers
Continue canvassing the office complex
Where dr. Michael tavis was shot and killed.
And investigators have a list of disgruntled patients
That may lead to a suspect.
- Harry: Any doctor who's performing cosmetic surgeries
Is probably gonna have dissatisfied clients.
Not every medical procedure of any kind
Works out 100% perfect every time.
And if it doesn't work out, they could be upset.
- Narrator: Detectives wrap up their last interviews with
Potential witnesses, including debra sojka who had been trapped
In a neighboring office building since the police arrived.
- Debra: When we were finally allowed to leave that day,
I notice as we're leaving and entering the parking lot that
They had the crime scene tape up,
And it was blocking my car in.
And if I'd parked in the normal spot where I would usually park,
I could have left and I was kinda kicking myself thinking,
"oh, jeez, why did I park in this different spot?
I just want to go home."
And then it dawned on me that that woman was there
That morning, in the truck, and that's why I didn't park there
And so I let the police know about that.
- Danny: The person sitting in it would be looking basically
Directly at the entry point where dr. Tavis and deborah
Typically entered and exited for their workday.
- Debra: I recall telling police that she had brown hair, and
I could see this round face through the windshield,
But I really couldn't get any details
Or any good description.
- Narrator: Soon after their interview with debra sojka,
Investigators receive an update
On the status of the second victim of the shooting:
Dr. Tavis' 59-year-old office manager kay carter.
- Kay carter was treated at the hospital,
And she never regained her speech.
She had a traumatic brain injury.
- Narrator: As kay endures the fight of her life,
Detective fish and his team focus on their list of potential
Suspects provided by deborah tavis.
- Patrick: Our investigators began working actively
To follow up on them to see if there was anything unusual
In their behavior.
Do they have criminal arrest records?
Had they made prior threats?
And so they began working on each of these people
As potential suspects.
- Danny: Just by knowing their names,
We were able to put detectives and officers on the task of
Locating each and every one of them for an interview.
We ask them if they know even that dr. Tavis
Has been murdered,
Find out what their relationship was, and, in some cases,
Perhaps even eliminate them as being suspects.
And we were able to do that with four of the five names because
They had legitimate alibis.
There was a fifth that we had not be able to contact yet.
And that particular name was theresa ramirez.
- Patrick: Officers did go to the home of theresa ramirez.
She was not at home when they arrived.
They left a message for her to contact them, she did not.
That caused them some concern.
So she became somewhat of a focus at that point.
- Narrator: Theresa mary ramirez was born in san francisco
On February 8, 1952.
The oldest of three children of a fireman and a homemaker,
She grew up to be a strong-willed,
Independent woman.
- Theresa was--she was a little, tiny thing.
Very outspoken.
She'd tell you what she thought, never smoked, drank,
Swore or anything. Just a pleasant person.
- Harry: She got her nursing degree,
She had been working at the kaiser hospital in santa rosa
For a number of years.
- Terry opened up the orthopedic department in 1985,
I believe, when she started working there.
So, she was one of the originals.
- Deborah l: Theresa and I attended the same college
In san francisco.
She never talked about any relationships, any kids,
Any siblings, nothing like that.
She never revealed any part of herself to us.
- I never knew theresa to be friendly in the way of
Interacting with other co-workers and colleagues.
I worked there probably--down the hall from her for 10 years,
And I really didn't know a whole lot about her.
- John: I heard that when theresa
Was in south san francisco
Her dad had fixed her up with another fireman.
That was supposed to be a good relationship and all.
But evidently it fell apart.
It devastated her, so she never got into another relationship.
- Narrator: In 1988, theresa's solitary life
Was turned upside down
When she was diagnosed with breast cancer.
- Harry: She had a relatively minor finding
On one of her breasts,
And there was gonna be some minor surgery performed
In that regard.
Certainly not a mastectomy but maybe a lumpectomy or some other
Relatively minor version of it.
- Clark: She had had several members of her family that
Had come down with cancer.
Some that had died from it and so she was very concerned that
She would have the same fate.
- She volunteered and elected to have a bilateral
Or a double mastectomy.
- John: Being a nurse, she knew, I mean this is, you know,
Life threatening.
So, she decided, you know, to have them both taken off.
And after that's when everything started, uh, going south.
- Narrator: According to deborah tavis,
Her husband performed reconstructive surgery
On theresa.
- Clark: She went to dr. Tavis because she wanted to have
Silicone implants, so she'd have a matching pair of breasts.
Dr. Tavis, in his medical notes,
He said that the results were excellent,
And that theresa ramirez was ecstatic with the results,
But that proved to be, uh, overly optimistic because,
Within a week she was complaining about
The surgery and wanted more.
- Danny: She was unhappy.
She felt like that they weren't even.
And she ultimately ended up complaining to dr. Tavis
Multiple times and had multiple surgeries
To try to correct these flaws.
- Clark: I believe she had a half dozen in all.
Dr. Tavis had at one point considered a restraining order.
You know, there's always a question of whether
A restraining order can really protect someone against someone
Who really wants to do them harm.
