Sonya Caleffi was a nurse in the province of Como who worked in the autumn of 2004 on the internal medicine ward of the Alessandro Manzoni hospital in Lecco, in northern Italy. Between late September and early November of that year five elderly patients on the ward died whose deaths a court later attributed to her, and two other patients were the subject of attempted-murder counts. She was arrested in December 2004, told investigators why she had acted, and was sentenced after an abbreviated trial to 20 years. The sentence was upheld on appeal and by the Court of Cassation. She left prison on October 1, 2018.
The number of deaths linked to her was not settled by a verdict. Press reports in 2004 spoke of about ten suspicious deaths in Lecco; later accounts counted between 13 and 18 at the Manzoni hospital and, in some cases, further deaths at a hospital in Como where she had worked in 2003. Only five murders and two attempted murders ended in conviction. For seven other episodes the court either found that the act had not taken place or acquitted her for insufficient evidence. The remaining deaths stay in the category of suspected, not proved.
Caleffi came from the Como area and later lived in Tavernerio, a town in the province. The weekly magazine Panorama, in a profile of nurses convicted over patient deaths, reported that she suffered from depression and anorexia nervosa from the age of 15 while remaining a quiet student who drew no attention. In 1993 she married a carpenter from Cernobbio after about six months of courtship; the marriage ended after roughly a year, the magazine said, because of constant quarrels. She then lived with a radiologist in Tavernerio, a household the magazine described as secluded. Il Giorno, writing in 2011, likewise recorded the short first marriage and the later relationship with a radiologist from the Valduce hospital in Como, which also ended.
Her working life began in Como. According to Panorama she worked from 1993 to 2002 at the Valduce hospital, in general surgery, endoscopy and the emergency room, and at two care homes in Lombardy. The magazine also reported that she attempted suicide four times between 2001 and 2004. L'Unita, reporting in December 2004, said she had resigned from Valduce and then won a competitive examination for a post at the Lecco hospital. In between, Panorama said, she worked from September to November 2003 in general medicine at the Sant'Anna hospital in Como.
Her lawyer, Claudio Rea, told the press in 2004 that she had anorexia, was seeing a psychiatrist and had wanted attention and to feel useful and important at work. These are the defense's account of her state of mind at the time, relayed by the newspaper, and not a finding.
According to Panorama she worked at the Manzoni hospital in Lecco from September until November 8, 2004. The Unita report of December 17, 2004 located her on the second floor, in the internal medicine ward, which cared for elderly and chronically ill patients. The newspaper said the ward's deaths rose sharply after she began there: from about two or three a month to six in October.
The five deaths for which she was convicted, as listed by Prima Lecco in 2018, were these:
Biagio La Rosa, of Lecco, on September 27, 2004.
Teresa Lietti, of Oggiono, on September 30, 2004.
Elisa Colomba Riva, of Barzano, on October 2, 2004.
Ferdinando Negri, of Lecco, on October 5, 2004.
A woman named Maria Cristina, of Dervio, on November 8, 2004.
Of the five, only Maria Cristina's age was reported: she was 99, a patient from Dervio who died on November 8.
The two attempted-murder counts concerned patients who survived the episodes. The episode involving one of them, an elderly man, took place on October 30, 2004. Prima Lecco reported that he was in a coma for five days, spent twenty days in intensive care and stayed in the hospital for four months; by 2018 he had used a wheelchair for 14 years and depended on his wife for daily care. The second patient named in the attempted-murder counts died before the trial, the same outlet said, and his death was not among those attributed to her.
The five deaths occurred on five separate days, from late September to early November.
By late autumn the hospital had noticed what the figures showed. Prima Lecco said the hospital saw a sudden rise in deaths on the ward and that some relatives pointed to her. Panorama said the hospital's medical director identified her and informed the prosecutor's office. L'Unita reported what investigators had found: a computer analysis of staff shifts showed that she was often on duty when patients died.
She had been moved to an outpatient unit after returning from leave, L'Unita reported, and was then placed in isolation at the prison in Como, where she was watched around the clock. The investigating work was led by the prosecutor Luca Masini of the Lecco prosecutor's office. The investigating judge, Davide De Giorgio, was due on December 17, 2004 to rule on a request for her admission to a psychiatric facility, to which the prosecutor did not object.
