CHARLES CULLEN: ANGEL OF DEATH

Article BY Kelly Lynn Porter

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What exactly is the definition of an angel of death? Sometimes called angel of mercy, this is a rare type of criminal offender who intentionally harms or kills someone that they are in the care of. Most of these fall along the lines of a mercy killing, to keep the patient from having to suffer through the pain. In many of these instances, the amount of deaths can amount from 10 to 40. Most of them however, are in the hundreds and there is one killer that tops them all. One serial killer, who, after 16 years on a killing spree, multiple times of being investigated and attempted murders, may have had over 400 victims.

Direct from the mouth of a killer, “I was a person who was trusted and had responsibility for a lot of people dying…I hate myself for it because I don’t believe I had the right, but I couldn’t stop, I couldn’t.” Surprisingly after countless attempts by law enforcement and multiple investigations from the hospital system it still took more than a decade for one of these killers to be caught.

Charles Cullen was born in West Orange, New Jersey on February 22, 1960. He was the youngest of eight children and was unpopular in school with a knack for attracting bullies. He was very intelligent, but was off and unable to connect with peers. Cullen had fallen into deep depression during his teen years and had attempted suicide many times; the first being when he was nine years old with a mixture from a take home Chemistry set.

By Cullen’s 18th birthday, he had attempted suicide multiple times and had lost both of his parents. His brothers were dealing drugs out of the family home, and he was close to his much older sisters. While staying home from school one day he answered a knock on the door from the local police department. His mother and sister had been involved in an auto accident and his sister had been behind the wheel on a day she hadn’t taken her medication. When Despite his high intelligence and devastated by the loss of his mother, Cullen enlisted in the U.S. Navy after dropping out of high school. He quickly rose ranks to become a petty office third class and served on the USS Woodrow Wilson as a submarine serviceman. With this ranking, he was part of the team that operated Poseidon missiles.

This is when Cullen began to show signs of mental instability. An incident had been reported where he had completed a shift aboard the USS Woodrow Wilson while wearing a surgical gown, mask and gloves he had stolen from a nearby medical closet. During this time, Charlie would periodically help the priest on board in the sick bay. When the priest realized how much Charlie was interested in helping the patients on board, he mentioned that Cullen take correspondence classes to prepare him for a new line of employment when he was to leave the Navy. Finally, after being discharged from the army for to many suicide attempts and problems related to alcohol, Cullen discovered he had been accepted into nursing school due to his correspondence classes.

He was eventually transferred to a supply ship and over the course of this period he attempted several times over the next few years to end his life. On March 30th of 1984 he received a medical discharge from the Navy. Within the same month, he enrolled at the Mountainside Hospital School of Nursing in Montclair, New Jersey. He graduated in 1987 as the only male student, the president of his nursing class and accepted a job in the burn unit of St. Barnabas Medical Center in Livingston, New Jersey.

In the same year of his graduation, Cullen’s brother James died from a drug overdose. Even though the devastating event happened so soon after graduation, Cullen continued to overshadow the bad with the good. He went on to marry a computer programmer, Adrienne Taub in July. Cullen received the phone call of his employment status while on his honeymoon.

The year 1988 would serve as a new beginning to Charles Cullen and his discovery of digoxin (DIG) and insulin. Receiving a job at the St. Barnabas Medical Center, Cullen would murder his first patient in the same hospital where his mother had died. He administered a lethal overdose of intravenous medication to John W. Yengo, Sr. Yengo had been admitted to the hospital suffering from severe sun burns. He would die from an overdose of lidocaine and be the first victim at the hands of Charles Cullen.

Not only was Cullen starting his killing spree, but this would also begin his problem with drinking. As he started down this path he would also start being noticed by the local police for receiving numerous speeding tickets. He went on to murder 11 patients at the St. Barnabas Medical Center. This included an AIDS patient who had died from an overdose of insulin, even though the patient was not diabetic. In 1992, rumors began that the hospital authorities had begun to investigate into a reoccurring problem the hospital was having. It was being noticed that intravenous bags and their fluids were being tampered with and had raised an alarm to the hospital. It was ultimately determined that Cullen had been the culprit for the contaminations that had killed the patients. Before Cullen could be fired, he quickly resigned from his nursing position within the hospital.

