Introduction
It’s hard to imagine that anyone in the healthcare industry could have murder on his or her minds.
When you think of a nurse, the immediate image that comes to mind is of a caring individual who has embarked on their career for altruistic, rather than financial reasons. We all know that nurses are overworked and underpaid but in the spirit of pioneers like Florence Nightingale, they are committed to making a difference to people in need. And being in hospital or in poor health is a time of life where you are at your most needy and vulnerable.
Doctors are in a slightly different category, in that they are far better paid and have a lot of clout. We’ve all heard stories of some doctors having what is referred to as a ‘God Complex’, whereby they thrive on having the power over life and death.
There is no doubt that for a few healthcare professionals this power can be so alluring that they cross the line.
Many of the cases covered in this book happened several decades ago. These days there are tighter regulations, and there is also more understanding (one would hope) about how to identify a rogue healthcare professional. As a consequence of many of the cases featured in this book, legislation and therefore hospital procedures were tightened up to try and stop healthcare professionals, such as American nurse Charles Cullen, from becoming serial killers. In the case of Cullen, a law was introduced in New Jersey in 2005 as a direct response to his killings. The act requires healthcare professionals to report if they have information about incompetence, impairment or negligence of a healthcare worker. The act also means criminal background checks of healthcare workers are mandatory if they want to work in New Jersey. (It’s quite unbelievable that this wasn’t the case anyway and is one of the reasons that Cullen was able to kill so many people.)
Ultimately though, no policy, law or regulation can stop a rogue healthcare killer. Whether they are mentally disturbed, angry at the world or have a genuine belief that they are doing ‘the right thing’, it is clear from the stories in this book that you can’t stop someone who is hell-bent on harm. This is perfectly summed up by Dr Raj Patel, a GP who knew Dr Harold Shipman: ‘You can legislate against a poor doctor but you can’t legislate against evil.’
The victims of healthcare serial killers are almost always the elderly, disabled or the very young – the most vulnerable people in society. But in some of the cases you will read, serial killers such as Charles Cullen, Harold Shipman and Vickie Dawn Jackson also targeted people in the prime of their lives. Being younger and not chronically ill is clearly not immunity to being the target of a serial killer in a healthcare setting.
While writing Angels of Death, I noticed that the pattern of offending with medical serial killers is often alarmingly uniform – many of these evil angels worked on a nightshift where they were unsupervised, they had personal problems and mental health issues and there were always one or more red signals that meant they could have been stopped, whether it was a disciplinary issue that was not shared as they moved from job to job, a drug addiction, a criminal conviction or a cloud over their professional practice… In a number of cases detailed in this book, many of these murders could have been prevented had there been more rigorous checks and balances in place from the hospital right up to state legislation.
When I set out to write this book, I had heard of the high-profile cases of healthcare serial killers such as Dr Harold Shipman, Britain’s worst (and possibly one of the world’s worst) serial killers. Shipman is believed to have murdered more than 200 of his patients with overdoses of the narcotic diamorphine. I’d also heard of English nurse Beverley Allitt who killed four babies and children in her care with fatal doses of a drug that induced cardiac arrest. Allitt had the characteristics of the rare condition Munchausen syndrome by proxy (inflicting injury on others to gain attention for oneself) and Munchausen syndrome (inflicting injuries or inducing or faking sickness and symptoms on oneself). These conditions are extremely serious personality disorders that can prove fatal, as they did for Allitt’s tiny victims.
I was also familiar with the case of Roger Dean, the Sydney registered nurse who in 2011 started fires at the nursing home where he worked so that he could thwart an investigation into his theft of drugs from the facility. Dean’s actions caused the terrifying deaths of 11 of the nursing home residents who were elderly, frail and unable to flee to safety.
