In February 1996, nurses on a medical ward at the Veterans Affairs Medical Center in Northampton, Massachusetts, (three of them, by most accounts) went to the administration with a pattern they could no longer ignore. The number of emergencies on their ward had climbed sharply since 1995, most of them sudden cardiac arrests, and one nurse was almost always there. At the bedsides of patients who had died on her shifts they had found empty vials of epinephrine, a drug nobody had ordered. The nurse was Kristen Gilbert, twenty-eight, one of the most capable on the ward, whom colleagues had nicknamed the Angel of Death as a joke about how often she happened to be present when a patient coded.
She was born Kristen Heather Strickland in Fall River, Massachusetts on November 13, 1967, the elder of the two daughters of Richard Strickland, an electronics executive, and Claudia, a homemaker and part-time teacher. She did well at school and finished high school at Groton-Dunstable Regional at sixteen. Friends and family later described her as a habitual liar from her teens who faked suicide attempts to manipulate people, and court records later described violent threats going back to those years. At Bridgewater State College, which she entered in 1986, officials ordered her into psychiatric treatment after one staged attempt, and she moved to Mount Wachusett Community College in 1987 and then to Greenfield Community College, where she took her nursing diploma. She qualified as a registered nurse in 1988, married Glenn Gilbert the same year, and joined the staff at the Northampton VA on March 6, 1989; the magazine VA Practitioner featured her in April 1990. She had two sons, in 1990 and 1993.
The four men she would be convicted of killing were Stanley Jagodowski, sixty-six, an Army veteran, on August 21, 1995; Henry Hudon, thirty-five, Air Force, on December 8, 1995; Kenneth Cutting, forty-one, Army, on February 2, 1996; and Edward Skwira, sixty-nine, a veteran of the Second World War, on February 15, 1996. Two other patients survived attempts on their lives. Hudon's mother, Julia, and his sister, Christine Duquette, sat through the trial.
The method was epinephrine, adrenaline, injected into intravenous bags in doses far beyond anything ordered. In a compromised patient it drives the heart past what it can sustain and produces sudden cardiac arrest. It is also difficult to detect after death, which is part of why the case took years to build. She would then respond to the emergency call and often run the resuscitation herself.
The prosecutor, Assistant U.S. Attorney William M. Welch II, told the jury that she killed for the thrill of the emergencies and that she was having an affair with James Perrault, a hospital police officer who was summoned when a patient coded, and that a code brought him to her ward, since hospital rules required the police to attend every medical emergency. The hospital's chief of staff, the psychiatrist William Boutelle, thought she created the crises to show off her skill. Evidence was given that she played footsie with him while a patient lay in arrest.
The police were called in February 1996 and Gilbert left her post soon afterward. That fall she checked herself into psychiatric hospitals seven times, for stays of one to ten days. She was arrested on July 11, 1996, and the investigation, with exhumations and years of toxicology, went on around her. In the meantime she called in a bomb threat to the medical center, aimed at the coworkers and at Perrault, who by then had ended the affair and were helping investigators. She was tried for it in January 1998, convicted that April, and served fifteen months. Later in 1998 she was indicted for four murders and three attempted murders.
The murder trial opened in Springfield on October 16, 2000, before U.S. District Judge Michael A. Ponsor. Because the killings happened on federal property, she faced a federal capital charge in a state that had abolished the death penalty. On January 5, 2001, the prosecution's forensic case broke: the government conceded that the toxicology results said to show high epinephrine levels in the victims were wrong, and its expert was withdrawn. Ponsor called it an extremely disturbing development and told the jury the evidence was withdrawn. Two of the men had in any case been given epinephrine legitimately during the attempts to revive them. Prosecutors had told the jury that she was on duty for about half of the roughly 350 deaths at the hospital since she started in 1989, and put the odds of that being chance at one in a hundred million. They also alleged a history of violence: an assault with a kitchen knife in Greenfield in early 1988, pulling a patient's breathing tube on January 30, 1994, walking away from a patient in cardiac arrest on November 9, 1995, and an attempted poisoning of a patient on January 28, 1996. According to a later law review account, while working as a home health aide years before, she had scalded a mentally disabled child in bath water. What remained after the toxicology fell away was the pattern of deaths and missing drug, the testimony of colleagues, and two witnesses close to her: her estranged husband, and Perrault, who told the jury she had confessed to him by telephone during one of her hospital stays.
The jury convicted her on March 14, 2001, of three counts of first-degree murder, one of second-degree murder and two of attempted murder. It deliberated the penalty for about six hours across two days and on March 26 recommended life rather than death. She would otherwise have been the only woman on federal death row. Opinions among the families were divided; Kenneth Cutting's widow, Nancy, said she was content to see her sit in jail. On March 27 Ponsor sentenced her to four consecutive life terms without parole, plus twenty years, and in June 2001 he fined her $1.5 million. The families of Cutting and of at least one other patient went on to sue the government.
Her lawyer, David P. Hoose, argued throughout that the deaths were natural, that her presence at so many cardiac arrests showed competence rather than guilt, and that colleagues had turned on her over the affair. She did not testify. Staff at the hospital later speculated that she might have been involved in hundreds of deaths; nothing of that kind was ever proved. The four convictions rest on the pattern and on the confessions two men said she made to them, not on the toxicology the case had first been built on.
She divorced Glenn Gilbert in 1998; at the time of her arrest she was living in Setauket, New York. From the women's prison at Framingham she was moved to the Federal Medical Center at Carswell in Fort Worth, Texas, where she is still held. In July 2003 she dropped her federal appeal for a new trial after a Supreme Court ruling made clear that a retrial could expose her to the death penalty again.