A former nurse told prosecutors in New Jersey yesterday that he killed dozens of patients in several hospitals in the course of his 16-year medical career because they were "very sick" and deserved relief from their suffering.
The confession by Charles Cullen, 43, has sparked one of the most intense serial-killer investigations seen in the United States. Authorities said they were studying records from 10 hospitals where the suspect is known to have worked in New Jersey and Pennsylvania.
In his first court appearance yesterday, Cullen said he had no plans to contest the charges. "I am going to plead guilty. I don't plan to fight this," he said. He told Superior Court Judge Paul Armstrong that he did not want a lawyer. The judge ordered him held on $1 million bail.
Prosecutors charged Cullen with the murder of a Catholic priest, the Very Rev. Florian Gall, who died while hospitalised at the Somerset Medical Center in New Jersey in June. He was also charged with the attempted killing of another patient, a 40-year-old woman, at the same hospital.
After his arrest, the nurse reportedly told investigators that his record of killing was far more extensive. Under questioning, he insisted he had killed 30-40 patients by means of lethal overdose during his career, which began in 1987.
He went on to claim that they had all been mercy killings of patients who had been "very sick". He declared that his purpose was to spare them from unnecessary pain and suffering.
It may be weeks before investigators can finish attempting to corroborate his claims. However, officials last night said they were inclined to believe them. "The evidence that we have indicates that may very well be the case," commented Somerset County Prosecutor Wayne Forrest.
Mr Cullen came to the attention of investigators after he was fired by the Somerset Medical Center on 31 October. At the time, however, the authorities had no notion that the case might turn into a serial killer investigation.
The hospital acted after discovering that Cullen was linked directly to six cases where laboratory blood tests on patients had turned in unusual results, indicating abnormalities so serious as to be life-threatening. Four showed dangerously low blood sugar levels. Two others had elevated levels of a heart drug that can cause heart failure if excessive doses are used. Four of the six patients subsequently died.
The Very Rev. Gall died on 28 June this year after an excessive level of digoxin was found in his blood. The other patient, a woman with heart and cancer problems, recovered from a similar overdose of the drug and was discharged from hospital. She died in September, however. Prosecutors said Cullen had confessed responsibility in both cases.
Questions will be asked about how Cullen's alleged activities went undetected for so long. Several hospitals where he worked carried out investigations into him, but none of the information was shared between them. "None of these investigations were reported to the authorities," confirmed Dr William Cors, the Somerset Chief Medical Officer.