Anthony Garcia's case involves two sets of murders, committed five years apart.
The investigation into the 2008 killings — of Dr. William Hunter’s 11-year-old son, Thomas, and Shirlee Sherman, the family’s part-time cleaning lady — was revived in 2013 after Dr. Roger Brumback and his wife, Mary, were killed.
Both Hunter and Brumback worked in Creighton's pathology department, where Garcia years earlier had been terminated from the residency program.
"Further investigation led law enforcement to suspect Garcia of both sets of murders," Chief Justice Michael Heavican said in Friday's opinion.
Heavican said the evidence shows Garcia had traveled from Louisiana to Nebraska in 2008, taking precautions not to be identified, murdered Sherman and Thomas Hunter, and left the state.
"Garcia waited nearly five years, during which time he attempted to further his education, obtained employment, and bought a house and a vehicle — in short, he lived a normal life," the judge said. "But in 2013, Garcia began investigating individuals connected to his time at Creighton, before returning to Nebraska to murder two more people."
In 2013, Garcia was arrested in Indiana and charged with both sets of murders.
In 2016, a jury found him guilty. And at the sentencing phase that followed, Garcia was given a death sentence, prompting an automatic appeal.
In it, attorneys with the Nebraska Commission on Public Advocacy raised 130 alleged errors, many focusing on the constitutionality of the death penalty, aggravating and mitigating factors in the case and his initial trial counsel, Chicago-based "Team Motta."
Before trial, Alison Motta gave statements to the media about DNA testing that she said cleared Garcia in violation of the court's protective order and the rules of professional conduct.
She ultimately was removed from the case and disciplined for it.
Then, only after the jury found Garcia guilty did his remaining attorneys start asking what an aggravation trial was all about.
In Nebraska, the aggravation phase, where the jury determines if a case is eligible for the death penalty, immediately follows the guilt or innocence phase of trial. His new attorneys argued by then it was too late for them to adequately represent him.
After the jury found Garcia eligible for a death sentence, the commission was appointed as co-counsel and represented him alone at the mitigation phase before the three-judge panel.
In a 129-page decision, the state's high court said they couldn't determine on direct appeal whether counsel had been ineffective.
That would be an issue to be raised later in a motion for post-conviction relief, should Garcia file one.
"We otherwise affirm Garcia’s convictions and sentences," Heavican wrote.
The Supreme Court did say one of the aggravators considered by the three-judge panel (that a murder had been done to conceal the identity of the perpetrator) should have been disregarded because it overlapped another (that the defendant killed another at the time he killed the victim). But the court found it was a harmless error.
But they rejected the contention Garcia had acted under unusual pressures or influences and that, without it, he "would not have persisted at his (S)isyphean task of continuing to pursue medicine despite his apparent inability to succeed. And, had he abandoned medicine in favor of a more suitable career path, he would not have felt repeatedly thwarted by the Creighton Pathology Department."
Heavican said Garcia chose to remain in the medical field and continue to place himself under the pressures he perceived from that choice.
As for whether Garcia should have gotten a death sentence, the chief justice said: "The crimes committed against Hunter, Sherman, Roger and Mary were utterly senseless and cruel."
Heavican said Garcia had severed the jugular veins of all four of his victims, the carotid arteries of three of his victims, left the knives in at least two of his victims, both stabbed and shot one victim, and left multiple puncture marks on another.
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"One is absolutely sickened, not by the crimes that the wicked have committed,
but by the punishments that the good have inflicted."
— Oscar Wilde
but by the punishments that the good have inflicted."
— Oscar Wilde