The Good Nurse: A True Story of Medicine, Madness, and Murder (47 page)

While giving patients drugs in violation of a prescribed delivery schedule can cause serious harm, Beckert said Liberty was not aware of any cases in which a patient became ill. Liberty said it reported Cullen’s actions to the Pennsylvania Department of Health, which regulates nursing homes but does not have the power to discipline individual nurses.

According to a story in the December 18, 2003,
New York Times
,

the year after Ms. Pepe was fired, she sued the nursing home and filed a complaint with the federal Equal Employment Opportunity Commission. She and the hospital settled her claims in 2001, and the terms of the deal were sealed. Yesterday, through her lawyer, Donald Russo, Ms. Pepe declined to be interviewed, and Mr. Russo said he could not say much about the case.

But Ms. Pepe’s account is laid out in detail in her original suit and in a statement she gave the employment commission.

On May 8, 1998, she said, after Mr. Henry was taken to Lehigh Valley Hospital, staff members there called her three times to ask if she had given him insulin, and said his blood-sugar level had dropped to 25—so low that a patient is likely to lose consciousness and may suffer brain damage. Except in rare circumstances, a person’s blood sugar does not drop below 70 on its own. But insulin, a hormone used by diabetics to combat high blood sugar, could force such a drop, with the effect peaking one to two hours after injection. Ms. Pepe said Mr. Henry was not diabetic.

Ms. Pepe said that when she was asked about the incident days later, a nursing supervisor told her “they were not suspecting me at that time; they were, in not so many words, looking at my coworker, Charles Cullen.”

In a statement yesterday, Liberty’s parent company, HCR Manor Care, said, “To the best of our knowledge and according to our employee records, Charles Cullen was not under investigation by the center or outside pharmacy in May of 1998.”

11
Charles Cullen was employed through Health Force, an agency Easton Hospital used for its staffing.

12
Details of this incident are corroborated with police witness statements and police investigative records.

13
Ottomar Schramm had been taken from his nursing home by ambulance with aspirated food in his lungs.

14
These conversations are reconstructed as recorded from Easton Police interviews with Kristina Toth.

1
Northampton County coroner Zachary Lysek didn’t see how Schramm could have been accidentally given a dose of the deadly drugs in his system, and undertook a rigorous eight-month investigation of the death, interviewing dozens of staffers who had been involved with Schramm’s care, both in the nursing home from which he was transferred and at the hospital where he overdosed and died. He was aware from Toth of the mention of a man who seemed to be a nurse, but was unaware of that nurse’s identity. The forensic pathologist found that Mr. Schramm had died of pneumonia with digoxin overdose as a contributing factor, and, as a result, reported that Schramm’s “manner of death will be listed as accidental.” Lysek was still suspicious, but despite his personal opinion, had no evidence to take it further.

According to court documents and police investigation reports, Lysek was contacted three years later by an unnamed source, who told him that the mystery male nurse Toth had mentioned was named Charles Cullen, and that Cullen might have had some involvement in Mr. Schramm’s death. At this point, Lysek contacted the state police.

According to Mr. Lysek, he also called Easton to inquire about Charles Cullen’s records there. The Easton administrator looked up employee records and reported that they had no record of having employed a Charles Cullen. While of little help to Lysek, this was in fact technically true; while Mr. Cullen had worked at Easton Hospital, his employment had come through a personnel agency called Health Med One of Harrisburg, Pennsylvania. This was a familiar problem in the tracking of Charles Cullen throughout his career; and it taught Lysek the importance of forensic investigators in the future being sure to ask the right questions when compiling complete and accurate lists of all medical staff who might have had contact with a potential victim.

2
OxyContin entered the market in 1996.

3
This perception of the situation has been drawn from interviews, both by myself and by police detectives, with Charles Cullen; the facts surrounding his subsequent actions and the hospital’s reaction come directly from police investigative documents and witness statements to police.

4
Although Cullen recalled having killed four or five patients at Lehigh Valley, investigators were only able to definitively identify two of the victims: twenty-two-year old Matthew Mattern (August 31, 1999) and seventy-three-year old Stella Danielczyk (February 26, 2000); she had granny burns over 60 percent of her body, a death sentence by the rule of 9s.

5
The surgeons flapped out muscle to lay down a vascular grid over the bone to which they might eventually graft skin. The drugs in his system kept his body from fighting the transplant tissue, even as it prevented him from effectively fighting off infection. Each infection sent Mattern back to the OR.

6
This account comes from interviews and copies of Duddy’s police incident report. The dialogue has been taken from these sources and framed into quotes by the author.

7
Charlie was examined and sent home. There was nothing wrong with him physically, and he appeared quite sane.

1
In April 2000, Cullen used the unit’s computer to send an e-mail to two nurses who had recently been fired by the hospital, expressing sympathy and solidarity. Cullen was leaving the Burn Unit too, he explained—he’d already put in for a transfer to the Cardiac Floor. He was one of them, he said, aligned against the “Senior Service”—the fifteen-year veterans of the ward. Charlie called them “the SS,” for short, and continued on with the Nazi references—at the time, he didn’t realize that his e-mail would be sent not only to the two fired nurses, but to everyone on the Burn Unit staff, including the “Senior Service” members themselves. After that, life on the Burn Unit was utterly unbearable, and the Cardiac Unit no longer had any room for his transfer.

