The case started in Pennsylvania, but it was a couple of ICU nurses at Somerset Medical Center in Somerville who brought it the right attention when they discovered that two patients had been given the wrong medication. It happens. People slip up. But one patient had died as a result and the other had barely been saved. Digoxin, a heart medication, was the culprit. The doses seemed odd, because this facility had a state-of-the-art computer system, Cerner, which allowed the nurses to check a patient’s medical history at a terminal before giving him or her meds. Another system tracked the drugs and controlled a drawer that allowed staff access.
Yet on the night shift of June 15, 2003, someone had ordered digoxin for a patient for whom it had not been prescribed. Then, mysteriously, the order had been canceled. At least, the computer registered it as canceled. The drug had actually been taken from the drawer. Also, someone had accessed the records of Jin Kyung Han, a forty-year-old cancer patient. The following morning she’d gone into a cardiac seizure. Contrary to firm medical orders on her chart, someone had given her a strong dose of digoxin. An antidote was administered and she stabilized.
Less than two weeks later, a sixty-eight-year-old Roman Catholic priest, Reverend Florian Gall, unexpectedly expired. His body also registered far too high levels of digoxin.
The hospital administration sent records and samples to the New Jersey poison control center and initiated an internal investigation. An official at the CDC, alarmed, told them they had a dangerous person on their staff that was intentionally killing patients. He urged them to contact the police.
The administrators elected to keep investigating on their own. Hospital administrators are reluctant to admit they have a dangerous situation. It’s bad publicity for their facility. (In fact, had administrators taken this issue more seriously in Pennsylvania, none of this would have happened in New Jersey.)
Other patients suffered from having high levels of drugs in their systems. A male nurse who’d been at the hospital for the past year was the common factor in these cases. His name was Charles Cullen. Due to privacy laws, they didn’t know that Cullen had been at the heart of rumors about patients and drug mishandling in other healthcare institutions. In fact, he’d been at 10 in just 16 years, often being fired or leaving under a cloud of suspicion.
On October 31, Cullen was finally let go. Somerset County Prosecutor Wayne Forrest had initiated his own investigation, starting with Cullen’s work history. He was shocked at how many healthcare organizations had employed him.
Rick Hepp, a reporter from the Newark Star-Ledger visited Cullen’s bungalow-style home in Bethlehem, Pennsylvania, about an hour from the workplace, and knocked on the door. Cullen answered. A quiet, pale man, he looked weary. He admitted that he was being investigated but wouldn’t say much more.
It was over a month before Cullen, 43, was arrested on December 12, 2003, charged with one count of murder and one murder attempt.
AT THE INITIAL HEARING, CULLEN pleaded guilty said, “I don’t intend to contest the charges.” The judge did not want him to enter a plea yet, but Cullen persisted. He rescinded his request for a public defender. “I don’t plan to fight this,” he reiterated. His bail was set at $1 million and he was taken to the Somerset County jail.
But he’d already dropped a bombshell to detectives that would soon hit the papers: He’d intentionally overdosed thirty, possibly forty patients. He had a system, even when medication records were computerized. He’d order digoxin for patients under his own care. He’d take the drug from the drawer and cancel the order. There was no evidence with which to confront him, although the drug was clearly missing. (In other institutions, there was little oversight, so it was easier for Cullen to get away with this practice.)
Once Cullen’s story went public, other facilities where he’d worked began to think about his tenure there.
For example, in 1999, the coroner in Pennsylvania’s Northampton County, had voiced suspicions to officials that there might be an “angel of death” at Easton Hospital. He believed that a 78-year-old patient had been murdered with a fatal dose of digoxin. He requested an internal investigation at the hospital, but it was inconclusive. In 2002, he heard from a nurse at St. Luke’s in nearby Bethlehem about suspicious behavior by Nurse Charles Cullen. In June 2002, they had found opened and unopened packages of drugs improperly discarded, and had seen Cullen leaving the rooms of patients who then expired. The coroner contacted that county’s district attorney. They made a comprehensive investigation but found no proof of criminal activity. However, they had not interviewed Cullen.