- Virginia: She did have some anger issues
And some passive-aggressive issues.
- Theresa was dis--disgrunted about everything.
- When I found out that
She had so many reconstructive surgeries,
I was just, you know, kind of blown away.
She wasn't somebody that wore sexy outfits.
She wore her closed-in clothes, and so it surprised me that
She was so fixated on reconstruction.
- ♪
- Danny: Theresa ramirez was our most promising lead
So we did put the house under surveillance.
We did watch it for a full 24-hour period
All through the night to see if anybody came or went
And, uh, nobody did.
The fact that she had not come back to her house on any of
The days, or answered any of our attempts at contact,
Made us concerned that she may have fled.
- Narrator: Coming up...
An urgent tip launches the case into high gear.
- This is a life-threatening situation.
- Narrator: And an unnerving discovery
Shakes the entire community.
- They found two guns in her purse
And also a small notebook
With names of people.
- It was pretty obvious that I was her first target.
I was numero uno on her list.
- ♪
- Narrator: Investigators have identified theresa ramirez as
Their primary lead in the July 3 murder of dr. Michael tavis
And the attempted murder of his office manager kay carter,
Who is left unable to speak.
But so far, theresa has eluded authorities.
- On July 7, I was in my office going over all of
The notes on this case and I received a call
From the san francisco police department.
They put me in touch with an officer who said,
"hey, I might have something here to help with your case."
- A woman had checked into a hotel in san francisco.
The hotel staff went into the room
And the woman in the room was passed out.
- The paramedics were called, and the police were called
As well, and she was taken to the hospital.
- Narrator: It's at the hospital where they learn the woman has
A pre-existing condition.
- This is a life-threatening situation.
She was a diabetic and she was in a diabetic coma.
- Narrator: Hotel records indicate that the woman
Checked into the hotel at 5 p.M. On July 3--
Hours after michael tavis was murdered--
Under the name theresa brew.
- Police officers arrived at the hotel and they were able to look
Around the hotel room to try to find the person's identity.
And in doing so, police officers located her identification.
- Narrator: But the name on the driver's license
Isn't theresa brew.
It's theresa ramirez.
- Danny: The officers who had responded to the hotel took
Items of evidence that they had collected at her hotel room.
- Narrator: When police examine the items at the station,
A disturbing picture begins to emerge.
- Danny: She was carrying $5,000 in cash.
People who are, quote, "on the run,"
Tend to use cash because it can't be traced
Like a credit card could be traced.
Also in her belongings was a train ticket
To van nuys, california.
- Clark: They found two guns in her purse
And also a small notebook with names of people,
Including the name of dr. Tavis.
- Davis: The san francisco police department provided us
With the items that they had gathered from the hotel room,
Including her identification, the guns, cash,
And the booklet that had dr. Tavis's name in it
And we then made arrangements to go to the hospital
To try to interview theresa ramirez.
- Narrator: Petaluma investigators make
The 40-mile drive to san francisco,
And with theresa ramirez in a diabetic coma,
They prioritize looking at the evidence found
In her hotel room, starting with the notebook.
- Each page has personal identifying information about
A number of people, including dr. Tavis--his address,
His office address, his wife's name, kay carter,
Kay carter's address, her license plate number,
The name of multiple other doctors
That she has had contact with in the past.
It definitely gives you the idea
That this notebook that she was carrying
Was a hit list type notebook of the people she means harm to.
- Clark: There were about 20 names.
It's definitely a big development,
A huge significance for her to have this notebook
There in her own handwriting.
- Danny: As I'm looking at the notebook,
I am definitely solid in my belief
That we have the right person identified as a suspect.
And I am also flabbergasted and relieved to know
That she wasn't able to carry out
What I think she was planning to carry out.
- Narrator: One of the names in theresa's notebook
Is dr. Robert fies,
Who was tasked with approving theresa's requests
For further surgeries through her insurance provider.
- Bob: She had a very unfortunate history
Of surgeries.
As a medical director,
I was required to give a, uh,
A thumbs up or a thumbs down.
And I asked her to come in.
She came in rather tense, nervous and sat down abruptly.
She fidgeted and her eyes darted all over the room.
I explained to her why I asked her to see a psychiatrist,
That I was concerned that she's been having poor results.
And I wanted to get clearance that she would be a good patient
For future surgery.
And what happened was she looked at me and glared
And said, "I'll show you why."
And put her hands on her blouse and...
Made the motion as if she was going to rip open her blouse.
So, I told her, "theresa, that's not appropriate,
"because we can no longer do it here.
You'll have to accede to this or not do surgery."
And she just glared at me.
- Narrator: When investigators contact dr. Fies he explains
That theresa was unlike any patient he'd ever encountered,
Especially once he decided she needed a psychiatric evaluation.
- She had been operated on by multiple surgeons,
Most of whom refused to do more than one operation,
Because they found her too difficult.
And one particular surgeon, dr. Michael tavis,
Who was a very generous and compassionate service,
Kept giving in to her requests.