He then began to work at Warren Hospital in Phillipsburg, New Jersey where he admitted to killing 2 elderly women by giving those patients overdoses of digoxin. The drug digoxin is a heart medication that is used in the support of blood pressure and an antiarrhythmic agent. It can treat heart failure as well as heart rhythm problems. Although when used in small quantities it can help get the heart beat back to normal, in large amounts at levels of overdose it does the exact opposite and stops the heart. He later added a third woman to his list. This victim, who was the final victim in this hospital stated that she saw a “sneaky male nurse” inject her with something as she slept. The family members and other healthcare providers who were with her dismissed the comment. With no system to identify mental issues in health care professionals, his patient not being believed and the nation-wide shortages on nurses, Cullen continued.

By this time, Cullen and Taub had two small daughters and he was he scrambling to keep himself from being caught. His marriage to Adrienne was in fast decline. The marriage began to struggle in 1992 and with the loss of his job; Cullen’s depression came back with a vengeance. When his wife finally filed for divorce in 1993, she would come to also file 2 counts of domestic violence complaints against her husband. She stated he was an alcoholic, abused pets by putting the family pets in trash bins and poured lighter fluid into other people’s drinks. He had also been caught on occasion of making prank calls to funeral homes. He did not exclude the family from his torture and would regularly turn the heat off in the family home during the winter months. Cullen was finally kicked out of the home and he moved into a basement apartment, sharing custody of his children.

With his pending divorce as well as the court order to pay child support, Cullen stated he was unable to quit nursing all together due to his financial demands. His mental condition was crumbling, his marriage was on the verge of being dissolved and Cullen was feeling the strain. He attempted suicide in January of that year and was sent to the Behavioral Health Unit at Muhlenberg Regional Medical Center.

During one of his stays for psychiatric evaluation following a suicide attempt, Michelle Tomlinson, a friend and co-worker had come to visit him. Michelle and Charlie had worked together at the hospital. After being in the hospital for barely 6 days, Cullen returned to work he seemed to be in better spirits. He and Michelle had become close and Cullen had asked her out to dinner. The day after their date, Cullen showed up to the hospital with an engagement ring to purpose married. Royally creeped out, Michelle said no and began to distance herself from Charlie and his overbearing ways. He started to harass her and call her multiple times a day. With a final attempt to get her affections, Charlie broke into Michelle’s home late one night to watch her sleep. When Michelle awoke to catch Cullen in the act she called the police. Cullen was arrested for breaking and entering.

Suicide attempts, arrest records with drug and alcohol abuse would push Cullen’s wife over the edge. The divorce still hadn’t been finalized and the latest arrest had pushed her over the edge. She applied for and was granted a restraining order. His parental and visitation rights were immediately revoked. With this news, less than two months since his last attempt, Cullen tried again to commit suicide and was sent to Carrier Clinic in Belle Meade, New Jersey. Soon after being released from the hospital, he went on to kill Helen Dean with digoxin. Cullen was ultimately given a polygraph during the investigation into Dean’s death. And passed. By the end of the year, the divorce from Adrienne was finalized and she was awarded full custody, with Charles grated unsupervised visitations of their children.

Early the next year, he quit his job at Warren Hospital and took a job with Hunterdon Medical Center in Raritan Township, New Jersey. Here, he worked the ICU (Intensive Care Unit) which specialized in Cardiac care. He claimed that this hospital was different, and the first two years of his new position within this hospital he did not perform any killings. Many investigators took this with a grain of salt, and when attempting to obtain hospital records within these first two years, police discovered that the hospital records had been destroyed by the time of his arrest in 2003. By his third year, however, Cullen admitted to killing up to five patients by using overdoses of his favorite drug, DIG, also known as Digoxin.

