The deaths looked like the kind that happen every night in a nursing home. An elderly patient became unresponsive in the small hours and was pronounced dead before morning. What connected seventeen of them across five facilities in four Pennsylvania counties was the nurse on the medication cart. Heather Irene Pressdee, a registered nurse from the Natrona Heights section of Harrison Township, north-east of Pittsburgh, gave patients insulin they had not been prescribed, and took steps, prosecutors said, to make sure they died before anyone thought to test them.
Insulin lowers blood sugar. In a patient who is not diabetic, or who is diabetic but does not depend on insulin, a large dose brings on hypoglycemia, unresponsiveness, coma and death, and in someone old and frail the collapse can pass for a natural one. The Attorney General's criminal complaint described how Pressdee used that. She worked nights, when staffing was thinnest, and injected patients from the cart. A patient sent to a hospital would be tested, and a C-peptide test can tell insulin the body makes from insulin injected into it. If a patient looked likely to pull through, the complaint alleged, she gave a second dose or injected air.
Her employment record became the spine of the case. Investigators said she had worked at eleven facilities since 2018; lawyers for victims' families said she had been fired or forced out of six in under three years before Belair Healthcare and Rehabilitation in Lower Burrell, Westmoreland County, hired her, and that at Belair she rose to assistant director of nursing. Co-workers at several of her jobs questioned her conduct and reported that she spoke of patients with contempt. The five facilities named in the charges were Concordia at Rebecca Residence in West Deer, Allegheny County; Belair; Premier Armstrong Rehabilitation and Nursing Center in Kittanning, Armstrong County; Quality Life Services in Chicora, Butler County, where, according to the Attorney General's office, she supervised the nursing staff and was responsible for investigating reports of abuse; and Sunnyview Rehabilitation and Nursing Center in Butler.
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 counts only where there was physical evidence of the cause of death, and attempted-murder counts where a patient survived or where the cause of death could not be established. That distinction, drawn by the state, is why the convictions number three and the deaths seventeen.
At Belair, four patients died. Marianne Bower, sixty-eight and not diabetic, died in September 2021; her family were told it was 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. Afterward Pressdee sent his family a memorial tile bearing his name. Norman Paul Hendrickson, eighty-eight, a former steelworker admitted after a short hospital stay for COVID-19, also died there. A fifty-eight-year-old woman who did not depend on insulin was found unresponsive on August 9, 2021, treated in a hospital for low blood sugar, returned to the facility with no sign of it, and was found dead the next day. A Belair doctor reported Pressdee to the state Department of Health. According to the families' lawsuits, staff who raised concerns were disciplined while she stayed on.
At Concordia, where she worked from April 2021 to February 2022, the complaint describes an eighty-six-year-old woman, not diabetic, who was given 120 units of insulin in December 2021, roughly three times what a type 1 diabetic uses in a day, and whom Pressdee herself pronounced dead before her shift ended. The facility's regional director told investigators that staff had raised concerns that she was killing residents after a ninety-two-year-old woman died that month. At Premier Armstrong, two patients died; nothing further about them has been made public.
Chicora was where the case began. She worked at Quality Life Services from May 23 to November 28, 2022. A seventy-three-year-old man, a diabetic who did not use insulin, was found seizing in his bed on August 31, 2022 and survived after emergency hospitalization. A fifty-five-year-old man and an eighty-three-year-old man, neither of them diabetic, were each given sixty units of short-acting insulin half an hour apart; the Butler Eagle, quoting the affidavit, puts the injections at midnight and 12:30 a.m. on November 20, 2022, while the Attorney General's release gives the deaths as December 4 and December 25. In all, four patients died at Chicora and four more survived hypoglycemic episodes. It was a relative of one of the dead who went to the state Bureau of Narcotics Investigation and Drug Control and said Pressdee had been giving insulin improperly.
Sunnyview in Butler was the last. Co-workers there reported that she called a hundred-and-four-year-old woman disgusting and used a slur for Nicholas Cymbol, a forty-three-year-old man living with an anoxic brain injury, blindness and neuropathy; his family's lawsuit says she berated and isolated him and kept food and water from him. Cymbol died of an insulin overdose on May 1, 2023, three weeks before her arrest, and his was one of the deaths she pleaded guilty to as murder. Irene Simons, seventy-eight and not diabetic, was also in her care at Sunnyview and died of a fatal dose of insulin. Marguerite Laskovich, eighty, died there the same way.
On May 24, 2023 investigators came to Pressdee's home in Natrona Heights to ask about the Chicora patients. She first said two had died of natural drops in blood sugar and denied knowing anything about the third. Told that investigators believed all three had been injected, she admitted it, and said 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. She was arrested that day on 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, and held without bail at Butler County Prison.
A warrant for her phone turned up text messages to her mother, sent between April 2022 and May 2023, in which she complained about patients and colleagues and talked about harming them. Of one resident she wrote that the woman was going to get pillow therapy. The Attorney General opened a tip line, and over the following months families of other former patients called it.
On November 2, 2023 the office filed a second complaint 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, Phil DiLucente and Jim DePasquale, said from the start that their goal was to keep her off death row.
At a hearing in February 2024 she argued with her own lawyers and said she wanted to plead guilty. On May 2, 2024, before Judge Joseph Kubit in Butler County Court, she pleaded guilty to three counts of first-degree murder and nineteen counts of criminal attempt to commit murder. Asked why, she said it was because she was guilty. The plea removed the possibility of a death sentence.
She was sentenced the same day to three consecutive life terms without parole and a further consecutive 380 to 760 years for the attempts. Nearly forty relatives gave statements over two days in a packed courtroom. Elizabeth Simons Ozella said she would never forgive the woman who killed her mother and that Pressdee had played God. Melinda Brown, Nicholas Cymbol's sister, called her pure evil and said there could be no justice for it in this life. Pressdee told the families she was very sorry, and would not discuss what she had pleaded to when a television reporter asked. Attorney General Michelle Henry said the sentence would not bring back the lives lost but would ensure she never had another chance to do harm.
Fourteen of the seventeen deaths never became murder convictions, because the cause of death could not be proved to the standard a murder count requires, and the attempted-murder pleas that cover some of them are as close as the criminal record comes. The wrongful-death suits against the facilities, several of them brought by the Pittsburgh firm Robert Peirce and Associates, went on after the sentencing. Their purpose, the families' lawyer said, was to establish how a nurse whose colleagues were saying she was killing patients had been able to move from one building to the next.