Charles Cullen

Charles Edmund Cullen (born February 22, 1960) is a former nurse who is the most prolific serial killer in New Jersey history and is suspected to be the most prolific serial killer in American history. He confessed to authorities that he killed up to 40 patients during the course of his 16-year nursing career. But in subsequent interviews with police, psychiatric professionals, and journalists Charles Graeber and Steve Kroft, it became clear that he had killed many more, whom he could not specifically remember by name, though he could often remember details of their case. Experts have estimated that Charles Cullen may ultimately be responsible for 400 deaths, which would make him the most prolific serial killer in American history.

Early life
Cullen was born in West Orange, New Jersey, and was the youngest of eight children. His father, a bus driver, was 58 years old at the time of Charles' birth and died when Cullen was seven months old. Cullen described his childhood as miserable. He first attempted suicide at age nine by drinking chemicals from a chemistry set. This would be the first of many suicide attempts throughout his life. Later, working as a nurse, Cullen claimed to have fantasized about stealing drugs from the hospital where he worked and using them to end his life.

On December 6, 1977, Cullen's mother died in an automobile accident in a car that his sister was driving. In April 1978, devastated by his mother's death, Cullen dropped out of high school and enlisted in the U.S. Navy. He was assigned to the submarine service and served aboard the ballistic missile submarine USS Woodrow Wilson. Cullen rose to the rank of petty officer third class as part of the team that operated the ship's Poseidon missiles. At this point, Cullen began to show signs of mental instability. He was transferred to the supply ship USS Canopus. Cullen tried to end his life seven times over the next few years. He received a medical discharge from the Navy on March 30, 1984.

That same month, Cullen enrolled at the Mountainside Hospital School of Nursing in Montclair, New Jersey, where he was the only male student. Cullen was later elected president of his nursing class. He graduated in 1987 and took a job at the burn unit of St. Barnabas Medical Center in Livingston, New Jersey.

Murders
Cullen's first confessed murders occurred while working at St. Barnabas. On June 11, 1988, he administered a lethal overdose of intravenous medication to Judge John W. Yengo, Sr, who had been admitted to the hospital suffering from a photoallergic reaction to a blood-thinning drug. Cullen admitted to killing several other patients at St. Barnabas, including an AIDS patient who died after being given an overdose of insulin. Cullen left St. Barnabas in January 1992 when hospital authorities began investigating who had contaminated IV bags. An internal investigation at St. Barnabas determined that Cullen was most likely responsible for the contaminations, resulting in dozens of patient deaths at the hospital.

One month after leaving St. Barnabas, Cullen took a job at Warren Hospital in Phillipsburg, New Jersey. He murdered three elderly women at the hospital by giving them overdoses of the heart medication digoxin. His final victim said that a "sneaky male nurse" had injected her as she slept, but family members and healthcare providers at the hospital dismissed her comments as unfounded. The following year, Cullen moved into a basement apartment on Shaffer Avenue in Phillipsburg following a contentious divorce from his wife; he shared custody of his daughters. He would later claim that he wanted to quit nursing in 1993, but the court-ordered child support payments forced him to continue working.

In March 1993, Cullen broke into a co-worker's home while she and her young son slept, but left without waking them. Cullen then began stalking the woman, who filed a police report against him. Cullen subsequently pleaded guilty to trespassing and received one year's probation. The day after his arrest, Cullen attempted suicide again. He took two months off work and was treated for depression in two psychiatric facilities, but attempted suicide twice more before the end of 1993, at which point he quit his job at Warren Hospital.

Cullen began a three-year stint in the intensive care/cardiac care unit of Hunterdon Medical Center in Flemington. He claimed that he did not harm anyone during the first two years, but hospital records for that time period had been destroyed by the time he was arrested in 2003. He did admit to murdering five patients between January and September 1996, again with overdoses of digoxin. Cullen then found work at Morristown Memorial Hospital in Morristown, New Jersey, but was soon fired for poor performance.

Throughout the latter half of 1997, Cullen remained unemployed for six months and stopped making child-support payments. He again sought treatment for depression in the Warren Hospital emergency room. He was admitted to a psychiatric facility but left a short time later.