In Phillipsburg, New Jersey, the son of Helen Dean had long suspected Cullen, because his mother had pointed out the nurse who’d stuck her with a needle when no medication had been ordered for her. Then she’d died. Her son had felt certain that his mother had been murdered, but an investigation turned up no evidence.
Out of the blue, Cullen accepted a public defender, who said that Cullen would offer names in exchange for avoiding the death penalty.
Then the New Jersey State Police report was published, and based on a seven-hour interrogation, it was clear how Cullen had operated right under the noses of his colleagues and supervisors. He described how easy it was to go from one healthcare facility to the next, moving on as soon as suspicions about him were voiced. Cullen admitted that he’d intended to kill, and his motive had been to end the patients’ suffering. He’d injected patients with digoxin and once had put insulin into IV bags that were stored in a closet, just to see what would happen. He mentioned that he thought that patients his colleagues were treating patients as nonhumans, and this had been difficult for him to watch, so he’d decided to end their suffering. “I couldn’t stop myself,” he said. “I just couldn’t stop.”
Cullen stated that he’d wanted to quit but had bills to pay. Even his counselor thought he should stop nursing, he said, because he wasn’t dealing well with his depression. But he didn’t stop nursing and he didn’t stop killing.
After a two-year investigation that included Cullen’s review of around 240 files, Cullen had admitted to twenty-nine murders and six attempted murders. Officials were still investigating other possible cases to link to him, and there has been plenty of speculation of his ties to other murders.
Although Cullen had worked on a burn unit in one facility, several cases were clearly not mercy killings. An early murder had involved someone being treated for bee stings. Helen Dean had been doing very well when she died suddenly. Having done research on healthcare serial killers and having seen only rare examples of actual mercy killing, I looked at Cullen’s background and created a timeline to compare against the chronology of his confessed murders.
Cullen was the youngest of nine brothers and sisters in a religious working-class family. His father had died when he was an infant and his mother while he was in high school. Two of his siblings had also died. In 1978, he enlisted in the Navy and when he got out, he attended a nursing school. By 1988, he was working at a hospital.
He got married and had two daughters, but soon was divorced. In 1998, he filed for bankruptcy and had debts and child support payments of over $65,000. The animal protection agency confiscated his dog. In 1993, his wife filed for divorce and custody of their children, claiming that her husband was dangerous. In 1997, Cullen was taken to a hospital in New Jersey for treating severe depression. Two years later, he lit coals in a bathtub to kill himself. He didn’t succeed. He’d also been arrested for stalking a nurse. As his debt mounted, Cullen moved from one position to another, and at St. Luke’s in Bethlehem, Pennsylvania, he left to avoid an investigation into the deaths of sixty-nine patients.
In my estimation, Cullen had acted out during times of stress, powerlessness, and failure. At the same time that Cullen’s wife had left him and he was arrested for stalking, he killed three elderly patients, including Helen Dean. The record for this one-year period clearly shows that when things went wrong, Cullen reacted with aggression. He recovered his sense of
power (a common motive for healthcare serial killers.) Other murders likewise coincided with adverse life events. Among those patients killed was the 78-year-old man in Easton Hospital. The coroner had been right, but he’d been unable to prove anything, because Cullen had worked there via a temp agency. He hadn’t been on staff. By the time he went to New Jersey, he was probably addicted to the power over life and death.
CULLEN WAS TAKEN TO THE ANNE KLEIN FORENSIC CENTER in Trenton, where a panel of professionals examined him. He surrendered his NJ and PA nursing licenses. (He wouldn’t need those anymore!) That he could have – should have – been fired from half of the facilities where he’d worked was a serious red flag for the system, and officials had discussions about what should be done. Every hospital that had employed Cullen examined its procedures and prepared to defend itself against lawsuits – which came at once. Besides those families who had lost loved ones at Cullen’s hands, there were others who suspected in him the deaths of their relatives.
