Charles Cullen: the nurse who moved through ten hospitals and the records that stopped him

• Born1960, West Orange, New Jersey
• Navy1978–1984, including service on a nuclear submarine
• Nursing career1987–2003, at ten hospitals and nursing homes in New Jersey and Pennsylvania
• Arrested12 December 2003, Somerset County, New Jersey
• Pleaded guilty2004–2005: 29 murders and 6 attempted murders (22 and 3 in New Jersey, 7 and 3 in Pennsylvania)
• SentencedMarch 2006: 11 consecutive life terms in New Jersey, 7 more in Pennsylvania
• Earliest paroleJune 2388, as reported in 2022
• HeldNew Jersey State Prison, Trenton

Charles Cullen was a registered nurse. Between 1987 and 2003 he worked at ten hospitals and nursing homes in New Jersey and eastern Pennsylvania, in intensive care, cardiac and burn units. In 2004 and 2005 he pleaded guilty to murdering 29 patients and trying to kill six more, by putting overdoses of medication, most often the heart drug digoxin, into their intravenous lines and fluid bags. He is serving eighteen life sentences.

Twenty-nine is the number prosecutors could prove and he agreed to admit. When he was arrested he told detectives he had killed as many as 40 people. The journalist who wrote the best-known book about him believes the real figure runs into the hundreds. Nobody will ever know exactly, and this account tries to keep the figures apart: what he pleaded guilty to, what he claimed, and what others have estimated.

The case is remembered for something beyond the number. Cullen was investigated, disciplined, fired or allowed to resign at several of his jobs, and each time he found another one. The laws New Jersey and Pennsylvania passed afterwards were written to close that gap. This account rests on contemporary Associated Press and CBS News reporting, the 2013 60 Minutes broadcast, and later coverage by The Philadelphia Inquirer and others, listed at the end. Where they disagree, it says so. His victims and their families are not named here, and neither is the colleague who helped police, a private person who later chose to tell her own story.

West Orange and the Navy

Cullen was born in 1960 and grew up in West Orange, New Jersey. In 1978 he dropped out of high school and enlisted in the Navy. He trained on missile systems and served on a nuclear submarine; Salon gives his rank as petty officer second class.

Accounts of his Navy years, most of which trace back to Charles Graeber’s reporting for his 2013 book, describe a sailor who was bullied by his crewmates and behaved strangely. The most repeated story has him found at a missile control station dressed in a surgical gown and mask. He left the Navy in 1984. Salon describes it as a medical discharge; other accounts call it a general discharge.

He tried to take his own life several times over the years, beginning in his youth. Contemporary reports in 2004 mentioned at least two attempts; in his 2013 television interview he said he had made attempts throughout his life.

Nursing school and the first hospital

After the Navy, Cullen enrolled at the Mountainside Hospital School of Nursing in Montclair, New Jersey. The Inquirer and Salon say he graduated in 1986; Crime+Investigation and Sky News give 1987. By 1987 he was working in the burn unit at Saint Barnabas Medical Center in Livingston.

The first murder he was convicted of was committed at Saint Barnabas in June 1988. He left in January 1992, while the hospital was investigating a series of contaminated IV bags.

Sixteen years, ten workplaces

From 1992 he moved through a chain of jobs on both sides of the Delaware River. The record below is assembled from the employers’ own statements to the press in 2003 and from the guilty pleas. Sources count the workplaces differently: Associated Press reports at the time spoke of nine hospitals and a nursing home, 60 Minutes said seven hospitals, and other reports say ten.

• Warren Hospital, Phillipsburg, New Jersey, from 1992; the Inquirer says until 1994. He killed three patients there in 1993. The hospital investigated him over a suspicious death.
• Hunterdon Medical Center, Flemington, New Jersey, 1994–1996. He later admitted killing five patients between January and September 1996.
• Morristown Memorial Hospital, New Jersey, 1996–1997. A spokeswoman for its parent company said he was fired in August 1997 for “poor performance”. The Inquirer dates his time there to 1996–1998.
• Liberty Nursing and Rehabilitation Center, Allentown, Pennsylvania, 1998. He was fired. CBS News reported in 2004 that it was for giving a patient medication without a doctor’s order; later accounts give other reasons.
• Easton Hospital, Easton, Pennsylvania, 1998–1999. He killed one patient there in 1998.
• Lehigh Valley Hospital, Salisbury Township, Pennsylvania, from 1999, where he killed one patient and tried to kill another. He resigned; accounts differ on when.
• St. Luke’s Hospital, Bethlehem, Pennsylvania, June 2000 to June 2002. In June 2002 unopened vials of heart medication were found hidden in a needle-disposal bin. He was taken off patient care and quit rather than cooperate with the hospital’s inquiry.
• Sacred Heart Hospital, Allentown, July 2002. He was let go after about two weeks for, in a spokesman’s words, “interpersonal problems with existing employees”.
• Somerset Medical Center, Somerville, New Jersey, September 2002 to October 2003, in the critical care unit.

