The Good Nurse: A True Story of Medicine, Madness, and Murder (24 page)

N
ittoly met the detectives at his secretary’s desk: midfifties, broad-featured, graying in that distinguished way money guys do, the good dark suit with an Easter-egg tie. Danny clocked the clothes down to the wingtips as Nittoly led them back to an office outfitted with the usual leather-bound tomes and introduced them to his private investigator, a hulking guy named Rocco E. Fushetto. Then Nittoly settled in behind a desk while Rocco stood to the side, arms tight across his chest.

Nittoly’s notes, interviews, recordings, and contact master list for the CCU staff would represent a jump start on the investigation and keep the detectives from wasting their time covering old ground. The Somerset Medical investigation had spanned five months; Tim figured they’d have a heart-to-heart on the details of the five-month investigation, free of the medical mumbo jumbo. He figured he’d be lugging back file boxes of raw data.

But as Tim Braun would later remember it,
⁷
Nittoly seemed determined to keep the meeting brief. He said that he and his private investigator, Rocco, had investigated the occurrences but had not identified the person responsible. They hadn’t generated any final reports, Nittoly told them, and they had failed to reach any definite conclusions. As soon as they realized they had a police matter, they contacted the Prosecutor’s Office.

“How about your interviews with the nurses, then?” Tim said. “Anything at all would be helpful.”

“We didn’t generate any type of report,” Nittoly said.

“Do you have the tapes, or—”

Nittoly shook his head. “These were informal sessions,” he said. “We didn’t record anything.”

“Okay, just anything,” Tim said. “A legal pad, rough notes on the investigation, or—”

“We didn’t take any notes,” Nittoly said.

Tim blinked. “No notes.” He and Danny exchanged a look.

“We didn’t really write anything down,” Nittoly said.

“How about names and contact info?” Danny said. “For the staff. You know, so we don’t trample the same ground.”

Nittoly looked over at Rocco. “Sorry. We’ve already given you everything we have. You got the package?”

“Yeah,” Tim said. The four pages. They got it.

“About that memo,” Danny said. “There’s a nurse mentioned, a nurse Charles Cullen. You speak to him?”

“He was one of the nurses we interviewed on the unit,” Nittoly said.

“Anything special, or—”

“Nothing comes to mind,” Nittoly said. “But I remember he was kind of a strange guy.”

“An odd duck,” Rocco said.

“Okay, okay,” Tim said. “An odd duck.”

“Yes.”

“But you didn’t write anything down when you talked to this nurse?”

“No,” Nittoly said. “Sorry.”

T
im was trying to keep it cool but his mind kept screaming the same question:
What kind of a lawyer doesn’t write stuff down?
Tim thought about asking him. Then he thought about punching him. Then he thought about the parking lot.

Nittoly started to turn the questions around, asked if the detectives had any leads yet, anything off background, but Tim and Danny weren’t playing. Five minutes later, they were done. Tim waited until they were back on the highway before he let loose and smacked the steering wheel. “Okay,” he said. “Wanna tell me, what the fuck was that happy horseshit?”

“It’s bullshit, what it is,” Danny said.
Everything
ends up on paper in an investigation. Detectives knew that, lawyers—especially former prosecutors—knew that, too. There were printouts, records, memos, date books. You make lists, you make notes in interviews—at the very least, you’ve got names and phone numbers on a piece of paper, so you know who to talk to. A five-month investigation, six suspicious deaths, and a unit’s worth of nurses, and the guy came out without so much as a doodle on a legal pad?

“And these are lawyers,” Tim said. He was driving hard, flashing cars
out of the fast lane. “What else are they good for, except making paper? How did they even do the billing?”

“Maybe they just don’t wanna look stupid,” Danny said. “Show a couple detectives how bad they fucked this thing up.”

Tim could imagine it—Rocco, the private investigator, looking through those medical charts, probably making as little sense of it as they did. It was a nice picture, but it didn’t change the facts.

They’d given them nothing but a memo and a name: Charles Cullen. An “odd duck,” who wasn’t a suspect. A guy with red flags in his past. Danny sat, watching the highway, wondering why they’d given them that, if they didn’t have anything else.

35

D
anny took the morning, driving west to Pennsylvania to the Pennsylvania State Police barracks. He was briefed for several hours by Corporal Gerald Walsh and State Troopers Egan
¹
and Bruchak, soaking up all he could about their investigation into Charles Cullen and the incidents at Saint Luke’s Medical Center. He was back on 78 East in time to meet Tim and talk it out over late lunch. They chose the diner this time, taking a booth in back where Danny could lay it out. The investigation in Pennsylvania was barely a year old, and it had been a whopper. They had bodies, physical evidence, dozens of cooperative witnesses, and a strong suspect—everything a homicide detective could want in a case, except a happy ending.

According to the Pennsylvania State Police file, it wasn’t the Saint Luke’s administration that had called the cops, it was a Saint Luke’s nurse named Pat Medellin. She had seen some unusual deaths on her unit at Saint Luke’s, and she had also seen Charles Cullen marched out for diverting dangerous meds. Medellin felt certain that Cullen was responsible for the unusual deaths on the unit, and pressured the hospital administration to do something;
²
the Saint Luke’s hospital administration told Medellin that Cullen had not harmed any patients. Their investigation into the matter was closed.