In February 1998, Cullen was hired by the Liberty Nursing and Rehabilitation Center in Allentown, Pennsylvania, where he staffed a ward of respirator-dependent patients. While at Liberty Hospital, Cullen was accused of giving patients drugs at unscheduled times, and was eventually fired after he was seen entering a patient's room with syringes in his hand. The patient ended up with a broken arm, but apparently received no injections. Cullen caused a patient's death at Liberty which was blamed on another nurse. After leaving Liberty Nursing and Rehab Center, Cullen was employed at Easton Hospital in Easton, Pennsylvania, from November 1998 to March 1999. On December 30, 1998, he murdered yet another patient with digoxin. A coroner's blood test showed lethal amounts of digoxin in the patient's blood, but an internal investigation within Easton Hospital was inconclusive; nothing pointed definitively to Cullen as the murderer.

Even with his history of mental instability and the number of deaths during his employment at various hospitals, Cullen continued to find work due to a national shortage of nurses. Additionally, no reporting mechanism or other systems existed at the time to identify nurses with mental health issues or employment problems. Cullen took a job at the burn unit of Lehigh Valley Hospital in Allentown, Pennsylvania, in March 1999. During Cullen's tenure with Lehigh Valley Hospital, he murdered one patient and attempted to murder another.

In April 1999, Cullen voluntarily resigned from Lehigh Valley Hospital. Shortly afterwards, he took a job working at St. Luke's Hospital in Bethlehem, Pennsylvania, where he worked in the cardiac care unit. Within the next three years, Cullen killed at least five patients and is known to have attempted to murder two more. On January 11, 2000, Cullen attempted suicide again. He put a charcoal grill in his bath tub, lit it, and hoped to succumb to carbon monoxide poisoning. Cullen's neighbors smelled the smoke and called the fire department and police. Cullen was taken to a hospital and a psychiatric facility but returned home the following day.

No one suspected Cullen was murdering patients at St. Luke's Hospital until a co-worker found vials of medication, some used, some not, in a disposal bin. The drugs were not valuable outside the hospital and were not used by recreational drug users, so their theft seemed curious. An investigation showed that Cullen had taken the medication. He was offered a deal by the medical facility: resign and he would be given a neutral recommendation, or he would be fired. He resigned and was escorted from the building in June 2002. Seven of Cullen's co-workers at St. Luke's later met with the Lehigh County district attorney to alert authorities to their suspicions that Cullen had used drugs to kill patients. Investigators never looked into Cullen's past, and the case was dropped nine months later due to lack of evidence.

In September 2002, Cullen began working for Somerset Medical Center in Somerville, New Jersey in the critical care unit. Around this time Cullen began dating a local woman, but his depression worsened. He killed at least eight patients and attempted to kill at least one more by June 2003. As usual, his drugs of choice were digoxin, epinephrine, and insulin.

On June 18, 2003, Cullen attempted to murder Philip Gregor, a patient at Somerset Medical Center. Gregor survived and was discharged, but he died six months later of natural causes. Soon afterward, Somerset Medical Center began to observe clues indicating Cullen's wrongdoing. The hospital's computer system showed that Cullen was accessing the records of patients to whom he was not assigned, co-workers began seeing him in the rooms of patients' to whom he was not assigned, and the hospital's computerized drug-dispensing cabinets showed that Cullen was requesting medications that his patients had not been prescribed. Cullen's drug requests were strange, with many orders that were immediately canceled, and many repetitive requests within minutes of each other.

In July 2003, the executive director of the New Jersey Poison Information and Education System warned Somerset Medical Center officials that at least four suspicious overdoses indicated the possibility that an employee was killing patients. The hospital delayed contacting authorities until October 2003. By then, Cullen had killed at least another five patients and attempted to kill a sixth.

When a patient in Somerset died of low blood sugar in October 2003, the medical center alerted state authorities. That patient was Cullen's final victim. State officials castigated the hospital for failing to report a nonfatal insulin overdose, administered by Cullen, in August. An investigation into Cullen's employment history revealed past suspicions about his involvement with prior deaths. Somerset Medical Center fired Cullen on October 31, 2003, ostensibly for lying on his job application. Fellow nurse Amy Loughren alerted the police after becoming alarmed about Cullen's records of accessing drugs and links to patient deaths. Police kept him under surveillance for several weeks, until they had finished their investigation.