However, some of the cases were new to me, like the chilling story of Texas nurse Genene Jones, who is suspected of killing almost 50 babies while working as a nurse. Victims’ advocates and people involved in the original case are actively trying to stop the Texas baby killer from being released from prison. Jones is eligible for release in 2018 under a mandatory release law in Texas that means prisoners with good behaviour must be freed after serving a percentage of their sentence. In Jones’s case she will have served just over 34 years of her 99-year sentence for the murder of an infant girl. The loophole, which has now been closed, was intended to reduce prison overcrowding. Now, the families of Jones’s victims and are trying to find another family whose baby was killed by Jones so they can keep her in jail.
Before researching this book, I had not realised just how many healthcare professionals have been found guilty of murder. Frankly, it is disturbing. It could be argued that healthcare serial killing is the easiest type of murder to commit… and get away with for years, or possibly forever. Serial killer nurses and doctors do not have to go looking for their victims – they literally have a captive audience from which to choose.
All crime has a terrible impact on the lives of families and loved ones of the victims. However, there was something particularly sinister about the cases featured in this book. I kept thinking of it as ‘casual horror’ in that the very people who were tasked with caring for the victims had made a decision to instead end their lives, as quickly as it took to give an injection or smother someone who simply could not defend themselves.
Serial murder by healthcare professionals is particularly evil because these offenders have an enormous amount of responsibility and skill that should be used to save lives and comfort people. Instead, they use their position to violate the vulnerabilities of their victims.
It is an unforgivable betrayal of trust.
Charles Cullen
‘Satan’s Son’
Love was what Charles Cullen, a nurse in New Jersey, USA, believed could save him from the death wish that had been his companion since he was a child. At just nine years of age, Cullen had made his first suicide attempt by drinking a mixture from a home chemistry set. The attempts to end his life would continue for years until he found another way to channel the self-disgust, low self-esteem and depression that had plagued him for most of his life. In fact, Cullen’s mental torment and victim mentality belied a rat cunning that saw him prey on some of the most helpless, sick and trusting patients whose families believed they were safe and would be nursed with care and compassion. Little did they know that their loved ones were in grave danger at the hands of Nurse Cullen, who had a compulsion to kill. Cullen was able to hide away by working graveyard shifts in intensive care units (ICUs). The unsociable hours and inability for patients to communicate with him meant that Cullen could murder easily. There was no one to watch him and there was effortless access to his weapon of choice – prescription drugs.
Cullen is serving multiple life sentences at Trenton State Prison, New Jersey, for the murders and attempted murders of 29 patients – he also pleaded guilty to seven murders and three attempted murders while he was working in Pennsylvania. After he was arrested in 2003, Cullen told investigators that he estimated he had killed between 30 and 40 patients during his 16-year career at 10 healthcare facilities. These are the crimes that he confessed to but investigators believe there were many, many more victims, possibly hundreds.
Cullen tried desperately to hide his dark desires by trying to squeeze himself into a so-called normal life that he had craved since childhood. Divorced with two daughters, Cullen was living with a nurse who was pregnant with his third child at the time of his arrest. This was his attempt to find the love he had always felt was missing from his life. He told investigators, during a marathon seven-hour interview, that he believed love could halt the sickness in his mind that made him kill.
But Cullen was always a loner and his life was not a success. Neighbours who knew Cullen as a child and young man, described him as socially inept and strange.
Charles Edmund Cullen was born on 22 February 1960 in West Orange, New Jersey, the last of eight children. His family were working class and strong Catholics. Florence Cullen kept the home, as most women did those days, and Edmond Cullen drove buses to pay the bills and feed his brood. Little did the couple know but their little Charlie would grow up to bring shame and shock to the ‘Garden State’.
New Jersey (NJ) is famous for musicians Bon Jovi, Frank Sinatra and Bruce Springsteen, among others, but also has a disturbing crime history. Mass murderer John List annihilated his family – mother, wife and three children – in 1971 in their Westfield, NJ, home and then disappeared for 18 years. He was arrested in Virginia in 1989, after a tip to television show America’s Most Wanted when it revisited the crime and revealed a life-like, age-progressed bust of what List may have looked like.