- Narrator: Dr. Fies says he denied theresa's request for
Further surgery, but she refused to leave the room.
- Bob: I picked up the phone and I asked for our security
To come in and have her leave the building.
It was very clear f-- obviously from her demeanor
That she was not stable.
- Narrator: Unbeknownst to dr. Fies,
The most disturbing visit came on the morning of July 3.
- We determined that theresa ramirez showed up at
The doorstep of dr. Fies in santa rosa
The same morning that she murdered dr. Tavis.
- I was away from town.
So, I was not present on the day that dr. Tavis was killed.
But she came first to my own door.
And it was pretty obvious that I was her first target.
I was numero uno on her list.
- Narrator: On July 8, 1997,
Detectives obtain the physical evidence they need
To move forward with charges against theresa ramirez.
- The final piece of the puzzle came in the form
Of the forensic testing of her five-shot revolver,
Which was in her possession the day she was found in the hotel.
- Those handguns were taken to the state, uh, crime laboratory.
They took the bullets from the bodies and compared them to
Bullets that they fired from the handgun in their laboratory,
And they showed that they were actually fired
From the same gun.
- Narrator: Coming up...
Prosecutors have compiled a mountain of evidence against
Theresa ramirez...
But will justice prevail?
- We felt that that showed the foundation of
An insanity defense.
- Clark: She had this body dysmorphic disorder.
And this was something that really drove her and was the,
Uh, basis of her mental illness.
- ♪
- Narrator: On July 9, 1997, investigator danny fish
Arrives at san francisco general hospital
To interview theresa ramirez,
The prime suspect in the murder of dr. Michael tavis
And attempted murder of office manager, kay carter.
- I introduced myself at her bedside,
Told her I was there to interview her,
Asked her name and asked a number of questions,
And she refused to answer any of them.
She simply turned her head away every time I talked to her.
- Patrick: She pretended she couldn't talk
From her medical condition,
I mean, that would be understandable,
But they felt that she was able to talk.
She just was choosing not to.
- Danny: So, I read her her miranda rights at that point
And placed her into custody by telling her she was under arrest
For the murder of dr. Tavis
And the shooting injury of kay carter.
- She was charged with first-degree murder
And attempted murder.
- Narrator: In January 1999,
Theresa ramirez's trial gets underway.
- Debra: We were asked to testify at the trial--
Me and a couple of co-workers
Heard the first shots that struck kay.
And so, we were able to set up a timeline.
We could say when those shots happened.
We did not hear the second shots that hit mike tavis,
But by setting up this timeline, we were able to show the jury
That she was lying in wait.
- Clark: What they were able to piece together
Was that kay carter came in and turned on a computer
And also started some coffee,
And then theresa ramirez came in through the back door
And shot her. - [gunshot]
- Danny: I believe she hid in one of the offices
For the 15 or 20 minutes
That it took dr. Tavis and deborah to get there.
And when dr. Tavis walked in and down the hallway to go find kay,
I think that theresa ramirez stepped out into the hallway
Behind them, said what she said, shot him in the chest.
As he turned to run, I believe she started firing again
And hit him in the side and then twice in the back.
And then I think she ran out the back shortly
After deborah had run to the other office.
- Theresa's defense at trial was that she was
Criminally insane and therefore
Could not be held accountable for her actions.
- When I spoke to her, all she would ever talk about
Is the problem she had with her breast surgeries.
That was her focus all of the time.
She was, in her mind, horribly disfigured.
We felt that that showed
The foundation of an insanity defense.
- Clark: Some of the people that evaluated theresa ramirez said
That she had this body dysmorphic disorder.
And, uh, that this was something that really drove her
And was the basis of her mental illness.
- Deborah l: Theresa's body disorder.
It--it makes sense that she dressed in layers
And she covered her body pretty much.
You would not see any of her skin.
Just her hands and forearms and even her neck would be covered.
- Narrator: On February 11, 1999,
A jury finds theresa ramirez guilty of first-degree murder
And attempted murder.
She is sentenced to two consecutive life terms
In prison without parole.
- Harry: Theresa has a stone-faced reaction
To all of this. She doesn't say anything.
She just sits there and stares straight ahead.
- Virginia: She wasn't insane.
She was just evil.
Just because she wanted her breasts to look perfect.
- Sandy: She should spend the rest of her life behind bars.
Dr. Tavis was just being a good doctor and a good person.
- Narrator: But the verdict is little consolation
To the loved ones of dr. Michael tavis
And kay carter, who passed away in 2012
Due to her injuries.
- Kay carter had four kids and her husband had previously died.
She ruined their lives.
He was married, he has kids.
She ruined their lives.
Nurses are nurses for a reason.
We're out there to help people.
And here she was, a registered nurse,
That was taking someone's life because of her own
Dissatisfaction with her body image.
It was just so sad.
- Debra: Dr. Tavis has always been remembered
As a very well-liked, compassionate doctor
Who was very skilled and did excellent work.
And he was taken from us way too soon.
He did not deserve this and neither did kay.
- ♪