The pattern was not hidden at the time. After St. Luke’s, a nurse there took her suspicions to prosecutors in Lehigh County, who reviewed the deaths of 67 patients in the hospital’s coronary care unit during his last six months there. In May 2003 they closed the inquiry without finding evidence of a crime. Crime+Investigation gives the number as 69 and says Cullen was never interviewed.

Why he kept getting hired comes down to references. Hospitals, afraid of being sued, confirmed his dates of employment and little else; Sacred Heart’s spokesman told the AP that was all they had learned about him, and St. Luke’s said it had received positive references from two of his earlier employers. In 2004 New Jersey’s attorney general told CBS News that hospitals were not required to report such problems to the nursing board, which never heard about any of them.

Somerset Medical Center, 2003

At Somerset, Cullen drew medication from a Pyxis, a computerised dispensing cabinet that opens a drawer when a nurse enters an order. He found a weakness in it: according to later accounts he would request a drug and cancel the request, and the drawer would open anyway, leaving no clean record that the drug had been taken. Even so, the system logged a great deal. Investigators later found he had been withdrawing medications he had no reason to have, at what the National Law Enforcement Officers Memorial Fund called “an alarming rate”.

In the summer of 2003 patients at Somerset began showing laboratory results that made no sense, including dangerously high levels of digoxin in people who had not been prescribed it. The New Jersey Poison Control Center was drawn in that June. Its managing director has said the first call came from a concerned nurse; an NBC New York account says it was an assistant pharmacist in July. Either way, poison control staff concluded that someone was poisoning patients and urged the hospital to go to the authorities.

Somerset did not notify law enforcement until October 2003, more than three months later. The detective who led the case, Sergeant Timothy Braun of the Somerset County Prosecutor’s Office, told 60 Minutes in 2013 that during that delay Cullen killed five more patients there, and that the hospital told investigators its dispensing records did not go back far enough, a claim the system’s manufacturer contradicted. Those are the detective’s accounts, not findings of a court.

Somerset fired Cullen on 31 October 2003. By the AP’s count in 2006, it was one of five nursing jobs he had been fired from; he had resigned from two others amid questions about his work.

The colleague and the arrest

Braun and his partner, Detective Daniel Baldwin, needed someone inside the hospital who could read the records. They found her in a fellow nurse in Somerset’s critical care unit who had become a close friend of Cullen’s. When detectives showed her the dispensing logs, she saw quickly what they meant. She agreed to wear a hidden recorder and met Cullen at a restaurant (some accounts say a bar) to confront him about the deaths while detectives waited outside.

Cullen was arrested on 12 December 2003 and charged with one murder and one attempted murder at Somerset. In interviews with detectives he went much further, saying he had killed as many as 30 to 40 patients over his career. The colleague later spoke publicly about the case on 60 Minutes in 2013 and in the 2022 film and documentary.

The plea deal

New Jersey still had the death penalty, and prosecutors in seven counties, five in New Jersey and two in Pennsylvania, agreed not to seek it. In return Cullen would plead guilty and help investigators identify the patients he had killed. The guilty pleas came in stages:

• 29 April 2004, Somerville: 13 murders and 2 attempted murders at Somerset Medical Center.
• May 2004, Warren County: 3 more murders, at Warren Hospital.
• November 2004, Lehigh County, Pennsylvania: 6 murders and 3 attempted murders.
• 27 June 2005: 5 more murders, bringing the total to 29.

The final count was 29 murders and 6 attempted murders: 22 murders and 3 attempts in New Jersey, and 7 murders and 3 attempts in Pennsylvania, including the 1998 killing at Easton Hospital. He has said he killed out of mercy. Many of his victims were old and very sick, but not all: on 60 Minutes Steve Kroft pointed out that several were neither close to death nor in great pain, and Cullen conceded there was no justification.

Sentencing, 2006

On 2 March 2006 a judge in Somerville sentenced him to eleven consecutive life terms. Relatives of his New Jersey victims faced him for the first time and read statements calling him a monster; he wore a bulletproof vest.

