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A former nurse was the "common thread" in the death of one patient and the harming of five others seven years ago at Niagara Falls Memorial Medical Center, Special Prosecutor Thomas P. Franczyk told a jury Thursday.

"These were elderly, unsuspecting patients, and the defendant was intent on seriously harming these people," the prosecutor said in his opening statement at the County Court trial of Ann Marie Truscio.

Miss Truscio, 36, is charged with murder and manslaughter in the death of Edwin Klein. She is accused of killing him by injecting him with insulin.

She also is charged with 12 counts of first-degree assault for administering insulin to the other five patients who survived the injections.

During his opening statement, which ran 4 hours and 15 minutes, Franczyk took jury through detailed descriptions of various degrees of diabetes and the effects of insulin on blood sugar.

Franczyk's statement took so long that presiding Judge Mark H. Dadd delayed the opening statement by defense attorney Dennis O'Keefe until today.

All of Miss Truscio's victims were elderly, Franczyk said. The youngest was 61, and the oldest was 81.

Klein was a diabetic, Franczyk said, but three of the other victims were not.

Klein's death originally was diagnosed as cardiac arrest, but his family had doubts.

Four months later, when a patient named Clair Russell received a harmful injection of insulin and the case was reported in the press, Klein's family was "struck by the eerie parallels" with his case, the prosecutor said.

The family battled through a lot of red tape, he said, and eventually had Klein's body exhumed and an autopsy performed. The autopsy determined that death was caused by an insulin injection.

Miss Truscio is charged with assault against Miss Russell, William Spanogle, Edward Spiotti, Mary Marzec and Doris Dawson.

All the attacks occurred while Miss Truscio, a licensed practical nurse, was on duty at the hospital during the midnight shift.

"Lightning doesn't strike so many times in the same place," Franczyk said, noting that the assaults all occurred between June 29 and Oct. 30, 1988.

"All the patients were on the same floor," he said. "With mysterious regularity hypoglycemia (an abnormal decrease in blood sugar) occurred like clockwork at the end of the midnight shift or the beginning of the day shift."

The incidents, he said, "started four days after her (Miss Truscio's) assignment to the floor and ended when she was terminated."

Franczyk's opening statement was delayed when O'Keefe asked Dadd to have an attorney, Christina K. Hurnyak, barred from the courtroom for the duration of the trial, because he said she had served his client with two subpoenas involving civil suits filed by executors of the estates of two patients Miss Truscio is accused of assaulting -- Spanogle and Mrs. Dawson.

Dadd denied the motion, and Ms. Hurnyak would not comment on the pending cases.

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