The state is also home to the first documented ‘lone gunman’ killing spree in modern American history. In 1949, Howard Unruh, a 28-year-old war veteran, gunned down random strangers in a street in the town of Camden and killed 13 people, including three children. Unruh died in 2009 at age 88, having spent 60 years in a psychiatric institution.
Tragedy struck the Cullen family when Charles was just seven months old. His father, who was in his late 50s at the time of his youngest son’s birth, died and left his wife to struggle alone, raising her children on a pension.
Growing up, little Charles was not popular and was the target of bullies. He was a weedy, pale kid and one that teachers and fellow students would have found hard to remember, had it not been for the fact that he grew up to be one of America’s most prolific murderers. He was intelligent but odd and this was what attracted the attention of the other children who would target Cullen’s weaknesses and inability to connect with his peers and tease him.
Such was his unhappiness with life that Cullen made his first attempt at suicide by drinking a concoction made from a chemistry set. It did not give him the escape he craved so he plunged deeper into a fantasy life and a nihilistic view of the world. He had few friends at Our Lady of Lourdes Grammar School and later, West Orange High School. Further fuelling his dim view of the world was a fascination with the literary works of Fyodor Dostoevsky, the Russian writer famous for Crime and Punishment where the lead character, plagued by mental anguish, plots a murder. The protagonist justifies his action by his belief that the murder of a morally bankrupt pawnbroker was for a higher purpose and would make the world a better place. Dostoevsky published his famous book in 1866 after years of prison and exile in Siberia.
Cullen would later try to justify his crimes by telling investigators that he was showing mercy to his victims and ending a ‘high pain situation’. New Jersey newspaper The Star-Ledger exclusively obtained Cullen’s 12 December 2003 confession, in which he portrayed himself as a merciful and compassionate nurse and existed under the illusion that his crimes were a community service. However, Cullen also told police during his confession, as reported by The Star-Ledger exactly one year after his arrest, that he wished he had died the first time he attempted suicide as a child.
‘You know, maybe if I was nine years old and would have had to die that day, all these lives, including my family, wouldn’t be affected in this way,’ Cullen told Somerset County Detective Sergeant Timothy Braun.
Another – perhaps the most – significant event of Cullen’s young life was the death of his mother when he was 17. Mrs Cullen was killed in a car accident in 1978 and Cullen was said to be devastated. In his senior year of high school, Cullen, despite his reasonable intelligence, was not able to complete his schooling and he dropped out and joined the navy at 18 years of age.
Trained as a ballistic missiles technician from 1978 to 1979, Cullen received his first post aboard the nuclear submarine USS Woodrow Wilson. According to the Navy Cyberspace website, which provides information on all things to do with the United States Navy, missiles technicians are ‘a vital element in the maintenance of strategic deterrence’. So Cullen had an extremely important job to do, one that you could be forgiven for thinking would give the troubled young man a sense of direction and purpose in life.
However, just like in school, Petty Officer Third Class Charles Cullen did not fit in with his navy colleagues who considered the pale, strange teenager a misfit. Cullen was the target of relentless bullying during his time on the nuclear submarine and did not last long on his first assignment. A disturbing incident, which was reported to superiors by Cullen’s shipmates, was when the then-20-year-old was discovered in a stolen hospital gown, gloves and mask, sitting at the missiles control panel of the submarine.
In the 2004 New York Times article ‘Death on the Night Shift’, the authors tracked down men who had served with Cullen on the Wilson and they reminisced about the very strange behaviour of their now-notorious colleague. Petty Officer First Class Michael L Leinen, who discovered Cullen in the strange outfit, said while he did discipline Cullen, the reasons for his medical garb was never explained, though it seemed to hint at his healthcare aspirations.
A transfer from the Wilson saw Cullen on a less stressful assignment on the USS Canopus, a supply ship, but this did not help his depression or suicidal tendencies. Cullen made more suicide attempts between 1981 and 1984 and it was this unstable behaviour that led to his discharge from the navy, after serving six years. Interestingly the Wilson submarine was decommissioned and struck from the Naval Register on 1 September 1994. By this stage, Cullen, now a nurse, had already killed at least three patients.
