Heather Pressdee was a registered nurse in western Pennsylvania. Between 2020 and 2023, prosecutors said, she gave insulin to patients who did not need it, at five nursing and rehabilitation facilities in four counties around Pittsburgh. She usually did it on overnight shifts, when staffing was low. Some of the patients were diabetic and some were not. They ranged in age from 43 to 104.
She was arrested in May 2023 over three patients at a nursing home in Chicora, Butler County. Six months later the Pennsylvania Attorney General's office charged her over 19 more. On May 2, 2024, in Butler County Court of Common Pleas, she pleaded guilty to three counts of first-degree murder and 19 counts of attempted murder, covering 22 patients in all. Prosecutors said 17 of those patients died. Judge Joseph Kubit sentenced her the same day to three consecutive life terms without parole, plus 380 to 760 years. Asked in court why she was pleading guilty, she said, "Because I am guilty."
The legal record and the death count are not the same thing, and the difference matters to the families. Prosecutors charged murder only where physical evidence supported the cause of death. Where a patient survived, or where the cause of death could not be determined, they charged attempted murder.
Little is known about Pressdee's life before nursing. She lived in Natrona Heights, part of Harrison Township in northern Allegheny County, and was 40 when she was arrested. At her plea hearing her lawyer, Phil DiLucente, told the court that she had once worked for a veterinarian, sometimes putting animals to sleep, and that she believed she was helping people.
She entered nursing home work in 2018. Her first job, according to McKnight's Long-Term Care News, a trade publication for the industry, was at Encompass Health Rehabilitation in Harmarville, from October 2018 to April 2019; the facility disciplined her for improper use of insulin before she left. From then on she moved quickly. Investigators said she had worked at 11 facilities since 2018. Records showed that she had been disciplined for abusive behavior toward staff or patients, and that this had led her to resign or be fired, CBS News reported from the charging papers. The Associated Press, summarizing prosecutors, said she was disciplined at each job.
Lawyers for victims' families later gave their own account. Before Belair Healthcare and Rehabilitation in Lower Burrell hired her in April 2021, they said, she had been fired or forced to resign from six other health care facilities in less than three years, staying a couple of months at each. A later lawsuit against the Sunnyview home in Butler put the number before that job at ten facilities across western Pennsylvania between October 2018 and December 2022. Robert Peirce, whose firm represented several families, asked how anyone could work at 11 facilities in five years without someone checking the record.
Co-workers often questioned her conduct, according to court documents described by the Associated Press, and said she showed disdain for patients and made derogatory comments about them. According to McKnight's, staff at one facility began calling her "killer nurse" because of how residents were treated.
The Attorney General's office listed five facilities where the crimes occurred: Concordia at Rebecca Residence; Belair Healthcare and Rehabilitation (Guardian); Quality Life Services Chicora; Premier Armstrong Rehabilitation and Nursing Center; and Sunnyview Rehabilitation and Nursing Center. TribLive, reporting on the plea, placed the five homes in Allegheny, Armstrong, Butler and Westmoreland counties, and dated the crimes covered by the plea from December 2020 to May 1, 2023. For many of the 22, no name or detail has been published.
Ruth Erikson was 89. She died on December 17, 2020, at Concordia at Rebecca Residence, after having COVID-19, TribLive reported. Her son spoke at the sentencing and said he could not forgive Pressdee.
Belair Healthcare and Rehabilitation Center in Lower Burrell, Westmoreland County, is a skilled nursing facility run by Guardian Healthcare. It hired Pressdee in April 2021 as assistant director of nursing, according to the families' lawsuits.
Marianne Bower, of Freeport, was a mother and grandmother. WPXI-TV, reporting her family's lawsuit in October 2023, gave her age as 67. She had died about two years earlier at Belair, and her family had been told the cause was respiratory failure. About two weeks before the suit was filed, the family's lawyer said, the Attorney General's office told them that Pressdee had confessed to giving her a fatal dose of insulin that was not medically necessary. "What they thought was true turned out to be incorrect," the lawyer said. The suit also alleged that Pressdee texted Bower's son to tell him to come to the hospital because his mother was not doing well.
Jack Allen Rogers was 79, an Army veteran in long-term care at Belair. He had served in Vietnam, survived being shot down in a helicopter, and received the Purple Heart. His family said he was not diabetic and had not been prescribed insulin. Their lawsuit says Pressdee gave him insulin during an overnight shift on November 14, 2021, and that he died the next day. At the sentencing his brother-in-law told the court that the only justice the family wanted was for no one else to suffer as they had.
Norman Paul Hendrickson was 88, a former steelworker. He came to Belair after a short stay in a hospital with COVID-19. According to his family's lawsuit, he was not diabetic and was not prescribed insulin, but Pressdee gave him insulin during an overnight shift in February 2022. He went into acute respiratory failure, never recovered, and needed skilled nursing care until he died in December 2022. The families' lawyers said Pressdee confessed to giving both Rogers and Hendrickson excessive doses.