Though Cullen’s mental health was waning his intelligence was not. To make matters more complicated Cullen received his Pennsylvania nursing license in June. Now, he was licensed to move not only from hospital to hospital, but from state to state for additional jobs. He later received an award for diligence and hard work that was presented from his colleagues as well as began to date a married nurse at Hunterdon.

Within the year of 1996, Cullen went on to murder five people within seven months. Leroy Sinn, Earl Young, Catherine Dext, Frank Mazzacco and Jesse Eichlin all died of a lethal dose of digoxin at Hunterdon hospital. Within the next two months he quit his job at Hunterdon hospital and was dumped by his then girlfriend.

With no job and now no girlfriend, Cullen begins working at Morristown Memorial Hospital in New Jersey. Less than a year later he was fired from Morristown for poor job performance. Though there are no deaths recorded at this hospital, investigators remain skeptical.

By 1998, Cullen had moved to another hospital within the Pennsylvania Health System in Allentown known as Liberty Nursing and Rehab Center. This particular ward was for strictly respirator-dependent patients. He had not only been witnessed going into patients rooms that were not his own, but giving patients medication and assorted drugs at unscheduled times. Somehow, the patient had ended up with a broken arm and upon review; other nurses and staff were unable to locate an injection site. Before ultimately being fired from Liberty hospital, Cullen had caused a patients’ death with he had blamed on another nurse on the warm.

While there is no particular reason known for the sharp increases and decreases in the murders, they seem to parallel with Cullen’s major life events. After he declared bankruptcy in May of 1998, he was fired from Liberty Rehab enter after he “accidently” broke a patients arm. Within a month, he was working part-time at the Easton Hospital ICU in Easton Pennsylvania.

While working at Easton Hospital, he took a night nurse position in the burn unit of Lehigh Valley Hospital in Salisbury Township, New Jersey. He began to kill patients at both hospitals simultaneously. He killed Ottomar Schramm, 78 with digoxin at Easton Hospital and killed Matthew Mattern, 22, with the same drug at Lehigh Valley Hospital. After family members came forward regarding the suspicious death of Mattern the coroner later stated he had in fact found a lethal dose of the drug in the patients’ system. The report was later deemed inconclusive as there was no evidence that pointed to Cullen as the killer.

By April, Cullen continued to skip hospitals as fast as he killed his patients. Still, the nationwide nurse shortage was in full swing and Cullen continued to land job after job. And still yet, not only was there no system to check for any sort of medical histories regarding nurses themselves, but there was no protocol between hospitals regarding suspicions regarding malpractice. These issues were not only bad hospital to hospital, but once they crossed state lines it was pretty much non-existant.

By this point, Cullen’s life started an immediate downward spiral. His heightened bouts of alcohol and depression led to another suicide attempt. This was attempted by lighting a charcoal grill in his bathtub in an unusual attempt to kill himself with carbon monoxide poisoning. His neighbors, who smelled the smoke, immediately called the fire department who rushed to Cullen’s home to save him. He was quickly taken to a psychiatric facility, but was quickly discharged and returned home by the next morning.

After attempting to kill Stella Danielczyk with an overdose of digoxin, he resigned from Lehigh Valley Hospital he was immediately hired by St. Luke’s Hospital in Bethlehem, Pennsylvania, in the cardiac care unit.

Though it seemed like Charles’ had taken a break between 2000 and 2001, the death of his brother, Edmond, put a chain of deaths into action. By mid-2002 he killed Irene Krapf, William Park, Samuel Spangler, Daniel George and Edward O’Toole all in their late 70’s and early 80’s again with a lethal dose of digoxin.