Just a few months after his navy discharge, Cullen enrolled at the Mountainside Hospital School of Nursing in Montclair, New Jersey. The nursing school was founded in 1892 and its website shows photos of bright, young, shiny nursing students. Trying to imagine the sickly, slight Cullen as once being a student there is a difficult task. The alumni page reminds graduates to ‘save the date’ for a Mountainside Hospital Alumni Association luncheon, a gathering the school’s most notorious student definitely won’t be attending.
Cullen, now 27, completed the three-year course in May 1987 but just a few months before his graduation, his brother James died from a drug overdose. In spite of this traumatic event, that year had more hopeful signs for Cullen that any other time of his life. Not only did he graduate but he also married a computer programmer named Adrienne Taub, in July 1987.
Any hope that marriage and the arrival of two daughters would help Cullen out of his depression and maladjustment was short-lived. The marriage was not a success. Cullen had been steadily employed at Saint Barnabas Medical Center in Livingston, NJ, from his graduation until January 1992 when he was fired. Cullen was working in the burns unit of the hospital, where the patients required a very high level of care. It was revealed at his trial that the reasons for his termination were for allegedly tampering with bags of intravenous fluid. The hospital conducted their own internal investigation but police were not contacted at the time.
The couple struggled along until January 1993, when Ms Taub filed for divorce. Cullen admitted to investigators when he was confessing to his crimes that his depression was at its worst that year. Their daughters were aged four and one.
The year of 1993 was a catalyst year for Cullen. Not only was he served with the divorce papers but his behaviour had become increasingly strange, according to statements his ex-wife made to the judge presiding over the proceedings. The truth was that Ms Taub filed for divorce on the grounds of ‘extreme cruelty’.
The exact nature of Cullen’s behaviour towards his wife was revealed to the public after the Allentown, NJ, newspaper the Morning Call, applied for and was granted access to a domestic violence file on him. Many of the incidents were also mentioned in the couple’s divorce file, which had already been released to the press. The New Jersey Supreme Court noted in its 2004 decision that ‘because Mr Cullen is a serial killer there is a legitimate right of the Morning Call and others to have access to the bulk of this file. The reality is there is legitimate public interest…’
Adrienne Taub said in her divorce papers that her husband slept on the living-room couch for three years, was a recluse and never took her out. She also detailed disturbing instances of animal cruelty by Cullen where he would torment the family’s Yorkshire terriers to the extent that she and her daughters would be awoken by the pets’ terrified yelps. The New York Daily News reported that a former neighbour in Phillipsburg said Cullen would often leave his dog tied up outside for hours at a time in extreme weather conditions and that the Society for the Prevention of Cruelty to Animals finally rescued the animal. Cullen gets a mention in the People for the Ethical Treatment of Animals’ (PETA) report Animal Abuse & Human Abuse: Partners in Crime, which details research that acts of cruelty to animal are symptomatic of a deep mental disturbance in people and that those like Cullen (and many other serial killers) who commit acts of cruelty to animals ‘don’t stop there’.
Combined with his failed relationship, Cullen was also drinking heavily, as described by his ex-wife in her statements to the court. He also discontinued the medication he was taking for his depression.
The divorce proceedings, his state of mind and his inability to see his children sent Cullen on a rapid descent. Ms Taub filed at least two domestic violence complaints against her estranged husband in 1993 and also a restraining order. The first complaint was in January and she claimed that her husband’s state of mind and access to medications in his role as a nurse could put her and her daughters at risk. After each domestic violence complaint that Ms Taub filed, Cullen attempted suicide.
Just over a month after his first attempt in 1993 to die at his own hand, Cullen took the life of a woman who was initially believed to be his first victim, 90-year-old Lucy Mugavero, at the Warren Hospital in Phillipsburg. Mrs Mugavero was killed with an overdose of the heart drug digoxin, which became Cullen’s murder weapon of choice. Digoxin is used to treat the symptoms of congestive heart failure such as shortness of breath and rapid heartbeat. According to the Australian Prescriber website, particular caution is needed when using the drug for elderly patients who often require lower maintenance doses. So for Cullen, the drug provided a quick and easy method of murder in the mostly elderly victims that he killed.
