Crime Library: Criminal Minds and Methods

Angels of Death: The Male Nurses

Mercy or Power?

Charles Cullen
Charles Cullen

Charles Cullen, 43-years-old and a male nurse, is among those healthcare professionals who apparently decided over the years that certain patients should die. When he was charged in two cases in December 2003, according to the Newark Star Ledger, he admitted that in the past 16 years in the ten healthcare institutions in which he worked, he was responsible for taking the lives of 30 to 40 patients. He was being merciful, he said, but their cases and his actions indicate otherwise.

Although he has not yet specified the names of his victims as of this writing, in the past year he dispatched almost one patient per month — a rate that raises questions about his motives. He also confessed in a way that indicated the murders were a source of empowerment for him. He didn't have to confess, so why did he? Was he trying to tell those with whom he has worked, "See what I got away with all that time?"

Reverend Florian Gall
Reverend Florian Gall

Cullen has been charged with the murder of Reverend Florian Gall at the Somerset Medical Center in Somerville, New Jersey, and the attempted murder of cancer patient Jin Kyung Han, who was saved from his overdose by an antidote but who died months later from unrelated causes. On both, Cullen is suspected of using a lethal dose of digoxin, a heart medication, which he procured through deceptive computer manipulation from hospital supplies. After he was fired, he was found to be the common denominator among six patients with abnormal test results.

In fact, Steven Marcus, a toxicologist and executive director of New Jersey Poison Information and Education System, had warned Somerset Medical Center in July 2003 that they had a poisoner on their staff. He spotted a cluster of at least four cases. Hospital officials dismissed him, says the Newark Star Ledger, and had even complained about Marcus to the state's health department, saying he had rushed to judgment and was pressuring them unduly.

Likewise in 2002, nurses at St. Luke's Hospital in Bethlehem, Pa., had warned the state nursing board, law enforcement, the county coroner, and even Cullen's next employer that he could be a killer. They had seen a spike in Code Blues, reports the Morning Call, and had attempted to get a thorough investigation. Nurses at two nearby facilities had also demanded that Cullen be dismissed and investigated. However, hospital administrators had declined to pass the word along via a negative reference. One nurse was even fired for her part in whistle-blowing.

Three days after his arrest, Cullen became a suspect in the unexpected deaths of two more patients in Pennsylvania hospitals, and one woman was exhumed as part of the investigation. Another already had a toxicology report of digoxin in the blood although he had not been prescribed this medication. The results of both cases are pending.

In court at his arraignment, Cullen pleaded guilty to the charges and said he had no intention of fighting. He did not even want a lawyer, but in a quick turnabout accepted a public defender, who subsequently said Cullen might offer names in exchange for avoiding the death penalty.

A resident of Bethlehem, Pa., Cullen is the youngest of nine brothers and sisters. The New York Times reported that their father was a bus driver, their mother a home-maker. Cullen grew up in a working-class neighborhood in New Jersey, in a strongly religious Catholic family. His father died when he was an infant and his mother while he was in high school. Two of his siblings have also died, and he cared for one of them during the process.

In 1978, he enlisted in the Navy and when he got out, he attended a nursing school. By 1988, he was working at the first of many hospitals where he would stay only a short while. He got married and had two daughters, but soon was divorced. In 1998, says the Morning Call, he filed for bankruptcy and had a pile of debts and back payments due in child support to the tune of over $66,000. He lost his dog to the animal protection agency, and though he seemed inconsiderate of others, he claimed he felt picked on.

In 1997, signs of a troubled mind surfaced. Cullen was taken to a hospital in New Jersey because he suffered from depression. He refused to provide a blood sample and afterward filed a police report against the doctor. Just over two years later, he lit coals in a bathtub and sealed off his apartment in a suicide attempt. A neighbor called the police and when they took him in, they learned that this was not his first attempt. An A&E broadcast in 2004 indicated that he had threatened a former girlfriend by breaking into her home to let her know how vulnerable she was. He clearly was troubled.

As his debt mounted, he moved from one hospital to another, and at St. Luke's in Bethlehem, Pa., he left to avoid an investigation into the deaths of 69 patients and into a mysterious box of heart medication found in a disposal bin. While the coroner determined at the time that there was no evidence of criminal conduct in any of the cases, many of those deaths will be reviewed again in light of Cullen's confession. There had been no toxicology reports on those patients and only one autopsy had been performed. In short, it was a superficial investigation with no determination about the medications present in the bodies. The next step, if suspicions warrant it, would include exhumations.

Despite his spotty work record, Cullen never had trouble getting another job, probably due to the shortage of nurses. Yet he was fired outright in October 2003, amid questions concerning the death of Reverend Gall. Now he's being investigated in seven counties across two states.

Representatives from the Somerset Medical Center said they did not know that Cullen had been investigated elsewhere. When they checked his credentials, according to a report in USA Today, they learned nothing that would have made them hesitate to hire him. All they received were his dates of employment. It was at this facility where Cullen may have done his deadliest work, admitting to killing between 12 to 15 patients in only 13 months. Had concerns been passed along, things would have been different, and that upsets hospital officials. Now they're faced with a massive investigation and damage to their reputation. Someone, they believe, should have warned them.

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