The date of her arrest is given differently. A press review carried by Responsabilita Sanitaria says she was arrested on December 14, 2004; Panorama and LeccoToday say December 15, 2004. Reports agree on December 2004.
L'Unita reported that she had confessed to five deaths in one version of events and that, in a letter, she attributed six to herself. She had also listed the patients by name in a notebook. The newspaper quoted investigators and lawyers as saying that she apparently had not intended to kill outright: she had wanted to be the first to arrive in a crisis, and the patients had died instead. Panorama reported that she apologized and asked forgiveness, and that she said she had acted because she liked it when everyone rushed to save the patients. Prima Lecco reported her explanation as a wish to be noticed and valued by colleagues and superiors. Il Giorno's 2011 report said the court-appointed experts described her personality as borderline, and that her lawyer, Claudio Rea, said she had acted to create an emergency in which she could show she could step in.
Panorama counted the confessions as six homicides, of which investigators confirmed four, leaving two in the category of suspected. LeccoToday gave a different tally: thirteen deaths considered suspicious, four confessed and five established as her direct responsibility. In March 2005, LeccoToday reported, she retracted her confessions and said she did not remember what had happened. In later years, according to Il Giorno in 2011, she acknowledged responsibility. The court did not treat every admission as a proved death, and the sentence rests on the five murders and two attempts.
The size of the inquiry grew in the months after the arrest, and reports of it do not agree.
L'Unita, December 17, 2004: the Lecco prosecutor's office was investigating about ten suspicious deaths.
LeccoToday (2018): thirteen deaths considered suspicious.
Il Giorno and LaPresse (2016): between 15 and 18 deaths were attributed to her in the inquiry, of which five were established.
Panorama: 18 deaths at the Manzoni hospital between September and November 8, 2004, and eight terminally ill patients at the Sant'Anna hospital in Como between September and November 2003.
Blitzquotidiano and the Responsabilita Sanitaria press review (2018): she was initially suspected of, or charged with, 28 deaths, 18 in Lecco and 10 in Como.
Il Giorno (2011): the prosecution argued for at least fifteen murders.
The Como deaths were never part of the convictions. They remain suspected or investigated deaths, and no court has ruled on them.
Caleffi chose the abbreviated trial (rito abbreviato), the Italian fast-track procedure. Il Giorno's 2011 report puts the first-instance verdict on December 14, 2007. Prosecutors had asked for life imprisonment, Blitzquotidiano reported in 2018, and she received 20 years instead. LeccoToday, which gave the year of the sentence as 2007, said the life term was requested in the appeal hearing as well; LaPresse tied the lower sentence to the abbreviated procedure.
The court returned a partly favorable verdict on the other charged episodes, according to Prima Lecco. For five patients it found that the act had not occurred. For two it acquitted her for insufficient evidence. Neither group is a finding that she killed.
Affaritaliani reported that the trial judges recognized personality disorders but found her fully lucid and aware when she acted. Her confession, according to the Responsabilita Sanitaria press review, was key to the reduction of her sentence.
The Court of Assizes of Appeal of Milan (Corte d'assise d'appello di Milano) upheld the first-instance sentence of 20 years on March 3, 2008, according to Il Giorno in 2016 and LaPresse. The case went to the Court of Cassation, which, per a 2010 report of Ristretti Orizzonti, confirmed the 20-year sentence in October 2008. Blitzquotidiano in 2009 and Il Giorno in 2011 also describe the sentence as confirmed by the Court of Cassation, and Affaritaliani describes her as sentenced "in via definitiva."
After her arrest she was held at the Bassone prison in Como. She was later held at the judicial psychiatric hospital in Castiglione delle Stiviere, then in the Milan prisons of San Vittore and Bollate, Blitzquotidiano reported in 2018. Il Giorno recorded in 2011 that she had been moved from San Vittore to Bollate at the start of that year. At the time she was in her seventh year in prison. She worked in the prison call center and ironing service, attended Mass on Sundays, helped the chaplain, and her treatment consisted of stabilizing medication and psychological support. Her lawyers, Claudio Rea and Rosanna Pontieri, said she might be granted a Christmas leave to spend time with her family in Tavernerio.