For the Mugavero family, the reason for their loved one’s death only became apparent in 2004. The family had never suspected her death was unnatural until the prosecutor’s office contacted them for a photograph of Lucy Mugavero to show to Cullen. ‘I had closure, but this opens everything back up. It makes it seem as though she died yesterday,’ Philip Mugavero, Lucy’s grandson told the New York Times in 2004.
It turned out that Mrs Mugavero wasn’t actually the first person Cullen killed. The first victim he admitted to murdering (and only Cullen knows how many people he killed) was in 1988. In 2004, as he was facing court in New Jersey for murdering 24 of his former patients and attempting to kill five others, Cullen also confessed to the 1988 murder of retired New Jersey municipal judge John Yengo Sr, 72, with a fatal dose of lidocaine, a local anaesthetic. Mr Yengo had been admitted to the burns unit of Saint Barnabas Medical Center for severe sunburn in the days before his death.
Events escalated for Cullen after he killed Lucy Mugavero. A few weeks after he administered a fatal injection to her, Cullen was arrested for stalking Michelle Tomlinson, a nurse he worked with at Warren Hospital – specifically, for breaking into her home while she and her son slept. The harassment began after Cullen took Ms Tomlinson out to dinner. The New York Daily News reported that as well as breaking into her home, Cullen proposed to her at work and bombarded her with phone calls. Again, Cullen attempted suicide a few days after his arrest. He pleaded guilty to trespass.
The next years of Cullen’s life were marked by more job changes and murders. Everywhere Cullen worked, there was a cloud of suspicion. He left Warren Hospital in December 1993 and it was under suspicion of murder. Cullen had killed 91-year-old Helen Dean, who was recovering from breast cancer surgery, in the September of that year. He administered a lethal dose of digoxin to Mrs Dean as she was about to be discharged from hospital. In fact, Cullen entered her room, asked Mrs Dean’s son Larry to leave and then gave her the injection. Cullen was not even assigned to Mrs Dean’s room and after he left, Mrs Dean and her son complained to other nurses and doctors about the unexpected medication. The next day Mrs Dean died at home from heart failure.
Larry Dean knew his mother’s death was not of natural causes and complained to the county prosecutor’s office. An investigation proceeded and a medical examiner and the prosecutor’s office corroborated Mr Dean’s story about the unprescribed medication and identified Cullen as the offender. This investigation represented the chance to stop Cullen in his murderous tracks, yet the drug digoxin was left off the list of medications that her body was tested for. Cullen and other nurses at the hospital were given lie detector tests. When Cullen was arrested in 2003, Warren Hospital was quick to tell the media and investigators that Cullen had passed the lie detector test and that no conclusive evidence had been found to charge him with Mrs Dean’s death. Mrs Dean’s body was exhumed in 2004 to undergo chemical testing as part of the investigations into Cullen’s killings.
In fact, Cullen continued to work at the hospital, and the fact that he been convicted of the harassment of a work colleague and had been suspected of giving a patient unprescribed medication was not even grounds for his dismissal.
Cullen left the hospital under his own steam, and in April 1994, started work at Hunterdon Medical Center in New Jersey as an intensive care unit nurse. Cullen had again placed himself in an environment where he was caring for the most vulnerable of patients.
His divorce had been finalised the year before and he was able to see his children unsupervised. On the surface, Cullen’s life was improving – he had gained a nursing licence to work in the state of Pennsylvania and he had started dating again.
There were more murders in the years between 1993 and 1998 and several incidents where Cullen could have been stopped. In 1997 he was fired from News Jersey’s Morristown Memorial Hospital for ‘poor performance’ and then in 1998 dismissed from Pennsylvania’s Liberty Nursing and Rehabilitation Center for ‘accidentally’ breaking a patient’s arm. Cullen, whose mental state was fragile at the best of times, was succumbing to the stressors in his life, which included failed relationships and being forced to declare personal bankruptcy.