Still at St. Luke’s Hospital, vials and bottles of unused medications had been discovered in disposal bins by co-workers at the hospital where Cullen was still working. These vials held a major mystery. The glass vials contained medications that were not normally used for recreational use by drug addicts or drug dealers. Even more so, some of the bottles were empty while other bottlers were half full making them guess at first making them think it was a rather off theft attempt. After the hospital began an investigation, it was discovered that Cullen had stolen the drugs. Instead of St. Luke’s immediately firing Cullen, he was given an alternative. He could either resign and be given a neutral recommendation to other hospitals for further employment, or he could be fired. Cullen took the rather obvious choice and was escorted out of building security in June 2002. Cullen had begun to hear rumors circulating him about his recent conduct and investigations regarding his previous job. St Luke’s had reported that here had been unprofessional conduct to the state nursey board. He had also found out that while he was still at St. Luke’s the Pennsylvania state nursing board started an investigation of his activities while he was employed there.

Quickly afterwards, several coworkers, after months of suspicion, contacted the Lehigh County district attorney with their concerns. It was being documented that Cullen had been responsible for nearly two-thirds of the deaths that had occurred there. Still, by this year, hospital systems still had no way of tracking a nurse or medical professional through mental health evaluations or even prior work experience through a documented system. With no way to check in on Cullen’s many internal investigations and inappropriate employee behavior, police officers working the case dropped the investigation after a mere 9 months stating a lack of evidence to pursue charges.

After resigning from St. Luke’s Hospital with a promise of a neutral recommendation, he was hired on to Sacred Heart Hospital in Allentown, Pennsylvania. He then started Somerset Medical Center, another hospital in New Jersey and also began dating a local woman. He had been hired on to help in the critical care unit. This is also known as an intensive care unit (ICU), or intensive treatment unit (ITU). These departments of a hospital or health care facility provide intensive treatment medicines for life-threatening illnesses and injuries. Common conditions that are treated within these facilities are high trauma events, multiple organ failure and sepsis. Within these departments, Cullen’s drugs of choice were used every day in these types of situations to help with these kinds of patients and their treatment.

Even with a new job and new found love he had found his depression worsened. With his steadily darkening mind his number of victims came quickly and in a large number. During his tenure here at the hospital he went on to kille Elenor Stoecker, Joyce Mangini, Giacomino Toto, John Shangher, Dorthea Hoagland, Melvin Simcoa, Michael Strenko, Florian Gall, Pasquale Napolitano, Chris Hardgrove, Krishnakant Upadhyay, James Strickland and Edward Zizik. These also included the two attempted murders of Frances Agoada and Jin Jung Han. While he was still using digoxin to commit most of his murders, he began to include additional drugs into his M.O. Though all three of these new drugs are used to lower blood pressure, there are certain things that each drug does in addition that helped Cullen with his acts.

Norepinephine: also treats heart failure and is used mostly for blood pressure support.

Sodium Nitroprusside: used mostly when there is heart failure and during surgery to decrease bleeding.

Doutamine: also treats heart failure as well as helps the heart pump blood.

By the summer of 2003, The New Jersey Poison Information and Education System had warned officials and staff alike that there had been between five to six suspicious overdoses and attempted overdoses. They then indicated that these types of overdoses were definitely not accidental, and with the high number was most likely an employee murdering the patients. When Cullen realized that the authorities had figured out what was going on, he stopped manipulating the system. Killing patients, however, continued.

His old habits continued in this hospital as well and within 8 months he had found a way to manipulate the hospital computer system and was administering medication patients that he was not in the care of. He would be seen repeatedly coming in and out of those rooms when he had no reason to be there. With the major increase in deaths, the Somerset Medical Center reported suspicious deaths to the prosecutor’s office. While Cullen was being investigated for these murders he went on to kill his final patient, Edward Zizik with an overdose of digoxin.