In May 2010, Il Giorno reported, she married another San Vittore inmate who had been jailed on drug charges. The Ristretti Orizzonti report said her parents did not attend and that the couple could meet for four hours a month. The Responsabilita Sanitaria review said the marriage ended within months.
A 2009 Blitzquotidiano report said she would soon be eligible for her first leave permits, probably for a few hours or half a day with her parents, after half of her sentence had been served. The article gave her conduct in prison as irreproachable and said some of the victims' relatives were very perplexed by the prospect. It counted about nine years and three months already credited: five years of actual detention, three years under the 2006 pardon and one year and three months of early-release credit. Ristretti Orizzonti, in a later report, said she had passed the half-way point but had not yet applied for any leave.
Her former lawyer later wrote a novel based on the case, Difesa d'ufficio, published by Dalai. Rea said that the events from the killings to the trial were accurate, that names and some details had been changed, and that Caleffi knew about the book and consented to it.
In July 2018 Blitzquotidiano reported, citing Il Giorno, that she could leave prison as early as September of that year, after about 14 years. Rea said that her sentence, which had been due to run until the end of 2024, was reduced by the three years of pardon and by one year for every four years of good conduct. She had already left prison several times on permits, the outlet said, and a period of supervised release to social services had begun in March.
She was released on October 1, 2018. The release became public only on October 23, LeccoToday said, and by then she was living in Milan under the supervision of social services. LeccoToday gave her age as 48.
The Responsabilita Sanitaria review quoted Rea as saying her motives remained unknown but might relate to a personality disorder that had since been treated, and that prison and therapy had helped her reach remorse. Her father asked the public to let the matter be forgotten, saying his daughter had repented, been treated and recovered.
Relatives of the victims reacted differently. The granddaughter of the 99-year-old woman from Dervio called the release outrageous. The brother-in-law of one of the five patients who died, a lawyer, said the release followed the law and that he felt no anger, adding that the patient's widow had never recovered and had died shortly afterward. The wife of the patient who survived the attempt on October 30, 2004 told Prima Lecco that she could not forgive Caleffi for trying to kill her husband; family anger had returned in July, when the release was still a possibility.
Prima Lecco reported on October 24, 2018 that she had been released and was living in Milan. Nothing further about her has been made public.
Final and proved: the murder of five patients and the attempted murder of two, at the Manzoni hospital in Lecco, autumn 2004, by a judgment confirmed on appeal and by the Court of Cassation.
Not proved: seven further episodes in which she was charged. For five the court found the act did not occur; for two it acquitted her for insufficient evidence.
Suspected or investigated and not the subject of conviction: the remaining deaths on the Lecco ward and the deaths at the Sant'Anna hospital in Como in 2003. Reports give totals from about 10 to 28.
Where reports differ: the date of arrest (December 14 or 15, 2004); the number of confessions (five, six or four); when the life sentence was requested; whether she was in custody continuously at Bassone before transfers; and the number of deaths considered suspicious.
Motive: the explanations in the record are her own statements and the defense's account, and the experts' description of a borderline personality. One 2018 commentator offered a theory of a delusion of omnipotence over life and death, which was presented as an opinion and is not a finding.
1993: marries a carpenter from Cernobbio; the marriage lasts about a year.
1993 to 2002: works at the Valduce hospital in Como and at two care homes.
September to November 2003: works in general medicine at the Sant'Anna hospital in Como; deaths there later investigated.
September 2004: begins work on the medicine ward of the Manzoni hospital in Lecco.
September 27, 2004: death of the first patient later attributed to her in the judgment.
September 30, October 2 and October 5, 2004: three further deaths in the judgment.
October 30, 2004: the patient who survived is taken ill.
November 8, 2004: death of the fifth patient, aged 99.
December 14 or 15, 2004: arrested.
December 17, 2004: press reports a request for psychiatric hospitalization before the investigating judge.
March 2005: retracts her confessions.
2006: pardon law later credited against her sentence.
December 14, 2007: first-instance verdict, 20 years after an abbreviated trial.
March 3, 2008: Court of Assizes of Appeal in Milan upholds the sentence.
October 2008: Court of Cassation confirms the sentence.
May 2010: marries a fellow inmate.
Start of 2011: transferred from San Vittore to Bollate.
March 2018: begins supervised release to social services.
October 1, 2018: released; public on October 23.
October 24, 2018: Prima Lecco reports the release.