In the first days of May 1999 a porter at the Salgado Filho municipal hospital, in the Méier district of Rio de Janeiro, watched a nursing assistant named Edson Izidoro Guimarães fill a syringe with potassium chloride and inject it into a patient in a coma. The patient died almost at once. The police were called, and what the porter had seen fitted what the hospital's own figures had been showing for months: on the ward where Guimarães worked, the death rate on his shifts ran far above normal. He was arrested on the spot, and in custody he confessed to five killings.
He was forty-two, born in 1957, and worked in the unit for trauma and emergency patients. He killed them in two ways. He injected ampoules of potassium chloride, ten milliliters at a time, into their drips, or he took away the oxygen masks of patients who could not breathe without them. He described the choice to reporters as mercy. "I chose the patients I saw suffering, generally patients with AIDS, patients who were almost terminal," he said. "I am in peace because the patients were in a coma and had no way of recovering." Before his trial he told a television reporter that he did not regret it and had done it only to people in irreversible comas whose families were suffering.
There was also money in it. Funeral homes in Rio competed for the families of the newly dead, and Guimarães was paid about sixty dollars each time he was the first to tell one of them that a patient had died, so that its agents could reach the relatives before a rival. Josias Quintal, the state's secretary for public security, joined the two explanations together: "He may have begun doing it to earn money and then just lost control." The vile motive named in the charges was the funeral-home money.
He was tried in February 2000 before the 3rd Jury Court of Rio de Janeiro on four counts of triply qualified homicide: a vile motive, the use of asphyxia and poison, and victims left with no means of defending themselves. His lawyers told the jury he had been beaten and coerced into confessing. One of the four had died of a pulmonary embolism after an injection of potassium chloride; the others had been deprived of oxygen. The jury convicted him on all four, and Judge Mário Guimarães Neto sentenced him to nineteen years for each, seventy-six years in all, saying the defendant had shown a total disregard for the value of human life. Accounts give the date as February 17, 18 or 21.
The sentence did not hold. In March 2001 the 3rd Criminal Chamber of the state's Court of Justice ruled unanimously that the judge could not have imposed nineteen years for each killing and cut the total to thirty-one years and eight months. Because Brazilian law then gave anyone sentenced to more than twenty years the right to a second jury trial, he was tried again before the same court. The second jury sentenced him to sixty-nine years. On appeal the chamber refused to annul the verdict but reduced the sentence a second time, again to thirty-one years and eight months.
The larger number attached to his name comes from the deaths recorded during his shifts. He was accused of 126 other deaths that had occurred during his shifts, and a total of up to 131 patients between January 1 and May 4, 1999, has been repeated ever since. None of those deaths beyond the four was ever brought to a verdict.