3 From police investigation documents and Lehigh County district attorney James B. Martin’s memo of September 9, 2002.
4 Also present were coroners Zachary Lysek and Scott Grim, and Easton County Police captain John Mazzeo, the acquaintance to whom Medellin had first taken her suspicions about Cullen.
5 Only several weeks later (September 6), Saint Luke’s Hospital president and chief executive officer Richard A. Anderson wrote to the State Nursing Board, notifying them of the incident with the sharps box and that Cullen’s employment had been terminated on July 7 of that year.
6 While the Saint Luke’s administration had contended that Cullen had not harmed patients and their investigation had closed, they acted rather differently following Nurse Medellin’s actions and the attentions of the DA. Several weeks later (September 6), two months after Cullen’s removal from Saint Luke’s, Saint Luke’s Hospital president and chief executive officer Richard A. Anderson finally wrote to the State Nursing Board, notifying them of the incident with the sharps box, the discovery of numerous empty vials of dangerous drugs, and that Cullen’s employment had been terminated following the discovery.
7 In all, eighteen Saint Luke’s staffers were interviewed.
8 According to police investigation records, Tester had noticed the death trend early, going so far as to quantify the statistical increase in the death rate in the CCU.
9 Tester told the Pennsylvania State Police that she had brought her observation of this troubling trend to ‘people on the CCU Unit’ to her supervisors, but nobody had any answers.
10 According to documents supplied to the police investigation at Saint Luke’s, the hospital had supplied extensive investigations of its own in support of its assertions that administrators had no reason to believe Cullen had harmed anyone at their hospital, and that the death rate was within the statistical norm.
11 From witness statements in police investigation documents. Other nurses, including Judy Glessner and Darla Beers, also testified to their concerns that Cullen had harmed patients. (See Pl.Ex. RR at 72–77; Ex. PPP at 72–73; see also Ex. U at 2 [police report summarizing statement given by Nurse Gerry Kimble about his belief Cullen had harmed patients with diverted medications].) Assistant Pharmacy Director Susan Reed testified that she recalled expressing to Laughlin that the nature of the empty medications found, including vecuronium, raised a concern about potential patient harm. (See Pl.Ex. VV at 128–130.) And notes Attorney Laughlin apparently took during his conversation with Nurse Medellin contain abbreviated descriptions that could be understood as references to patients being harmed by Cullen and “cod[ing] fast.” (See Pl.Ex. CCCC.) Testimony from the hospital’s vice president of risk management, Gary Guidetti, indicates, however, that Laughlin never apprised him of concerns about patient harm or otherwise passed those concerns on to upper management. (See Pl.Ex. FFFF at 36–39.)
12 Retired Saint Luke’s CCU nurse Susan Bartos, quoted in the Morning Call, February 15, 2004 (“Nurses’ Warnings Unable to Stop Trail of Death,” by Ann Wlazelek and Matt Assad; http://www.mcall.com/news/all-5nursesfeb15,0,4417146.story).
13 On May 18, 2003.
14 Working with the Pennsylvania State Police, the district attorney retained a forensic pathologist, Dr. Isidore Mihalakis, who reviewed seventeen patient charts selected by Saint Luke’s. (Pl.Ex. MMMM at 18–35.) However, Dr. Mihalakis was not provided with a written list of the diverted medications and apparently had no contact with any of the nurses or their statements regarding suspicions about Cullen. (Ibid.) Dr. Mihalakis was unable to conclude that Cullen had harmed anyone. (Ibid. at 50–55.)
15 Cullen killed Pasquale Napolitano on July 13—though at the time he didn’t know the patient’s name.
CHAPTER 36
1 According to the Somerset Medical Center executive report given to the board of directors on July 17, 2003, the DOH review at SMC took place on July 11 and 14. named Edward Harbet, RN, the Health Care Systems Analysis complaints investigator, visited SMC and extensively reviewed the medical records of the four patients reported, as well as the summary of the SMC internal investigation to date, and pertinent policy and staffing assignment documents. Harbet also met with administrators. He was unable to identify any specific finding that would explain the relevant lab values, but he was comfortable with the level of attention being paid to these events by SMC, and he did not advise any additional external agency report. He said copies of the charts and his report would be reviewed by his department.