The lawsuits against Guardian Healthcare and Belair accuse the company of failing to check Pressdee's background properly. They allege that when other Belair nurses raised concerns about her, the administration disciplined those nurses and kept her on as assistant director of nursing. "There were complaints by staff and nurses that were concerned Heather Pressdee was actually killing patients," Peirce told KDKA-TV in November 2023. He said five patients died at Belair, that staff complained patients were dying at an alarming rate, and that the company let her keep working after a brief suspension. He also said Pressdee admitted, during a state Department of Health investigation before Bower's death, to skipping certain protocols. Guardian Healthcare said it was "devastated and disheartened" that someone entrusted with its patients' care could do such a thing, that privacy law and the pending lawsuit limited what it could say, and that Belair had hiring policies meant to vet candidates.
A warning did reach the state in this period. In February 2022, a hospital doctor alerted state officials after treating two patients for low blood sugar who had Pressdee listed as their nurse, WPXI reported in June 2024. The state Department of Health and Department of State did not make a joint referral to the Attorney General's office until December 2022. At least six residents died in that interval, WPXI reported, and at least six more before her arrest.
Pressdee was hired at Quality Life Services, a skilled nursing facility in Chicora, Butler County, on May 23, 2022, and worked there until November 2022. The company is family owned and has ten locations in Pennsylvania.
James Fair died there on August 6, 2022, hours after Pressdee clocked in, according to TribLive's account of the sentencing. His daughter told the court she forgave Pressdee, who would not look at her. His granddaughter remembered bringing him HoHos.
On August 31, 2022, a 73-year-old man was found having a seizure in his bed. He was stabilized and moved to another facility, and he survived. When investigators later questioned her, Pressdee said that he had been in COVID isolation, was having a very hard time, and had asked her to kill him, Fox News reported from the affidavit. That account is hers.
James Bartoe, known as Matt, was 55. He had beaten brain cancer after a fight of about ten years that began when he was 27. His brother told the court about his love of Chevrolets, Dale Earnhardt, art and his cats. His mother told Pressdee that she had visited him twice a day. According to the affidavit as reported by Fox News, he and an 83-year-old man who shared his suite became ill on November 19, 2022, and were taken to the hospital the next day with low blood sugar, about ten minutes apart. Bartoe was not diabetic. He returned to the facility and died on December 4, 2022. The 83-year-old man, who had diabetes but did not depend on insulin, also went back to the facility, and he died on December 25, 2022. A nurse practitioner told investigators that Pressdee had said the older man would be "better off dead."
These three men, two who died and one who survived, were the subjects of the first charges. Two of the three were not diabetic, the Attorney General's office said.
The Attorney General's office received a referral in late 2022 about a patient in Pressdee's care, the office said when she was sentenced. Its Medicaid Fraud Control Section and Bureau of Narcotics Investigation took up the case. Her nursing license was suspended in early 2023, the Associated Press reported.
Her last job was at Sunnyview Nursing and Rehabilitation Center in Butler, where she was a unit manager. A lawyer for one family said she was there about five months.
Gerald Shrum Sr. was 90, a Korean War veteran who earned his pilot's license later in life. He died at Sunnyview on March 25, 2023. One of his daughters told the court that the family lived with questions and guilt. Another daughter said she had "looked into the face of Satan" the morning her father died, and called Pressdee "evil personified." Pressdee admitted to investigators that she gave him insulin, according to TribLive.
Irene Simons was 78 and lived at Sunnyview. She was not diabetic, KDKA-TV reported. After she died, Pressdee sent flowers and a handwritten note to the funeral home and a sympathy card to the family, according to the family's lawsuit. "Words can't say how sorry I am for the loss of Irene," the card read in part. Months later, the suit says, Pressdee admitted to injecting her with insulin. Her daughter told the court that her mother would probably have forgiven Pressdee.
Sandra Lincoln was 82. Her family's lawsuit says a nursing assistant heard Pressdee say that Lincoln "needed to die" about 50 minutes before she was pronounced dead, and that about 40 minutes later Pressdee told Lincoln's daughter that her mother was "actively dying." According to the Attorney General's office, as WPXI reported, Pressdee confessed to giving Lincoln insulin. WPXI reported in April 2024 that Pressdee faced criminal charges over the deaths of both Simons and Lincoln.
Louise Skinner had just turned 90 and was in Pressdee's care for about two weeks, her granddaughter told the court. While Skinner was dying, the granddaughter said, Pressdee offered the family chairs and tissues, which she called "another level of cruel."
