Sunday, February 1, 2015


Who remembers the sad tale of Charlie Cullen, dubbed the Angel of Mercy by the Media?  Perhaps in Cullen’s mind, he was an Angel of Mercy, but in my mind, he is the Demon of Death, a heinous, serial killer, who killed arbitrarily and indiscriminately.  Cullen murdered at least 30 hospitalized patients according to legal records, but by some estimates, he killed over 300 patients in seven hospitals over a 16-year career.
How could this have happened?  Didn’t anyone notice that patients were dying, people who shouldn’t have died?  Cullen’s clinical practice was suspect in several hospitals and he was even caught stealing drugs in one hospital and fired, but no one reported him to the Board of Nursing, the organization that governs the practice of nursing and whose mission is to safeguard the public. Cullen was non-selective and random - anyone qualified for death at his hand. He killed elders, healthy adults recovering from surgery, young people, and patients scheduled for discharge within hours of their deaths. He killed ”often on impulse” according to his own words.  Of course, he also murdered people to ”ease their suffering and pain” but mostly he killed because he felt like it.
 What were his weapons of choice?  As a critical care nurse, Cullen had easy access to plenty of lethal medicines.  Lidocaine, a powerful anesthetic and cardiac stimulant that in large doses causes a collapse of the cardiovascular system, was his drug of choice for his first kill.  Another drug of choice was insulin, a life-sustaining drug used to treat Type I diabetes mellitus.  The wrong dosage can cause the blood sugar to quickly fall leading to heart failure, and, in toxic doses, it causes an irreversible coma leading to heart and multi-organ failure and death. Digoxin, commonly used drug to treat heart failure was also a favorite of Cullen.  Digoxin speeds up the heart in therapeutic doses, but in toxic doses, it causes heart and kidney failure and death.
How did he do it? Easy.  None of these drugs are controlled substances. Cullen simply accessed the Pyxis Medication system (a big, computerized drug cart the pharmacy fills with meds for each patient each day) and signed in for Tylenol, vitamins, or some other innocuous pills that would not raise suspicion.      He would then steal vials of lethal drugs and inject them into a patient’s IV bag.  Trust me folks, none of these patients passed away quickly or easily.  They knew something was wrong. I’m willing to bet most of them were terrified, in pain, and suffered an agonizing death.

Why did it take 16 years to catch him?  Simple…no communication. Cullen murdered repeatedly.  He was suspected of malpractice in a number of hospitals, and even fired from a couple, but he just went out and got a new job. Several hospitals had complaints from other nurses that Cullen entered patient rooms and viewed patient records that he wasn’t assigned to, but nothing was done.  After all, there was, and still is, a nursing shortage and Cullen commanded a great skill set as an experienced critical care nurse. .
How was he caught?  After 16 years, and considerable discussion and suspicion about his nursing practice, one Medical Center observed clues indicating Cullen's wrongdoing. The hospital's computerized drug-dispensing cabinets showed that Cullen was requesting medications that his patients had not ever been prescribed. Cullen's drug requests were strange and confusing with many orders that were immediately cancelled, and many repetitive requests within minutes of each other. Concerned by what he was seeing, the hospital pharmacist called the State Poison Information and Education System asking for guidance and advice.  Shortly afterward, the executive director of the Poison Information and Education System warned the hospital that at least four suspicious overdoses indicated the possibility that Cullen was killing patients and urged the hospital to talk immediate action. For reasons unknown, the hospital delayed contacting authorities for three months, until October 2003. By then, Cullen had killed at least another five patients and attempted to kill a sixth.  I don’ understand why that hospital allowed Cullen to work.  Oh, I know there was a nursing shortage but a leave of absence, even with pay, would have allowed an additional five patients to live. Moreover, it would have saved the sixth patient a lot of post-traumatic stress.
A Travesty?  Yes. Shame on you, American Health Care System.

Until next time,

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