On July 14, two clinical laboratory evaluators from the DOH reviewed SMC lab services, focusing on the testing procedures and facilities in validating the abnormal results reported. No deficiencies in the lab process were identified. The SMC executive report says that investigators were “satisfied that all appropriate steps had been and were being taken to identify the cause of the unexplained events.”
2 The DOH files would eventually be made available by a police subpoena, but would shed little light on the incidents at Somerset Medical Center, and they were of minimal use to the SCPO during their own initial investigation.
CHAPTER 37
1 The pieces of this recording are abridged from the original transcript, but context has been carefully maintained.
2 A standard homicide term referring to a body newly murdered and thus potentially still bearing the greatest cache of evidence and trace, as distinct from a body discovered much later and disturbed by time and environment.
CHAPTER 38
1 He was still in his thirties at this time.
2 Details of Detective Baldwin’s meeting and conversation with Lucille Gall were taken from police investigation documents.
CHAPTER 40
1 Dr. Smith found that the cases of patients Lehman and Crews could possibly be medically explained without exogenous influence, and were thus not as suspicious as the other four.
2 Joseph P. Lehman and McKinley Crews were the two Somerset patients whose lab values were not as suspicious.
3 The manner and cause of death would be determined later by toxicologist George F. Jackson, PhD.
CHAPTER 42
1 According to documented court proceedings and police investigation documents, Laughlin hadn’t provided specifics in his call to Easton, but had told them, in regards to reconsidering hiring Charles Cullen, “Don’t”—this word, in quotes, was handwritten in quotes on the back of a page in Charlie’s Easton personnel file, which was obtained during the police investigation.
CHAPTER 43
1 Coincidentally, from the standpoint of minimizing Somerset Medical Center’s liability, this was the best possible situation.
SMC couldn’t fire Cullen without a reason. If the reason was a suspicion of murder, Somerset might then be liable for those murders. But following directions from the prosecutor’s office was not an admission of their own suspicions. It was reasonable compliance with the legal authorities based on the prosecutor’s suspicions.
Instead, Cullen was gone—the detectives had investigated a crime, discovered Cullen’s history, and advised SMC to fire Cullen. But if it couldn’t be definitively proven that Cullen was actually the one responsible for the specific patient deaths, then SMC was not liable to civil suits.
2 From Detective Baldwin’s interviews and SCPO records.
CHAPTER 44
1 From Tim Braun’s notes.
2 This had been the pattern at many of the hospitals they’d looked into, a confusing thing to the detectives. During Detective Baldwin’s November 14, 2003, interview with Betty Gillian, the vice president of the Saint Barnabas Hospital corporate office (and Cullen’s former supervisor, the woman who had fired Cullen for “nurse practice issues” and remembered Cullen being the focal point of an internal investigation concerning IV bags that were contaminated with insulin), she recalled the Saint Barnabas staff had been upset when Cullen was accused of tainting the IVs, because “they liked him because he was very helpful.”
3 Police investigation document
s and interviews with detectives.
CHAPTER 45
1 On November 21, 2003.
2 Police investigation documents and interviews with Amy Loughren and Detective Baldwin.
3 This incredible detail is from a direct recounting in one of the author’s interviews with Amy.
CHAPTER 46
1 Police investigation documents and interviews with Loughren, Baldwin, and Braun.
2 Amy had suspected something was off before, when she’d been asked to sign her name to the insulin levels without having any means to actually check them.
CHAPTER 47
1 The information in this passage is taken from author interviews with Amy and from her journals.
CHAPTER 49
1 Following Cullen’s arrest, Pyxis bolstered the security of their dispensing system.
CHAPTER 52
1 After the exposure of what Charles Cullen had done, this loophole in Pyxis was fixed by the manufacturer.
2 Code status indicates whether or not a patient is to be resuscitated if they code, and what measures are and are not permitted for them—a decision made by the patient or the patient’s family.
CHAPTER 53
1 Even Lucille Gall, the Reverend Gall’s sister, had recalled a conspicuous argument about Tylenol she’d had with the male nurse; it was clearly a drug he favored, even when it was not clinically prudent. Charles Cullen could easily claim the rest of the Tylenol orders were valid as well; certainly nothing the SCPO investigation had turned up could prove otherwise. Whether by design or accident, Cullen had made Lucille Gall his alibi.