As nothing in life, the hospital drug administering system was not perfect. Say hello to the Pyxis MedStation system. These MedStations’ are automated medication dispensing systems and usually come with a cart. Manufactured by a company called Cardinal Health, the machine is basically a medical supply vending machine. It safely and accurately dispenses medication while supporting the pharmacy workflow. Its main key points are maximized security, bulk item security, time saving and Increased medication availability. They can keep track of everything they use electronically including inventory at which when something is close to running out, it will be automatically shipped over and re-entered into the box for continuous use. It also would track a nurse’s drug withdrawal, linking it to the account of the patient and to the nurse so everyone connected to using this medicine is well documented in the computer files. Though this machine was supposed to regulate and hold accountable those in possessions of these drugs… It was Cullen’s one way ticket to murder.

Though the Pyxis MedStation did not appear in every hospital nation-wide and were not openly documented to being used in 2010, Somerset Medical Center had some form of this technology. The same time that the hospital system was revealing Cullen’s unnecessary checking on other patients, it had been discover that he was manipulating the computerized drug-dispensing cabinets to access medications that had not been prescribed. Like most machines, the Pyxis machine came with its quirks and issues. Cullen found that if he ordered the medication, then immediately cancelled it, the drawer would open and the medication would still be accessible. The records would show that the product was never ordered and Cullen could take the medication. On June 18, 2003 Philip Gregor was the next person on Cullen’s list. In an attempt to fatally overdose Gregor, Cullen did not succeed with his plan and Gregor was discharged but in a turn of unfortunate events, died from natural causes several months later.

One of Cullen’s friends and co-workers at hospital had turned confidential informant for the prosecutor’s office. She noticed that Cullen was ordering acetaminophen (Tylenol) on regular bases from the computer system. She was confused. Why he would go through all the trouble of logging in his personal information into the system to get something as trivial as Tylenol? Then, days later, while on her shift, she ordered acetaminophen for a patient. As the drawer popped open she realized that the draw was holding multiple medications. In alphabetical order. That means, the drawer that the acetaminophen was in was the same drawer that came open with digoxin. ‘A’ and ‘D’ shared the same drawer and Cullen had once again found out how to abuse the system.

By the next month, the hospital had been penalized by state officials for failing to report a nonfatal insulin overdose. One that Cullen himself had administered on a patient in October of 2003. When Cullen’s final patient had died from having low blood sugar in October of the same year the hospital, scared of another penalty, alerted state authorities. Also in the same month, Gall’s body was exhumed and an autopsy was performed. It was revealed by the coroners office that the had died from a deliberate overdose.

After being fired from Somerset a full investigation was done into Cullen’s employment history and revealed his suspicious behavior as well as suspicions in the deaths of multiple patients. He was fired for the last time on October, 31, 2003 for being dishonest on his hiring enrollment paperwork. A fell nurse Amy Loughren went to police after becoming alarmed when seeing Cullen’s drug ordering records and links to patient deaths. Finally, after 16 years, multiple psychotic episodes and attempted suicides, states in psychiatric treatment facilities and numerous hospital jobs, Charles Cullen was arrested on December 12th, 2003.

Two days after his initial arrest and at the end of a 7-hour-long police interrogation by detectives Dan Baldwin and Tim Braun, he confessed to the murder of Rev. Florian Gall and the attempted murder of Jin Kyung Han. To the investigators surprise, he then confessed to killing approximately 40 other patients while working as a nurse in New Jersey and Pennsylvania hospitals. Even more surprising, is when Cullen went into detail regarding his murderous acts and his reason behind them. Within this same month, Cullen was transferred to Trenton State Psychiatric Hospital, surrendered his New Jersey Nursing License and also stated that he would not help with the investigation any further unless authorities agreed not to seek the death penalty.

He claimed that through his 16 year killing-spree, he wanted to spare them from being “coded”. This is also known as a “Code Blue” emergency.

Code, Hospital: While there is no formal definition, doctors often use the term as slang to refer to a patient in cardiopulmonary arrest (cardiac arrest), requiring a team of providers to rush and begin immediate resuscitative efforts.

Code, Hospital: While there is no formal definition, doctors often use the term as slang to refer to a patient in cardiopulmonary arrest (cardiac arrest), requiring a team of providers to rush and begin immediate resuscitative efforts.