2
Cullen’s confessed recollection of his time at Lehigh includes having been responsible for the deaths of four of five patients there. Only two murders have been successfully identified from the Lehigh records: Matthew Mattern on August 31, 1999, and Stella Danielczyk on February 26, 2000.

3
According to police investigation reports, Saint Luke’s Hospital HR called for references from coworkers at “Liberty Nursing Home,” and Lehigh Valley Hospital Burn Intensive Care Unit; the quotes in this paragraph come from those references.

4
According to a March 9, 2008, article in the
Morning Call
, Saint Luke’s share of the medical care pie grew at an astounding 25 percent between 1990 and 2007, outstripping neighbor Lehigh Valley Hospital’s 2 percent gain, and taking between 29 and 39 percent of the patients and patient dollars from smaller Easton and Sacred Heart hospitals.

5
Saint Luke’s offered him full-time on the overnight shift starting at $21.45 an hour.

6
The nine patient rooms were arranged around the nurse’s station in a semicircle, usually just one patient per room.

7
The perceptions of the nurses come from witness statements and police investigation records.

8
Taken from police investigation witness statements and police investigation documents, including subpoenaed records of reports and incidents from the hospital itself.

1
Julie (family name withheld) was not a nurse but a unit clerk at Saint Luke’s.

2
From Nurse Brad Hahn’s statement to Pennsylvania State Police.

3
The president of the hospital had a PhD in biostatistics.

4
Statements of Cullen’s recollection of events are all taken directly from Charles Cullen interviews and corroborated by police investigation records, including witness statements and Cullen’s statements to police.

1
Police investigation documents and court records.

2
Nurse Thelma Moyer’s comment, as recollected in the confidential memo between attorney Paul Laughlin of the law firm Stevens and Johnson and Saint Luke’s Hospital attorney Sy Traub.

3
Joe Chandler was a day-shift nurse who ordered the restock for the med room. He had noticed that the drugs had started going missing as early as December 2001.

4
From police investigation documents and witness statements, personal interviews with Cullen, and Cullen’s own recollection and documentation to police. Three patients coded that night. Whether Charles Cullen was responsible for all three is a point of contention. Cullen was ultimately charged only with the death of Edward O’Toole, seventy-six, on that night.

1
Extensive interviews detailing these incidents are contained in police investigative documents, Pennsylvania Board of Nursing investigative reports, and subsequent court proceedings.

2
Biohazardous materials, used gloves, bloody material, amputated limbs, and excised organs, the abortions and tumors and liposucked fat, etc.; hospitals use and remove a great deal of mass.

3
It is used to help becalm patients who couldn’t keep their ventilators in—for patients whose diaphragm musculature had seized up as a side effect of other drugs.

4
For this reason, vec is always prescribed in as small a dose as possible for efficacy—enough to relax the diaphragm for breathing but not enough to impair oxygen delivery to the brain and other vital organs.

5
Cullen admitted to having used vec to kill at Saint Luke’s.

6
Reports of the exact numbers vary between sources, but most fall in the middle of Kimble’s recollection of seeing between six and twelve used bottles of vec.

7
Because O’Toole’s death was not specifically investigated until many years later, his cause of death cannot be officially determined. Charles Cullen would later confess to having killed O’Toole with vec in his voluntary statement to Somerset detectives.

8
Janice Rader’s interview with Pennsylvania State Police was used to create this specific language regarding the reasons for contacting outside council, i.e., that it would be best for the hospital. Sy Traub is the individual cited in Paul Laughlin’s confidential memo regarding his response to the call from Saint Luke’s regarding this issue.

9
The same firm which had been retained by Easton hospital, in light of the suspicious death of Ottomar Schramm. Some partners, including Laughlin, have since moved on.

10
In a deposition before the civil trials, however, Laughlin made clear that his job here was simply to determine who had put the drugs into the sharps box, not to extrapolate as to what had happened to the drugs nor what the proper course of action for the hospital should be regarding that information.

11
Charles Cullen also said these words when security brought him out.

1
Laughlin’s brief to Saint Luke’s in-house counsel provides an account of his meeting with Cullen, and subsequent interviews with Charles Cullen have confirmed and colored in that account without contradiction; this passage reflects both. I have taken the liberty of inserting quotation marks into this account for clarity.

2
These are the questions and phrasings from Laughlin’s report; the use of quotes is only perhaps appropriate.

3
Charles Cullen maintained that he didn’t wear gloves for this, and the vials had his fingerprints on them. It’s impossible to know what is true. This is Charlie’s recollection; the vials are gone, and Laughlin has never commented.

4
Laughlin was part of an administrative meeting in which it was decided that Charles Cullen would be offered the opportunity to resign; it was not his decision.