In a morbidly ironic move, Cullen offered to assist authorities in preventing other nurses from committing murder. There should be protocols for accountability of staff and for drug-handling procedures, he said. Among them would be installing surveillance cameras, the use of swipe cards and bar codes, and a daily count of lethal medications. He also said there should be a national database for updating employment history of healthcare workers.
He held hospital administrators responsible for not stopping him or reporting him. He blamed the manner in which hospitals operate. He left “tracks,” he said, but no one checked. The system is too trusting, and thus lax in its vigilance.
Cullen’s attorney hired several psychologists to perform a formal assessment. There was no need to decide on his mental state for a trial, but there were other issues, such as where Cullen would spend the rest of his life. In addition, people wanted answers. Dr. Frank Datillio told reporters that he believed that Cullen had identified with the pain of his patients and had killed them as a way to relieve his own pain and depression.
Yet people with experience in the psychology of healthcare serial killers would hesitate to accept such an evaluation. They know that there’s usually more between the lines. It appears likely that, similar to others in his position, Cullen killed because he derived something from ding so. He could be mean and even malicious. Not all of the patients were dying or in pain. Some were recovering.
“These people are sociopaths mostly interested in getting their own needs met,” says Beatrice Yorker, who has conducted an extensive study on this category of serial killer. “I liken them to firefighters who set fires. Often what they need is power and control or excitement and attention.”
Too often, these killers have been allowed to move on from one facility to another, rarely brought to justice until after incriminating evidence has reached shocking levels. While there’s no distinct psychological type to look for, there are red flags: secretive behavior, missing medications, a preference for the night shift, spikes in unexpected deaths on a certain person’s shift, and spotty past work records can be troublesome signals. Cullen had all of these. It seems that, contrary to his claims, he actually looked for ways to kill. He was a predator.
“Last Call” Killer
ALONG THE RURAL EAST COAST during the early 1990s, a very strange case developed. When this killer was identified, I got to cover his trial for my gig at Court TV’s Crime Library. I don’t often do reporter-type stuff, but it was interesting to watch the developments unfold, especially because these were such grisly incidents. This case also made forensic history, in terms of one of the methods used to solve it.
Although it started in Pennsylvania, it soon moved into New Jersey. On May 5, 1991, a maintenance worker looking for recyclables along the turnpike in Pennsylvania’s Lancaster County spotted several plastic wrapped bundles that smelled bad. He called the police.
Each package contained the dismembered parts of a middle-aged man’s nude body. From the torso, it was clear that the victim had been stabbed numerous times and sexually mutilated. Oddly, the wounds had been washed. Using the head, a police artist drew a rendition of what the victim had looked like for posters, which were hung at tollbooths and rest areas. Eventually someone recognized him: The dead man was Peter Anderson, missing from Philadelphia.
Police learned that Anderson had been at the Five Oaks bar and Waldorf Astoria, where he was put, intoxicated, into a cab. Investigators tried to lift usable prints from the bags that had wrapped his body parts, but were unsuccessful.
In 1992, New Jersey state workers unloading trash at a Burlington County Department of Transportation maintenance yard discovered several heavy parcels wrapped in tan and white plastic bags. One worker picked up a bag and thought it felt like a pumpkin. He was wrong. The bag contained was a decomposing human head.
The police arrived to open the parcels. Each contained the body part of an adult middle-aged male. Inside one that held the intestines were a plastic cup and a latex glove. All parts were present except the legs. Packaging for latex gloves in another bag bore a tag from a CVS store on Staten Island. Also found was a briefcase with identification and a pair of shoes, a box of Acme plastic garbage bags, and a sewing needle. Soon, the missing legs were located in a trashcan in a rest area along the Garden State Parkway. As with Anderson’s body, some of the wounds on this victim had been cleansed.