He couldn’t bear to hear of a patient having his their saved or even attempting to have their life saved due to resuscitation. He overdosed his patients to end their suffering. But what exactly were Cullen’s patients suffering from? All of Cullen’s patients here not terminally ill. The Reverand Florian Gall, Readington Township priest whom Cullen had killed in Somerset, had been given an optimistic diagnosis of recovering from pneumonia. His body was discovered to have four times the normal dosage of digoxin after exhumation. Most of them were even scheduled to be released from the hospital, one of which was supposed to go home the very next day. He was found on many occasions to give investigators hypocritical and contradictory statements.

He would observe patients suffering for several days and for that time period he would constantly think about murdering them, to end their suffering. But when it came to the act of taking their life it was a complete impulsive reaction. He never stated exactly how many victims he had, what his modus operandi (MO) was, or what it was about these certain victims that made him choose them. Cullen only started to confess to additional murders after being shown the medical records from the hospitals that he had been in residency with and admitting he was their cause of death.

In April of 2004, Cullen pleaded guilty to killing 13 people and attempting to kill 2 others while working at Somserset Medical Center. While making his plea agreement, he promised to cooperate as long as they kept the death penalty off the table. In less than a year, he pled guilty to 9 additional murder charges and 3 additional attempted murders. He was sentenced to 11 consecutive life sentences in New Jersey and is currently incarcerated in Trenton, New Jersey. By July of 2005, Cullen was spending time in the Somerset County Jail, a mere 4 minute drive from Somerset Medical Center while being investigated for additional killings.

He is currently serving a life sentence without parole for over 100 and 18 consecutive life terms in New Jersey and isn’t eligible for parole until the year 2403. He is now serving the remainder of his time in the New Jersey State Prison in Trenton, New Jersey.

On March 10, 2006, Cullen was brought back into the courtroom for another sentencing hearing. Charles was becoming upset with the judge and continued to tell Judge Platt to “You need to step down.” For 30 minutes the Judge let Cullen continue to repeat these words before having Cullen gagged with a cloth and duct tape. Even after being silenced, Cullen continued to try and repeat the phrase. He was then given an additional six life sentences. As part of a plea bargain, Cullen has been attempting to help identify additional victims.

Signature on Charles Cullen’s plea agreement to keep death penalty off the table.

Being an angel of death has many different meanings. Cullen stated that he lived most of his life in a fog and he blacked out the memories of murdering most of his victims, and that is why he only confessed to 40. Because this was as many as he could remember.

He had went undiscovered for so long. And even after he was being found out he was still able to get away with it for multiple years after. Charles Cullen spoke candidly to investigators and police regarding why it took him so long to find out. They believe it was a perfect triangle of three key points.

• Most states did not provide investigators with legal authority to workers employment history.

• Hospitals and Health Institutions were fearful to investigate incidents. If something was found here, all the hospitals practices would be questioned and would stop patients coming to that particular health center. They were also fearful to give a unsavory employment reference for fear of being sued.

• Cullen himself stated that multiple hospitals he worked at suspected he was harming and/or killing patients but did not take the appropriate action for fear of backlash.

Shortly afterwards, 37 states filed motions to encourage health care administrations and personnel to provide honest job performance reviews and any other information that states the appraisal of an employees. This includes issues with mental and physical health issues. Other laws were put into place that states all licensed health care professionals undergo criminal background check, fingerprinting and protect facilities that report improper care of patients.

Cullen had been able to move so freely from employer to employee because of the lack of requirements to report such suspicious behavior. And since he was jumping from one state to another when things were getting hot, it was easier since the hospitals were not in the same state. Institutions had been afraid to investigate incidents or give poor employee referrals for fear of being sued or a lawsuit would be filed. According to detectives, several of these hospitals he worked at knew he was harming and killing patients but never brought it to the attention of investigators. Though the investigators continue to believe that there are many more murders that Cullen committed, without full disclosure from the hospital system and Cullen himself there is no hope of ever tracking down every victim of the angel of death.