At the Liberty Nursing and Rehabilitation Center a nurse took the fall for the death of a patient who, of course, Cullen had murdered, this time with a fatal dose of insulin. Cullen worked at the nursing home for around eight months in 1998. Night- shift nurse Kimberley Pepe was assigned to care for the patient Cullen murdered – an 83-year-old man called Francis Henry. Ms Pepe denied to hospital administrators that she had given Mr Henry any insulin but she pointed the finger of suspicion at Cullen, who had been caring for the other patient in the room. Ms Pepe was fired from her position at the facility and later filed a lawsuit against the nursing home, which was settled out of court.
The New York Times reported that the nursing home sacked Cullen following the incident where a patient’s arm was broken, after Cullen had been seen going into the room of the elderly female with syringes in his hand (she was not injected, but her arm was somehow broken).
Time and time again Cullen was able to gain employment despite his dubious employment record – and always in high-dependency wards such as burns or ICU. At the end of 1998 he took on two jobs – one in ICU at Easton Hospital in Pennsylvania and the other as a night-shift nurse in the burns unit of Lehigh Valley Hospital in New Jersey.
Cullen’s killing spree continued and in 1999 at Lehigh Valley Hospital he murdered his second-youngest known victim, 22-year-old Matthew Mattern, with digoxin. Mr Mattern had been severely burned in a car accident. The Philadelphia Inquirer reported that when Cullen confessed to this murder in 2004, he said it was to ‘end his [Mr Mattern’s] suffering’.
Rumours circulated about Cullen and despite being on the radar of the hospital authorities at several of his workplaces, he would often leave before anything concrete could be discovered about his murders.
St Luke’s Hospital in Bethlehem, Pennsylvania, reported Cullen to the state’s nursing board in September 2002 – he had killed at least five patients there over two years – because they were suspicious that he had mishandled medication. Cullen had left the hospital amid growing suspicions of his conduct and the nursing board embarked on an investigation and shared their findings with police. Nurses who spoke to police shared their grave concerns – proven right – that Cullen was the cause of patient deaths while he’d worked at St Luke’s and they were upset that the hospital had allowed him to leave and take up employment elsewhere.
The nurses seemed to play detective more convincingly than hospital authorities or the police and had compiled their own notes and theories about Cullen being a killer: Why did there seem to be more patient deaths when Cullen was on shift? Why had he left so abruptly?
Time and time again investigations of Cullen fell short. No links could be established between deaths of patients and the hospitals where he worked. According to the New York Times 2004 feature article ‘Death on the Night Shift’, if Cullen’s nursing history had been scrutinised then they would have seen that he had been accused of a patient death at one hospital… implicated in a medical ‘mistake’ at another. This information should have raised alarm bells and warranted a more thorough look at Cullen. But Cullen had no criminal charges relating to his work or disciplinary actions from state nursing boards so he was able to work unrestricted. New Jersey and Pennsylvania, like many US states, were experiencing nursing shortages in the late 1990s and early 2000s and this made it easier for Cullen to gain employment.
Cullen’s last post was his deadliest. He started work at Somerset Medical Center in New Jersey in September 2002. Cullen killed at least 13 patients and attempted to murder two others.
One of the patients murdered by Cullen was the Very Reverend Florian Gall, 68, who had been admitted to hospital with heart disease and other medical problems. Father Gall had been very ill but the priest was making a good recovery. Doctors prescribed digoxin to calm Reverend Gall’s rapid heartbeat – a normal use of the drug – and a blood test after his last dose of the drug showed normal levels. Father Gall had started to come out of his drug-induced coma. But on 27 June 2003, Cullen took a dosage of digoxin from a medication cart, slipped into Father Gall’s room and injected him with the drug.
