Efren Saldivar: Hospital Executioner

Forensic Science Center
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To put Saldivar in jail for life, they only needed a few obvious murders. One by one, throughout the summer months of 1999, the investigators brought potential victims up out of the ground. The pathologists examined them and took tissue samples from the livers, bladders, and muscles and the toxicology lab then went to work. Brian Andreson, at the Lawrence Livermore Forensic Science Center in Oakland, California, demonstrated a new scientific protocol for the proper procedure to retrieve and preserve the biological evidence. He concentrated on Pavulon, because succinylcholine chloride breaks down into elements natural to the human body and because the test recently discovered for its detection in Sweden was expensive. Pavulon was a synthetic muscle relaxant sometimes given in low doses to patients on respirators, and it could remain detectable in the body for years. In order to prove that a homicide had taken place, Andreson and his team looked for dosage levels out of the normal range.

At first, they reported only negative results, which disappointed the task force. They hoped they had not just spent a year and a half of their time for nothing. Then Andreson got some hits. First there were three, and then after the 20 exhumations were complete, he found six that gave positive results.

Efren Saldivar,
arrested (AP)

In January 2001, criminal charges were prepared. The officers followed Saldivar, now 31, to work one morning on his way to a construction job and then arrested him for the murder of six patients—all of them elderly and one of them a retarded woman. He was booked and reminded of his rights. He began to talk once more, but this time he said that he'd been understaffed on some shifts, so to ease the workload, he'd eliminated a few patients. As Lieberman describes it, when he was at his wit's end, he would look at the board and decide, "Who do we have to get rid of?"

He admitted that he'd killed patients at other hospitals, too, where he'd worked part-time. He had mentioned this before but had not admitted to actually giving injections. After 60 victims, he'd lost count. He figured it was more than 100. It had just been a gradual thing, an act that had bothered him a little at first but then he'd grown used to it and let it all slip from his mind. "You don't plan it," he said to the investigators. "After that, you don't think about it for the rest of the day, or ever."

Between this confession and the evidence, it was enough to go to court. Lead prosecutor prepared the case, finding a star witness in Jean Coyle, the complaining patient whom Saldivar had attempted and failed to kill. Thus, along with the six murder charges was an attempted murder charge, too. Ursula Anderson, the female respiratory therapist who knew what Saldivar was doing, got immunity in exchange for her agreement to testify that she had given Saldivar the Pavulon and knew what he was doing with it.

Around this time, three full years after the murders first came to light, the Glendale Adventist Medical Center put out a statement in a press conference. They apologized to the families and assured them that they were helping the police, who had already expended thousands of man-hours, with the investigation. They were disheartened by the way someone would so shockingly abuse a position of trust, especially one to which people were so vulnerable. The hospital spokesperson said that they had no idea how Saldivar obtained the drugs that he used, but as a result of this case they had tightened their own controls and procedures.

• Hereafter, they would institute a "mortality analysis," in which a single physician would review all records after a death, thus making it possible to spot suspicious trends and patterns. The data would be set in columns for easier visibility.
• They would have greater controls over the types of drugs that could be used to induce death.
• The respiratory therapists would now be subject to the orders of a physician for the use of a ventilator. In addition, there would be computer surveillance of all ventilator settings, so that changes made would be recorded on a printed report.
• Any medications not used during a Code Blue resuscitation would be secured at the conclusion of the incident.

The hospital offered settlements and a few families accepted.

In March 2002, Saldivar pleaded guilty to six counts of murder in exchange for life imprisonment rather than the death penalty—although the prosecutor had never intended to go for the ultimate sanction. Saldivar contested nothing about the investigation and accepted his sentence, which was formally meted out on April 17. Judge Lance Ito, who had presided over the O.J. Simpson criminal trial during the mid-1990s, gave Saldivar six consecutive life sentences and fifteen more years for attempted murder.

Saldivar did offer an apology to the families. "I know there is nothing I can say," he mumbled, "that can sooth their anger or bring relief to their anxiety. I want to say that I'm truly sorry and I ask for forgiveness although I don't expect any."

Had he been executed, Lieberman points out, he'd have been given the same drug as the one he'd used on his patients.

In May 2002, the California Department of Consumer Affairs Respiratory Care Board petitioned a judge to suspend the license of Ursula Anderson. She had aided and abetted a criminal and had acted unprofessionally and with extreme neglect. Three other therapists who worked with Saldivar were put under investigation as well.

Right away there was film interest in this story. Disney-based Spyglass partners Roger Birnbaum and Gary Barber bought the rights for a feature-length film, which plays the cold and cunning "angel" against the shrewd but fatigued Detective McKillop. A script is written and production is scheduled for the summer of 2002.