CHAPTER 54
1 This was SCPO captain Andy Hissim.
CHAPTER 55
1 Benadryl and ibuprofen—though Benadryl is a sedative that Cullen’s ex-wife Adrianne had accused him of using on his children, a charge Cullen adamantly denies.
CHAPTER 56
1 This material and all quoted matter here is taken and abridged from Detective Braun’s notes, made during these calls.
2 Tim had faxed the completed questionnaire to them, but there hadn’t been enough time to actually get the consultation before they kidnapped him.
3 After Cullen’s arrest, the detectives would have the opportunity to speak with famed forensic scientist Dr. Henry Lee about the difficulties in bringing a case against Cullen. Dr. Lee’s opinion regarding medical serial killers was captured in an April 29, 2002, interview in the Los Angeles Times:
“You have to figure out who the victims were long after they were buried,” he said. “You have to dig up [bodies]. You are going to have a difficult time finding true trace drug or elements in there. The next issue is how to link to the suspect. Why him? What’s the proof? Prepare to fail.”
4 This was despite Charlie’s having been investigated for suspicious deaths by all three hospitals. It’s not clear whether Montgomery ever had the opportunity to call any of his references.
5 From a police investigation report.
CHAPTER 59
1 Cullen couldn’t read without his glasses, either. Whether or not Charlie Cullen was wearing his glasses on a given night might have determined what he could read, and which patient got the deadly cocktail.
2 Cullen misstates the name of the paper; it was the Newark Star-Ledger, Rick Hepp reporting.
3 Amy remembers Charlie Cullen telling her that the first person he killed at Saint Barnabas was a young woman.
4 Cullen has never been tried for this patient’s death.
5 It’s more likely that Cullen was simply bought out of his contract and paid for the months of sick-leave time he accrued while in various mental institutions during his tenure there, and that added up to less than $18,000. Charles Cullen filed for bankruptcy the following year, claiming over $68,000 in debt; it is possible, but unlikely, that the settlement from Warren Hospital was an addition to his base salary.
6 In fact, with all the stories flying around and the police visit, Cathy believed that Charlie was going to run away with Amy to Mexico.
CHAPTER 61
1 Baldwin’s report lists this as six hours; however, Cullen had been processed by 6 p.m., and the interview didn’t wrap up until 3 a.m.
2 The SMC board included a former state senator. The chief of police was his son-in-law.
CHAPTER 62
1 Captain Nick Magos’s office.
POST SCRIPT
1 The hospital suits each alleged that the fault lay with whatever hospital had previously hired Charles Cullen and then allowed him to move on; all of the suits named Saint Barnabas as being the birthing ground of the serial killer. One of the larger battles occurred between Saint Luke’s Hospital and Somerset Medical Center. Somerset Medical Center’s lawyers argued that Saint Luke’s should be responsible for any lawsuits brought by the families of victims at Somerset. Judge Garruto of the New Jersey Superior Court sided with Somerset without weighing in on the specific merits of the actual cases. The fact that Saint Luke’s administrators had called other hospitals was one of the main contributors to his decision as to their responsibility for those suits. By making those calls, advising some hospitals against hiring Cullen but not alerting others, they had, in Judge Garruto’s opinion, effectively “decided who would live and who would die.”
2 An adverse event is one that results in death, loss of a body part, disability, or loss of bodily function lasting more than seven days or still present at the time of discharge, where the event could have been anticipated or prepared against, but occurs because of an error or other system failure [NJSA 26:2H-12.25(a)].
Contents
Welcome
Author’s Note
PART I
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Chapter 19
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 26
Chapter 27
Chapter 28
PART II
Chapter 29
Chapter 30
Chapter 31
Chapter 32
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Chapter 42
Chapter 43
Chapter 44
Chapter 45
Chapter 46
Chapter 47
Chapter 48
Chapter 49
Chapter 50
Chapter 51
Chapter 52
Chapter 53
Chapter 54
Chapter 55
Chapter 56
Chapter 57
Chapter 58
Chapter 59
Chapter 60
Chapter 61
Chapter 62
Post Script
Acknowledgments
About the Author
Newsletters
Notes
Copyright
Copyright
Copyright © 2013 by Charles Graeber
All rights reserved. In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher constitute unlawful piracy and theft of the author’s intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at [email protected]. Thank you f
or your support of the author’s rights.
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ISBN 978-1-4555-0612-5
The Good Nurse: A True Story of Medicine, Madness, and Murder Page 33