Nicholas Cymbol was 43. He had been diagnosed with diabetes at 10. In 2016 he took two doses of insulin by mistake, which left him with brain damage and close to a persistent vegetative state, but he recovered and lived seven more years. His family planned to adopt a Great Dane for him. According to his family's lawsuit, other nurses said Pressdee was especially abusive toward him: she insulted, berated and bullied him, called him gross, and said he would be the next to die. He died on May 1, 2023. Pressdee told investigators she deliberately gave him an overdose of insulin, TribLive reported. The lawyer for his family called him "the last victim."
The Sunnyview lawsuits say the facility hired her as a unit manager despite her history, failed to investigate a string of suspicious deaths, failed to act on reports of abuse and failed to report unusual deaths to the Department of Health. One suit says six residents died there because of her during her five months.
On May 24, 2023, investigators interviewed Pressdee at her home in Natrona Heights about the Chicora patients. According to the affidavit, she admitted giving them insulin. She said she felt their quality of life was not good, and that "she had hoped that they would just slip into a coma and pass away." While the investigators were there she spoke by phone with her mother and said she had given patients insulin they did not need, Fox News reported.
She was arrested that day and charged with two counts of homicide, one of attempted murder, one of aggravated assault, three of neglect of a care-dependent person and three of reckless endangerment. She was arraigned that night and held without bail in Butler County Prison. Attorney General Michelle Henry called it "the callous abuse of incredibly vulnerable patients by a professional nurse." Instead of caring for them, Henry said, she "intentionally and maliciously injected them with insulin to kill them." Quality Life Services said it was "shocked and devastated" and that residents at Chicora were safe.
The office set up a tip line and asked anyone with concerns about a relative's care involving Pressdee to call. Many families learned of her role only when investigators contacted them. Several told the court a year later that they had grieved twice, once when their relative died and again when the Attorney General's office told them what had happened.
On November 2, 2023, the Attorney General's office announced new charges covering 19 more patients at the five facilities: two counts of first-degree murder, 17 of attempted murder and 19 of neglect of a care-dependent person. With the first three, that made 22 patients. Seventeen of them had died, the office said. Judge Maura Palumbi of the Butler County Court of Common Pleas arraigned her, and she waived her preliminary hearing. "The damage done to the victims and their loved ones cannot be overstated," Henry said.
According to McKnight's, a 32-page affidavit said she admitted harming, with intent to kill, all the patients named in it. Court documents also described text messages she sent her mother between April 2022 and May 2023, the Associated Press reported, in which she complained about patients and colleagues and talked about harming them. McKnight's quoted her as writing that she was "gonna murder my aides," and that "I may kill this resident" to "set some sort of boundary with him."
The first wrongful death suit, for Marianne Bower's family, was filed against Belair in October 2023. Two more against Belair, for the families of Jack Allen Rogers and Norman Paul Hendrickson, followed on March 5, 2024. Cymbol's family sued Sunnyview in late March 2024, and the families of Irene Simons and Sandra Lincoln filed separate suits against Sunnyview in April 2024. A relative of one of the Chicora patients also sued Quality Life Services, WPXI reported. Peirce said the families hired his firm to find out how Pressdee had been allowed to keep working, and to prevent it from happening again. These are civil claims, and no outcome has been reported.
At a hearing in February 2024 Pressdee argued with her lawyers and said she wanted to plead guilty, the Associated Press reported. Her lawyers were James DePasquale and Phil DiLucente. DiLucente said she had wanted to plead guilty from the start.
On May 2, 2024, in a packed courtroom in Butler, she pleaded guilty before Judge Kubit to three counts of first-degree murder and 19 counts of criminal attempt to commit murder. She told the judge she had not been coerced and understood her trial rights. The plea agreement spared her a possible death sentence. DePasquale said there was "no doubt" she would have been sentenced to death, and that a proffer session with prosecutors had led her to disclose more victims.
Senior Deputy Attorney General Jeffrey Baxter set out the facts for 17 minutes. "In all instances, this was done with the intent to kill," he told the court. Executive Deputy Attorney General Michele Kelly Walsh said the evidence of Pressdee's depravity was outshone by the love of the families. The prosecution team also included Senior Deputy Attorney General Edward "Kee" Song and Deputy Attorney General Peter Caravello, of the Medicaid Fraud Control Section.
Judge Kubit imposed three consecutive life sentences without parole for the murders and a consecutive 380 to 760 years for the attempted murders. "The defendant used her position of trust as a means to poison patients who depended on her for care," Henry said. The plea and sentence would not bring back the lives lost, she said, but would make sure Pressdee had no further chance to harm anyone. After the hearing DePasquale asked to withdraw from the case.
Relatives of the victims spoke over the course of the hearing, which was expected to run into a second day. Several told Pressdee she had tried to play God, and that none of the victims had been ready to die. One speaker shouted an expletive at her and the gallery applauded; she did not react. She did not look at the families while they spoke, TribLive reported, but she cried in the afternoon when a victim's daughter said Jesus would forgive her. Her parents sat behind the defense table and said nothing.
