Saying that to call the case tragic would be an understatement, a Philadelphia judge on Monday held a nurse for trial on involuntary manslaughter and two related charges in the April 13 nursing home death of the father of President Trump's former national security adviser.

Christann S. Gainey of Earp Street in South Philadelphia, a licensed practical nurse, was ordered held for trial by Municipal Court Judge Karen Y. Simmons after a three-hour preliminary hearing at the Criminal Justice Center in the death of Herbert R. McMaster Sr. Gainey, 30, also faces trial on charges of neglect of a care-dependent person and tampering with records. An earlier part of the hearing took place June 5.

McMaster, 84, died at the Cathedral Village senior community in Roxborough, where he was being cared for after a stroke. The Medical Examiner's Office ruled that his death was caused by blunt-force trauma from hitting his head in a fall on April 12. He was the father of H.R. McMaster Jr., national security adviser in 2017 and part of 2018.

Herbert R. McMaster Sr., a retired Army lieutenant colonel, in 2016 before he suffered a stroke.
Herbert R. McMaster Sr., a retired Army lieutenant colonel, in 2016 before he suffered a stroke.

"To say this is tragic would be the biggest understatement that I could say, because we will never know if but for the actions and inactions of a number of people, including Ms. Gainey, that Mr. McMaster would still be alive," said Simmons, adding that it was also tragic that others who provided poor service to McMaster on the day he died were not charged.

"But I can only decide on the cases [of] the people or entities that are before me," the judge said.

Defense attorney Sharon Piper Donovan had argued that Gainey, a single mother employed by General Healthcare Resources, a medical staffing agency, was being "scapegoated" even though she had provided care to McMaster and about 38 other patients on the last day of his life while other staffers had not, including one who reported to work more than an hour late and took a nap during the shift.

"Even the judge made it clear that there were a number of other people that failed to do their job to give care to Mr. McMaster," Donovan said after the hearing.

Saying that Gainey — who is free on bail — should be cleared of manslaughter, Donovan said during her closing argument that there was no evidence of criminal intent or recklessness on the part of her client.

She said the medical examiner was unable to say exactly when McMaster suffered the fall that resulted in his fatal head injury, meaning it could have happened before Gainey's shift began.

"To label her care of Mr. McMaster as reckless is really beyond the scope of criminal court," Donovan said. "The evidence is not there. She did attend to Mr. McMaster."

Donovan also asserted that the criminal investigation into McMaster's death only began after the White House called the Philadelphia Police Department to request the inquiry. Before the call, she said, "everyone who looked at it said, 'There's nothing here.' "

Albert Chu, Philadelphia deputy chief medical examiner, testified on June 5 that Philadelphia Police Lt. Philip Riehl called him on April 16 and told him the White House had called the homicide division regarding the death. McMaster Jr. left his White House post on April 9. Gainey was arrested May 10 by the state Attorney General's Office.

Deputy Attorney General Chris Jason argued that the case comes down to Gainey's subpar care of McMaster and an attempt to cover it up after he had died. During Monday's hearing he played video from inside the nursing home to try to demonstrate that Gainey had repeatedly falsified neurological flow sheets to indicate that she had checked McMaster's vital signs and eye, verbal, and motor responses throughout her shift when she had not.

"The fact is that the defendant's repeated failure to conduct any neurological evaluations," Jason said, "further cements the defendant's recklessness."

He added: "Your Honor, at the end of the day, common sense dictates that we have one fall that leads to a head injury, eight hours later we have a man dead in a lobby, literally feet from the defendant, and the defendant failed to do anything to try to give him a chance."

McMaster fell four times at Cathedral Village between 9:45 p.m. April 9 and 1:55 a.m. April 12, according to testimony on June 5 by Syreeta Carter, assistant director of nursing. The last fall, which led to his death, was not witnessed by staff, even though he was supposed to be receiving one-on-one care, Carter said.

McMaster's family has filed a lawsuit against Cathedral Village, according to Donovan.

The homicide unit of the District Attorney's Office's referred the case to the state Attorney General's Office because nursing homes and assisted-care facilities are regulated by the state and the Attorney General's Office has specialized personnel to prosecute such cases, said Ben Waxman, spokesperson for the District Attorney's Office.