The very thought of preparing for an accreditation survey weighed so heavily on one nurse's shoulders that it drove her over the edge. How else would you explain her telling lie after lie to her surgeon and colleagues that, yes, they were all set for an accreditation survey when she hadn't even applied to the accrediting body? Or dreaming up excuses not once but twice for why the surveyor she'd said was coming the next day had cancelled at the last minute? Or finally setting a small fire to her office after-hours to destroy paperwork and buy herself more time, after she'd cried wolf a third time and told everybody once again that the surveyor was due the next day?

Misty Ann Weaver, 33, a licensed vocational nurse for a Houston cosmetic surgery office, confessed to arson authorities that she went to such lengths to keep her fabricated accreditation tale from caving in only after she was questioned for a third time about her whereabouts the night of the fire.

"The motive she supplied police was that she told her boss that the surveyor was due to visit the next day and she had procrastinated in preparing paperwork needed for an accreditation survey," says Harris County Assistant District Attorney John Jocher.

The small fire she set in the supply room turned into a fast-moving, four-alarm blaze that charred two floors of a Houston office building, killed three people and injured six others. The mother of two now sits in the Harris County Jail on $180,000 bail, charged with three counts of felony murder and one count of first-degree arson with injury. All this over an accreditation survey.

"Desperate people do desperate things"
When Misty Ann Weaver left Capriotti Cosmetic & Laser Surgery at 5 p.m. Wednesday, March 28, police say she was so distraught over an accreditation survey she hadn't prepared or planned for and so fearful of losing her job of eight years that she returned 15 minutes later to the fifth floor of the six-story office building with a mad mission on her mind: Start a small fire in the supply room of the two-OR surgical suite to destroy some key paperwork and buy herself more time.

"Desperate people do desperate things," says James Snowden, a Houston Fire Department senior arson investigator.

She told police that she'd taken a lighter from the kitchenette and held it to a cardboard box filled with plastic tubing. When the flames reached four inches to five inches, she left the supply room and exited the building.

"She was hoping that it would remain a small fire and that the building's sprinkler system and the firefighters' extinguishing the fire would destroy paperwork necessary for the accreditation and allow her more time," says Mr. Snowden.

But fanned by 20 mph winds outside, the fire tore through the fifth floor and reached four alarms during the evening rush hour. The three people who died worked on the fifth floor.

Prolonged procrastination
Ever since his three-year accreditation with the Accreditation Association for Ambulatory Health Care lapsed last May, cosmetic surgeon Robert Capriotti, MD, had been anxious to have his facility reaccredited, say investigators. "I must have asked her 50 times a month if she was ready and she said, 'Yes, no problem,'" Houston Fire Department chief arson investigator Roy Paul quotes Dr. Capriotti as saying. "She told him she was on the case and she wasn't. Never did she even attempt to do it, to our knowledge. And I think [Dr. Capriotti] wanted that accreditation."

Ms. Weaver helped prepare for the initial 2003 survey, "but since then we've had no contact with them. Nothing at all," says an AAAHC spokeswoman. "No application for re-accreditation had been filed with us. There is no pending survey scheduled for that office."

Investigators say Dr. Capriotti placed Ms. Weaver, whom Mr. Snowden described as Dr. Capriotti's "right-hand person" when it came to scheduling patients and ordering supplies, in charge of the accreditation project. For reasons that aren't known, Ms. Weaver never got the project off the ground.

"[Ms. Weaver] couldn't say the surveyor canceled again or else the doctor would get involved and find out that she was scamming," says Mr. Paul. "She needed another reason to cancel the accreditation."

Dr. Capriotti told The Houston Chronicle that Ms. Weaver had financial woes, including filing for bankruptcy, but that her problems didn't seem "pressing."

"Dr. Capriotti seemed to be totally shocked that she would resort to that type of behavior when she could have just come to him and told him that she was overwhelmed by the task of it," says Mr. Snowden.

Citing the ongoing investigation, Dr. Capriotti declined comment. The Texas Board of Nurse Examiners calls its investigation into the status of Ms. Weaver's license a "high priority."

Web of lies
Besides lying about accreditation, Ms. Weaver - who continued to work in Dr. Capriotti's relocated office after the fire - also lied to arson investigators, who quickly determined that the fire was no accident and that there were holes in Ms. Weaver's story.

Investigators say Ms. Weaver left the office with a co-worker but was seen on surveillance tape re-entering the building a few minutes later, a fact she didn't volunteer to them. When presented with the evidence during a second round of questioning, she told investigators that she'd re-entered the building because she thought she'd left her cell phone in the office, but then realized she'd had it all along in her pocket once she reached the lobby. "We knew differently," says Leocadio Gonzales, assistant chief investigator with the Houston Fire Department arson division.

Something else was nagging investigators. Where was the AAAHC surveyor Ms. Weaver promised was coming on March 29, the day after the fire? "We were concerned from the beginning when she mentioned that the surveyor was scheduled to be there the next day," says Mr. Paul. "Why didn't the accreditor show up the next day? He never did."

Ms. Weaver's story soon began to unravel. Finally, on April 7, 10 days after setting the deadly fire, Ms. Weaver confessed, say police. "Maybe she was tired of living a lie," says Mr. Gonzales. Ms. Weaver's court-appointed attorney, Todd Dupont, didn't return phone calls seeking comment.

"This is more than just a bizarre case," says Mr. Snowden, who's been investigating arsons for 14 years. "I rank this one as one of saddest cases of arson I've seen because of the loss of life."