Nicholas Cymbol's sister called Pressdee "pure evil." "There's no justice for this," she said. "We'll get justice when she meets her maker."
Relatives of surviving patients also spoke. A woman who survived had a stroke afterward and can no longer feed herself or speak; her niece said she was still with them but was not the person she had been. The son of a surviving man, a veteran, said his father had not come home since he was poisoned. "I hope prison, the judicial system and God have zero mercy on you," he told her.
Pressdee apologized. She said she had affected many lives, including her parents'. Outside the courtroom, when KDKA-TV asked her about the plea, she would not discuss it.
Pressdee has been in custody since her arrest in May 2023. Under the sentence she will spend the rest of her life in prison with no possibility of parole, the Attorney General's office said. As of June 2024 she was serving her life sentences, WPXI reported. No appeal has been reported.
In June 2024 state lawmakers began looking at ways to protect nursing home residents. State Representative Rob Mercuri, a Democrat from Allegheny County, backed Senate Bill 885, sponsored by Senator Doug Mastriano, which would create a statewide registry of people found to have abused older adults. WPXI noted that the bill probably would not have stopped Pressdee, because the allegations against her were not fully investigated for years. Mercuri said he was "very concerned" by the delay between the hospital doctor's warning and the state's referral, and that lawmakers were looking into it. The office of Senator Lindsey Williams asked to meet both state departments to find legislative fixes. Zach Shamberg, president of the Pennsylvania Health Care Association, said the state had no "real red flag system." He suggested following New Jersey's Cullen Law, passed after the nurse Charles Cullen confessed in 2003, which requires providers to report employee misconduct to a state clearinghouse. Mercuri said that model was being studied but that real change could take a year or more.
Several points in this case rest on different footing, and the accounts do not always agree.
The number of deaths. The Attorney General's office said 17 of the 22 patients died. WPXI, in June 2024, gave 18 deaths and four survivors with disabilities. The figure of 17 comes from the prosecutors.
Which deaths are murder convictions. She pleaded guilty to three counts of first-degree murder. The May 2023 charges included two homicide counts for the Chicora men, and the November 2023 charges added two first-degree murder counts; KDKA described her in March 2024 as facing four homicide counts. Which three deaths the final murder pleas cover has never been made public. The other deaths linked to her appear in the record as attempted murders or not at all.
The lawsuits. The accounts of what Belair and Sunnyview knew and did are allegations in civil suits, made by the families' lawyers. No outcome of those suits has been reported.
The texts and remarks. The words attributed to her by co-workers and in her text messages come from charging papers and lawsuits as reported by news outlets and a trade publication.
October 2018 to April 2019: Works at her first nursing home job, at Encompass Health Rehabilitation in Harmarville; disciplined for improper insulin use (McKnight's).
December 17, 2020: Ruth Erikson, 89, dies at Concordia at Rebecca Residence.
April 2021: Hired by Belair Healthcare and Rehabilitation, Lower Burrell, as assistant director of nursing.
November 14 to 15, 2021: Jack Allen Rogers, 79, is given insulin on an overnight shift and dies the next day, according to his family's lawsuit.
February 2022: Norman Paul Hendrickson, 88, is given insulin at Belair, according to his family's lawsuit; a hospital doctor alerts the state about two patients with low blood sugar who had Pressdee as their nurse.
May 23, 2022: Hired at Quality Life Services, Chicora.
August 6, 2022: James Fair dies at Chicora.
August 31, 2022: A 73-year-old man at Chicora is found having a seizure; he survives.
November 2022: Leaves Quality Life Services.
December 2022: The state health and licensing departments refer the case to the Attorney General's office; Norman Paul Hendrickson dies.
December 4, 2022: James "Matt" Bartoe, 55, dies.
December 25, 2022: An 83-year-old man from Chicora dies.
Early 2023: Her nursing license is suspended.
March 25, 2023: Gerald Shrum Sr., 90, dies at Sunnyview, Butler.
May 1, 2023: Nicholas Cymbol, 43, dies at Sunnyview.
May 24, 2023: Interviewed and arrested at her home in Natrona Heights; held without bail in Butler County Prison.
October 2023: Marianne Bower's family sues Belair.
November 2, 2023: Charged over 19 more patients; waives her preliminary hearing.
February 2024: Says at a hearing that she wants to plead guilty.
March and April 2024: Wrongful death suits filed against Belair and Sunnyview.
May 2, 2024: Pleads guilty to three counts of first-degree murder and 19 of attempted murder; sentenced to three consecutive life terms without parole plus 380 to 760 years.
June 2024: State lawmakers consider a registry and other changes.