When new blood tests showed Father Gall’s digoxin levels were almost five times the normal and safe level, panic mode set in and the hospital tried an antidote to save Father Gall’s life. But it was to no avail. The hospital knew Father Gall’s death came from a massive overdose of digoxin but did not mentioned this to his loved ones, including his sister Lucille Gall, who was also a nurse. Lucille had spent time with her brother at his bedside and was there as staff tried to save her brother.
Father Gall’s family and parishioners were shocked by his death but assumed that ill health and his advancing age were the causes. However, it was Father Gall’s death on 28 June 2003 that set Cullen’s downfall into motion. Computerised records later showed hospital administrators that Cullen had taken the drug and had also checked the medical records and status of Father Gall.
In his final months at the hospital, co-workers reported seeing Cullen in rooms he was not meant to be in and the hospital’s computer systems showed that he was accessing records of patients he was not assigned to, as well as requesting medications for patients that had not been prescribed. The New Jersey Poison Information and Education System was first to alert Somerset Medical Center that a recent pattern of drug overdose deaths at the hospital could be the work of an employee killing patients.
The hospital pondered this information for several months until October 2003, when it contacted authorities with its concerns about Cullen. In that time Cullen had killed five more patients and attempted to kill a sixth.
Cullen was fired from Somerset Medical Center in October 2003. Just two months later, Cullen was arrested on suspicion of murder and the whole, terrifying truth of one of America’s worst serial killers started to emerge.
Cullen was at dinner with a female friend on 12 December 2003 when police entered the restaurant to arrest him on the suspicion of murdering 68-year-old Reverend Gall.
Cullen was also charged with the attempted murder of 40-year-old Jin Kyung Han, whom he had tried to kill a week before Father Gall. Ms Han had cancer and health problems. She survived Cullen’s murderous attempt on her life but she later died of cancer.
Proving the point that ‘computers don’t lie’, it was the computerised drug-dispensing machine at Somerset Medical Center that provided rock-solid evidence for prosecutors that Cullen had administered lethal doses of digoxin to patients. The machine recorded the times and days Cullen ordered the drug, as well as the names of the patients who were supposed to receive it. Somerset County Prosecutor Wayne J Forrest said the data showed that Cullen dispensed digoxin at an ‘abnormally high rate’ while he was employed at Somerset. The Morning Call newspaper reported on 24 January 2004 that the drug-dispensing machine logs told the Somerset prosecutor’s office Cullen ordered digoxin for one patient who was not prescribed the drug, took it and then cancelled the order ‘in an attempt to conceal his theft of the drug’.
To dodge the death penalty, Cullen agreed to plead guilty and help authorities in New Jersey and Pennsylvania identify all his victims. Investigators say they will never know how many people Cullen really killed. His memory was sketchy and some hospitals he had worked at had destroyed records that may have revealed more victims. By Cullen’s own recollection he killed at least 40 people.
His youngest known victim was murdered at Somerset in May 2003 – 21-year-old Michael Strenko. Michael, a star athlete, had a blood disorder and was in hospital for a spleen transplant. Though it was a serious procedure, Michael was expected to make a full recovery.
A heart-wrenching memorial website made by Michael’s parents shows baby pictures and the promising life of the young man who was cruelly killed by Cullen in a place where he should have been safe.
Michael’s father, Thomas Strenko, was one of the many loved ones of Cullen’s victims who spoke at his sentencing hearing on 2 March 2006.
‘For someone to be able to hop from hospital to hospital with these problems for over 15 years defies trust,’ Mr Strenko said. ‘We are outraged that no one stopped Charles Cullen from murdering my son.’
In a disturbing and deeply distressing scene for the victims’ families, Cullen broke his silence of the previous years and started rambling and repeating over and over again, ‘Your honour, you need to step down.’ He kept chanting the words, despite the judge telling him to stop. Even a white cloth gag with duct tape fixed over it failed to stop Cullen shouting. He kept going for 30 minutes while families were reading out their impact statements.
In another bizarre twist that threatened the justice process, Cullen, who was responsible for taking the lives of so many people, then decided to try and save one.
