Heather Irene Pressdee lived in the Natrona Heights section of Harrison Township, Allegheny County, north-east of Pittsburgh, and was forty years old when she was arrested there in May 2023. She was a registered nurse. Beyond that, very little about her life before the killings has been made public, and this entry does not guess at it.
What is documented is her employment record, because it became the spine of the case against her. Between 2020 and her arrest she worked at a series of skilled-nursing and rehabilitation facilities across four counties: Concordia at Rebecca Residence in West Deer, Allegheny County; Belair Healthcare and Rehabilitation in Lower Burrell, Westmoreland County; Premier Armstrong Rehabilitation and Nursing Center in Kittanning, Armstrong County; Quality Life Services in Chicora, Butler County; and Sunnyview Rehabilitation and Nursing Center in Butler. Lawyers for victims' families told the court and the press that she had been dismissed or forced out of six facilities in under three years before Belair hired her, and that at Belair she rose to assistant director of nursing. At Quality Life Services, according to the Attorney General's office, she was in charge of the nursing staff and of investigating reports of abuse.
Insulin lowers blood sugar. In a patient who is not diabetic, or who is diabetic but not insulin-dependent, a large dose produces hypoglycaemia, unresponsiveness, coma and death, and the death can look like a natural collapse in a frail elderly person. The Attorney General's criminal complaint set out how Pressdee used that. She worked the medication cart on the night shift, when staffing was lowest and the buildings were quiet, and injected patients with insulin they had not been prescribed. In one case she told investigators she had given an eighty-six-year-old non-diabetic woman 120 units, roughly three times the daily dose of a type 1 diabetic, and then pronounced the woman dead herself before her shift ended.
The complaint says she took steps to make sure her patients died before the morning handover, because a patient sent to hospital would be tested. A C-peptide test distinguishes insulin the body makes from insulin injected into it, and would have exposed her. If a patient looked likely to pull through, the complaint alleges, she gave a second dose or injected air.
Twenty-two patients were named in the charges, aged from forty-three to a hundred and four. Seventeen of them died. Prosecutors were explicit that they brought murder charges only where there was physical evidence of the cause of death, and attempted-murder charges where a patient had survived or where the cause of death could not be established. That distinction, drawn by the state itself, is why this archive records three victims and not seventeen.
The three murder counts she pleaded to are not all identified by name in the public record, and this entry does not assign them. The patients who can be named come from the criminal complaint, from wrongful-death suits filed by families, and from the victim impact statements given at sentencing.
At Concordia at Rebecca Residence, where she worked from April 2021 to February 2022, the complaint describes an eighty-six-year-old non-diabetic woman given 120 units of insulin in December 2021 and pronounced dead by Pressdee. The facility's regional director told investigators that staff had raised concerns she was killing residents after the death of a ninety-two-year-old woman that month.
At Belair in Lower Burrell, four patients died. Marianne Bower, sixty-eight and not diabetic, died in September 2021; her family were told she had died of respiratory failure, and learned two years later from investigators that Pressdee had admitted giving her insulin. Jack Allen Rogers, seventy-nine, an Army veteran and Purple Heart recipient who was not diabetic, was injected on November 14, 2021 and died the next day; afterwards Pressdee sent his family a memorial tile with his name on it. Norman Paul Hendrickson, eighty-eight, a former steelworker admitted after a short hospital stay for COVID-19, also died there. A fourth Belair patient, a fifty-eight-year-old woman who was not insulin-dependent, was found unresponsive on August 9, 2021, treated in hospital for low blood sugar, returned to the facility showing no sign of it, and was found dead the next day. A Belair doctor reported Pressdee to the state Department of Health, and staff who raised concerns were, according to the families' lawsuit, disciplined while she stayed in post.
At Quality Life Services in Chicora, where she worked from May 23 to November 28, 2022, the original charges concerned three men. A fifty-five-year-old man and an eighty-three-year-old man, neither of them diabetic, were each injected with sixty units of short-acting insulin about half an hour apart; the Butler Eagle, quoting the affidavit, gives the injections as midnight and 12:30 a.m. on November 20, 2022, and the Attorney General's release gives the deaths as December 4 and December 25. A seventy-three-year-old man, a diabetic who was not insulin-dependent, was dosed on August 31, 2022 and survived after emergency hospitalisation. Pressdee told investigators that two of the men were immobile and one was in hospice care, that she felt bad for their quality of life, and that she hoped they would slip into a coma and pass away. In all, four patients died at Chicora and four more survived hypoglycaemic episodes.
At Premier Armstrong in Kittanning, two patients died. No further detail has been made public.
At Sunnyview in Butler, the last facility, co-workers reported that she spoke of a hundred-and-four-year-old woman as disgusting and used a slur for Nicholas Cymbol, a forty-three-year-old man with an anoxic brain injury, blindness and neuropathy, whom his family's lawsuit says she berated, isolated and deprived of food and water. Both died of insulin overdoses; Cymbol died on May 1, 2023, three weeks before her arrest. Marguerite Laskovich, eighty, also died there of an insulin overdose. Irene Simons was among those whose death was described at sentencing as a lethal overdose she acknowledged inducing.
The case reached the Attorney General's office through the Chicora deaths. On May 24, 2023 investigators interviewed Pressdee at her home in Natrona Heights. She first said two of the patients had died of natural blood-sugar crashes and denied knowledge of the third; when told they were believed to have been injected with insulin, she admitted it. She was arrested that day and charged with two counts of criminal homicide, one of attempted homicide, three of neglect of a care-dependent person, one of aggravated assault and three of reckless endangerment. She was held without bail at Butler County Prison.
A search warrant for her telephone recovered text messages to her mother between April 2022 and May 2023 in which she complained about patients and colleagues and discussed harming them. Of one resident she wrote that she was going to get pillow therapy. The Attorney General opened a tipline, and over the following months families of other former patients came forward.
On November 2, 2023 the office filed a second set of charges covering nineteen more patients at the five facilities: two further counts of first-degree murder, seventeen of attempted murder and nineteen of neglect. The release said she had admitted trying to kill all nineteen. She waived her preliminary hearing. Her lawyers said she was cooperating.
At a hearing in February 2024 she argued with her own lawyers and said she wanted to plead guilty. On May 2, 2024, at Butler County Court, she pleaded guilty to three counts of first-degree murder and nineteen counts of criminal attempt to commit murder. Asked by one of her lawyers why she was pleading, she said: because I am guilty. The plea took the death penalty off the table.
She was sentenced the same day to three consecutive life terms without parole, followed by a consecutive 380 to 760 years for the attempted murders. Nearly forty relatives gave impact statements over two days. Elizabeth Simons Ozella, whose mother Irene Simons died, said she would never forgive her and that she had played God. Melinda Brown, Nicholas Cymbol's sister, called her pure evil. Pressdee said she was very sorry. Attorney General Michelle Henry said the plea would not bring back the lives lost but would ensure Pressdee never had another opportunity to do harm.
Fourteen of the seventeen deaths were never the subject of a murder conviction, because the cause of death could not be proved to the standard a murder charge needs. They are recorded here as deaths in her care, not as murders, and the attempted-murder pleas that cover some of them are the closest the record comes. Several wrongful-death suits against the facilities, brought by the law firm Robert Peirce and Associates among others, were still moving through the Pennsylvania courts after her sentencing; their object, the lawyer said, was to establish how she had been able to move from one facility to the next while staff were saying she was killing patients.
She has no established alias. The press called her the killer nurse, which is a description, not a name.