Arrest and sentencing
Cullen was arrested at a restaurant on December 12, 2003, charged with one count of murder and one count of attempted murder. On December 14, 2003, Cullen admitted to homicide detectives Dan Baldwin and Tim Braun the murder of Rev. Florian Gall and the attempted murder of Jin Kyung Han, both patients at Somerset. In addition, Cullen told the detectives that he had murdered as many as 40 patients over his 16-year career.

In April 2004, Cullen pleaded guilty in a New Jersey court to killing 13 patients and attempting to kill two others by lethal injection while employed at Somerset. As part of his plea agreement, he promised to cooperate with authorities if they did not seek the death penalty for his crimes. A month later, he pleaded guilty to the murder of three more patients in New Jersey. In November 2004, Cullen pleaded guilty in an Allentown, Pennsylvania court to killing six patients and trying to kill three others.

In July 2005, Cullen was in the Somerset County Jail in New Jersey as authorities continued to investigate the possibility of his involvement in other deaths. Cullen is currently serving a sentence of life in prison without parole for over 100 years, to be served consecutively with his other sentences in Pennsylvania. On March 2, 2006, Cullen was sentenced to 18 consecutive life sentences in New Jersey, and is not eligible for parole until year 2403. Currently, he is held at New Jersey State Prison in Trenton, New Jersey.

On March 10, 2006, Cullen was brought into the courtroom of Lehigh County President Judge William H. Platt for a sentencing hearing. Cullen, who was upset with the judge, kept repeating "Your honor, you need to step down" for 30 minutes until Platt had Cullen gagged with cloth and duct tape. Even after being gagged, Cullen continued to try to repeat the phrase. In this hearing, Platt gave him an additional six life sentences. As part of his plea agreement, Cullen has been working with law enforcement officials to identify additional victims. Cullen originally told authorities about 40 patients he could specifically recall killing during the course of his 16-year nursing career.

In August 2006, Cullen donated a kidney to the brother of a former girlfriend.

Motive
Cullen stated he administered overdoses to patients in order to spare them from being "coded" — going into cardiac or respiratory arrest and being listed as a "Code Blue" emergency. Cullen told detectives that he could not bear witness to or hear about attempts at saving a victim's life. Cullen also stated that he gave patients overdoses so that he could end their suffering and prevent hospital personnel from de-humanizing them. However, many of his victims were not terminal and were to be released from the hospital shortly.

Investigators stated that he may have caused patients to suffer, but that Cullen appears not to realize this, contradicting his claims of wanting to save patients. Similarly, Cullen told investigators that although he often observed patients' suffering for several days, the decision to commit each murder was performed on impulse.

He told detectives in December 2003 that he lived most of his life in a fog and that he had blacked out memories of murdering most of his victims. He said he could not recall how many of them there were or why he had chosen them. In some cases, Cullen adamantly denied committing any murders at a given facility. But after reviewing medical records, he admitted that he was involved in patient deaths.

Legal impact
Experts state that Cullen was largely able to move from facility to facility undetected because of the lack of requirements to report on suspicious behavior by medical workers, and inadequate legal protection for employers. New Jersey and Pennsylvania, like most states, required health care facilities to report suspicious deaths only in the most egregious cases, and penalties for failing to report incidents were minor. Many states did not give investigators the legal authority to discover where a worker had previously been employed. Employers feared to investigate incidents or give a bad employment reference for fear that such actions might trigger a lawsuit. According to detectives and Cullen himself, several hospitals suspected he was harming or killing patients, but failed to take appropriate legal actions. A number of hospitals had individual workers contact nearby hospitals in secret, to alert them that they should not hire Cullen.

Prompted by the Cullen case, Pennsylvania, New Jersey, and 35 other states adopted new laws which encourage employers to give honest appraisals of workers' job performance and which give employers immunity when they provide a truthful employee appraisal. Many of the laws, passed in 2004 and 2005, strengthen disclosure requirements for health care facilities, bolster legal protections for health care facilities that report improper patient care and require licensed health care professionals to undergo criminal background checks and be fingerprinted at their own cost.