In August 2006, he donated one of his kidneys to Ernie Peckham, the brother of a former girlfriend. Peckham’s mother wrote to the serial killer, begging him to help her son. Cullen had once lived with Peckham’s sister Michelle, and he was determined to be a match to donate. Cullen’s lawyer, Johnnie Mask, said the kidney donation was a way for his client to ‘atone for his sins’.
So determined was Cullen to donate his kidney that he threatened to stop cooperating with the detectives who were investigating his crimes that stretched back to the 1980s. The families of Cullen’s victims saw this as blackmail and cowardice on the part of the killer who said he would not appear at his sentencing if he were denied the right to surgery to help Mr Peckham. After a series of meetings, New Jersey Attorney General Peter C Harvey agreed to let Cullen have the surgery but only after he appeared at his sentencing hearing.
In New Jersey, the Health Care Professional Responsibility and Reporting Enhancement Act (also known as the Nurse Cullen Act) became law in 2005 as a direct response to the serial killings. The act requires healthcare professionals and bodies to notify the New Jersey Division of Consumer Affairs if they have information about incompetence, impairment or negligence of a healthcare worker. The act also means criminal background checks of healthcare workers seeking licence to work in New Jersey is mandatory.
There has been criticism of this act among healthcare professionals in New Jersey who say it is too extreme and people’s careers can be ruined by a legitimate mistake or a simple lack of experience.
In 2013, the American television program 60 Minutes secured an exclusive interview with Cullen. It was the first the award-winning news show had ever interviewed a serial killer and veteran correspondent Steve Kroft interviewed Cullen, who appeared nervous and pathetic behind a glass barrier.
Recalling the interview for the program’s online extra ‘Correspondent Candids’, Kroft said he wasn’t sure Cullen would even answer any of his questions.
Producer Graham Messick said Cullen was the ‘ultimate insider threat’.
‘It takes a really subversive, devious mind to sort of break all the rules and actually use that to commit the worst crime of all, to kill people,’ Messick recalled.
During the interview, Kroft asked Cullen if he got pleasure from killing people.
‘No, I thought that people weren’t suffering anymore. So, in a sense, I thought I was helping,’ Cullen answered.
Kroft said that many of the victims were expected to recover and were not in pain and Cullen replied, ‘You know, again, you know, I mean, my goal here isn’t to justify… You know what I did there is no justification. I just think that the only thing I can say is that I felt overwhelmed at the time.’
Somerset nurse and Cullen’s closest friend at the hospital, Amy Ridgeway was also interviewed for the program and told Kroft that at first she couldn’t believe Cullen had done anything.
‘He was always early, always on time, crisp. Very serious about getting to work,’ Ms Ridgeway recalled.
She said she had considered him a good nurse but when she was confronted by investigators about the evidence, his real employment history and the damning drug printouts that showed Cullen had been taking deadly drugs from the computerised dispenser, the truth could not be denied.
It was at this point a devastated Ms Ridgeway knew her friend was killing people and she offered to help the police. Ms Ridgeway was crucial in helping police to obtain a confession from Cullen. She recalled that she lied to Cullen and told him that investigators were also looking at her as a suspect in the killings.
‘What did you say to get him to confess?’ Kroft asked Ms Ridgeway.
‘I wasn’t very honest with him and there’s a part of me, I still feel guilty about that. I was manipulating him a bit. I told him the investigators were also looking at me and how could he think that I wasn’t somehow going to be implicated,’ she said.
‘I remember saying to him, “Who was your first victim?”… He started to talk and said it was a long time ago.’
Journalist and author Charles Graeber, who wrote the definitive book on Cullen called The Good Nurse: A True Story of Medicine, Madness, and Murder, said, ‘We’ll never know how many people Charlie Cullen killed.’
‘I would be very surprised, as would pretty much everyone I have spoken to with any knowledge of this case if it was not in the hundreds, multiple hundreds,’ Graeber said.
During the 60 Minutes interview, Cullen said he was sorry for his crimes but added chillingly, ‘Like I said, I don’t know if I would have stopped.’