Pat Medellin wasn’t satisfied with that answer. On August 29, 2002,
³
Medellin stepped out and told her story to an acquaintance who worked as a cop with the Easton, Pennsylvania, Police Department.
⁴
It snowballed up the command from there: the cop told his captain, the captain pushed it to the coroner, the coroner carried it to the office
⁵
of Lehigh County district attorney James B. Martin.
⁶
One by one, the Pennsylvania state troopers called the Saint Luke’s staffers to the carpet.
⁷
Their stories of death on the night shift were damningly consistent.

Many mirrored that of Nurse Lynn Tester,
⁸
who noticed that “people on the mend” had been dying, suddenly and strangely, and soon after Nurse Cullen changed their IVs.
⁹
Nurse Robin Saulsberry observed Charles Cullen sneaking from her patient’s room shortly before her patient unexpectedly coded and died; Saulsberry later shivered when she recalled how Cullen had watched the unit’s EKG monitor, too transfixed to even look away when he spoke. Saulsberry, who held a PhD in chemistry, strongly believed the patient had been given Pronestyl—the drug Cullen was discovered to have dumped from the med closet shelves.

She was certain more patients were coding and dying since Cullen had begun on the CCU. Nurse Tester calculated that while Cullen worked only 26 percent of the hours, he was somehow on hand for 58 percent of the deaths.
¹⁰
Another nurse
¹¹
recalled that when Cullen worked the CCU, they’d average twenty to twenty-two Code Blues a month, but after Charlie left, they didn’t have a code for six months.
¹²
Charged by the state, coroners Zachary Lysek and Scott Grim had gone to work on a caseload of medical charts; privately, Lysek worried how many deaths Cullen might ultimately be responsible for; for all he knew, it might be fifty; then again, it might be none. He had his suspicions, but speculation was useless, even dangerous, in such a situation. Certainty could only come from the science. To that end, the DA had hired an outside medical pathologist, Dr. Isidore Mihalakis—the same doctor involved in the investigation into Helen Dean’s suspicious death at Warren Hospital years before. Dr. Mihalakis spent months reviewing the charts of seventeen patients that Saint Luke’s had selected, but found nothing prosecutable in the paperwork. Meanwhile, Charlie Cullen had moved on, with neutral references, to Somerset Medical Center.

Cullen’s personnel file at Saint Luke’s presented a simple and unremarkable story of a nurse who resigned after being repeatedly reprimanded. “Charles resigned” was the way it was phrased in the Employee Change of Status Record. “Would not consider for rehire—medication issue.” The words
vecronium bromide
or
vec
never appear, nor do the names of any of the other powerful drugs that Cullen had stashed and used. It was easy to understand that Saint Luke’s administrators did not have the sort of concrete evidence required to conclusively determine that their nurse had definitely and intentionally administered an overdose to a specific patient. At the same time Danny Baldwin and Tim Braun couldn’t help but notice that whether by design or accident, Saint Luke’s Hospital had consistently
dealt with the Cullen problem in a manner that created the fewest possible legal ramifications for themselves and the slightest possible paper trail for others.

T
im Braun and Danny Baldwin had worked hundreds of cases and seen as many variables on the means and motives of murder. None provided the slightest context for this. DA Martin’s investigation was a shocking document, but it was the final page that surprised the detectives the most. Only five months before Braun and Baldwin started their investigation,
¹³
the Lehigh County DA had closed his. Eight months of work had been, from a prosecutorial standpoint, a waste of time and paper.
¹⁴

Why would DA Martin drop the case against Cullen? The most obvious answer was that he didn’t believe he could win it. Could he even prove he had a victim, much less that Cullen was to blame? Braun tried to imagine the next eight months: traveling the same road with fewer resources, no witnesses or evidence—and, somehow, reaching a different destination.

Danny had no choice but to start back in on the medical reports. Danny spread the files across a table in the conference room. Each of the six potential victims had a file, mostly scribbles and printouts tracing their progress, prescriptions, and decline. The medical Greek was starting to make some sense, thanks in part to hours spent flipping through a
Physician’s Desk Reference
and the patience of Danny’s OB/GYN wife, Dr. Kimberly Baldwin. But even clarified into laymen’s terms, the charts and lab reports were little use. The hospital had already told them as much: the dig had somehow gotten into the patients, and it was apparently in their labs. But it wasn’t in their charts. The smoking gun was nowhere on these pages. That was the whole point.

The dig might not be the smoking gun, but they were fairly sure it was Cullen’s murder weapon. It was useful to think of the dig in a syringe, loaded and pointed at someone. Picturing the weapon like a gun made this medical murder stuff less abstract.

Like any other weapon, the dig had to come from somewhere. The most obvious source was the medical cash register machine—the Pyxis drug dispenser on the CCU floor. The record of that withdrawal should have been recorded in the Pyxis records. But here, the detectives had another dead end; Mary Lund had already told them Gall’s death was over thirty days old, so those records didn’t exist anymore.

“But somebody saw them,” Danny said.

“What do you mean?”