He was identified as Thomas Mulcahy, 57, a married business executive from Sudbury, Massachusetts. He’d gone to Manhattan on July 7 to make a sales presentation and had met a friend for drinks at the Townhouse bar, known for its gay clientele. The next day, he had drinks at a bar near the World Trade Center and withdrew $200 from an ATM. Apparently, he met his killer shortly thereafter. But there were no leads and the case went cold.
The next year, on May 10, 1993, a man driving on Crow Hill Road in Manchester saw a ripped plastic bag on the side of the road. He rolled down his window to look. When he saw human fingers, he called the police.
Investigators soon identified 44-year-old Anthony Marrero, who was missing from New York. Five other bags scattered along the roadway contained more of his parts, wrapped first in shopping bags and then in plastic bags. The body had been cut into seven parts and cleaned up post-dismemberment.
Just over two months later, Michael Sakara, 56, went missing. He was a regular at the Five Oaks piano bar. He introduced a man to the bartender, Lisa Hall, before disappearing on July 30, 1993.
The next day, a hot dog vender in Haverstraw, New York, found Sakara’s head and arms wrapped in plastic bags and tossed into a 55-gallon can. Nine days later, on August 8, the legs and torso turned up in bags at a second location. He’d been bludgeoned and stabbed before his body was dismembered. Like the two victims in New Jersey, Sakara had been cut into seven pieces.
From the method of cutting with a saw and a knife, wrapping the parts tightly in plastic trash bags, cleansing the bodies, and disposing of them along the roadway, investigators believed the victims were linked to a single perpetrator. It was potentially a gay hate crime. The media dubbed this unknown suspect the “Last Call Killer.”
However, identifying this offender stymied police; despite more than five hundred interviews by a dozen investigators, they had little to go on. The victims had no apparent connection with one another, other than having been in gay establishments in Manhattan.
There was some suggestion that the killer could be a male nurse. Lieutenant Matthew Kuehn, a New Jersey State Trooper in charge of the Mulcahy investigation, collected photos of male nurses working in area hospitals and showed them to bartender Lisa Hall. She thought Richard Rogers had the same hairstyle as the man she’d met, but she thought that man’s name had been more common, like John. Although names didn’t really mean anything in bars, she could not make a positive ID from the photo.
In 2000, Kuehn sent four-dozen plastic bags collected from the victims’ remains to Toronto for analysis by a special process called vacuum metal deposit
ion. It took six months, but finally the scientists there lifted 35 fingerprints and a few palm prints from four of the bags that were of sufficient quality for identification.
A year later, Maine went online with the Automated Fingerprint Identification System, and among the prints in its database were those of a male nurse from Staten Island, Richard Rogers, Jr. In 1973, he’d bludgeoned his roommate to death, but he’d been acquitted on grounds of self-defense. What caught investigators’ attention was that Rogers had wrapped the body in a plastic tent and dumped his corpse along the side of a road. More important, Rogers’s fingerprints matched the prints lifted from bags found on the Last Call Killer’s victims.
Detectives from three jurisdictions converged with warrants to search Rogers’ condominium. They found medication often used as a date-rape drug; rug fibers consistent with those found on one body; a Bible highlighting passages that mentioned decapitation and dismemberment; and photos of shirtless men on which wounds had been drawn with red ink. They also found plastic bags like those used to wrap the dismembered body parts.
Rogers was charged with the murder of the two New Jersey victims: Thomas Mulcahy and Anthony Marrero.
The trial got underway in October 2005 in Toms River. During jury selection, Rogers, 55, was offered a deal: plead guilty to manslaughter and receive two 30-year sentences with the possibility of parole in fifteen years, and plead guilty to third-degree murder in the Anderson case for 10-20 years. Rogers considered this, but turned the deal down. Judge Citta ruled that he would allow accounts about the two similar murders from out of state (Anderson and Sakara).
Shadows of Death (True Crime Box Set) Page 6