Eight days later, on 10 March, he was sentenced in Pennsylvania. In Northampton County he received life without parole for the Easton death. In Lehigh County he refused to stop repeating “Your honor, you need to step down”, apparently because the judge had given an interview to a newspaper, and kept at it for about half an hour. He was gagged with a cloth and duct tape, and the hearing went on. The judge added six more life sentences, bringing the total to eighteen. 60 Minutes later put the number at seventeen, and some reports count only the eleven New Jersey terms.

When he first pleaded guilty in 2004, New Jersey authorities said he would not be eligible for parole for 127½ years. Accounts written after sentencing give his earliest possible parole date as June 2388; other secondary sources give 2403. He is held at New Jersey State Prison in Trenton.

Between the plea and the sentencing, Cullen asked to donate a kidney to the brother of a former girlfriend, who was seriously ill. When prosecutors said it would have to wait until after sentencing, he threatened to skip his sentencing hearing. A judge gave permission in February 2006, and on 20 August 2006 he was taken from prison to a hospital for the surgery and returned the next day.

How many?

The figures attached to Cullen range widely, and they come from very different places:

• 29 murders and 6 attempts: what he pleaded guilty to and was sentenced for.
• 30 to 40: his own estimate, given to detectives after his arrest and repeated on 60 Minutes in 2013.
• “In the hundreds”: Charles Graeber, author of The Good Nurse, on 60 Minutes, reasoning from what Cullen told him about how often he had harmed patients in his early years. The book’s publisher has used the phrase “perhaps as many as 400”.
• Up to 400: a figure repeated in much of the 2022 coverage of the Netflix film, usually credited to investigators without a name attached.

Only the first number has been tested in court. The rest are estimates, and the gap between them is itself part of the story: drugs like digoxin and insulin are hard to detect after death, records were incomplete, and many of the deaths he might have caused were never questioned at the time.

Lawsuits and new laws

Families of victims sued the hospitals. In February 2008, according to the Associated Press, several New Jersey hospitals, along with St. Luke’s in Pennsylvania, settled a lawsuit brought by families of his New Jersey victims, on confidential terms. In March 2010 a jury in Lehigh County awarded $95 million against Cullen personally to the families of eight patients who died at St. Luke’s, after he did not mount a defence; he was never charged over those deaths.

The larger change was in the law. In 2005 New Jersey passed what became known as the Cullen law, which requires health care facilities to report misconduct, incompetence and negligence by staff to the state Division of Consumer Affairs, and protects them from lawsuits when they report disciplinary action. The same year, The Inquirer reports, Pennsylvania’s governor, Ed Rendell, signed a law protecting employers from being sued over the work histories they disclose, largely in response to the case. A separate New Jersey Patient Safety Act, requiring hospitals to report serious preventable adverse events, had been signed in April 2004.

The book, the interview and the films

Charles Graeber, who had first written about Cullen in a 2007 New York magazine article, published The Good Nurse: A True Story of Medicine, Madness, and Murder in April 2013. Days later, on 28 April 2013, 60 Minutes broadcast Steve Kroft’s interview with Cullen from prison, billed as the first time the programme had interviewed a serial killer in its 45 years. Asked whether he was sorry, Cullen said he was, and then: “I don’t know if I would have stopped.”

In October 2022 Netflix released The Good Nurse, a film based on the book and directed by Tobias Lindholm, with Eddie Redmayne as Cullen and Jessica Chastain as the colleague who helped catch him. A documentary, Capturing the Killer Nurse, followed in November 2022, with interviews with the detectives, Graeber and the colleague herself.

The portrait

The drawing above is a crop of Cullen’s coloring page in the True Crime Activity Book for Adults. Around his face the page gathers the case: a syringe, a submarine for his Navy years and a badge with the words “fire missiles”. He also has a full page as the C of Bloody Alphabet II and stands for New Jersey in Bloody America. For another medical killer, the British doctor whose victims were counted by a public inquiry, see Harold Shipman.

If you find an error in this account, write to hello@truecrimeart.com and it will be corrected.

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Questions people ask

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Sources

Every date and name on this page was checked against at least two of the following. Where they disagree, the disagreement is stated in the text rather than resolved silently.

1. Nurse was subject of criminal investigation (Associated Press)NBC News, 15 December 2003
2. Did Hospitals ‘See No Evil’?CBS News, 2 April 2004
3. Ex-nurse pleads guilty to 13 patient deaths (Associated Press)NBC News, 29 April 2004
4. Nurse Pleads Guilty To 13 Killings (Associated Press)CBS News, April 2004
5. Ex-nurse pleads guilty to three more murders (Associated Press)Fox News, May 2004
6. Killer Nurse Pleads Guilty Again (Associated Press)CBS News, 2004
7. Killer nurse admits to 5 more patient murders (Associated Press)NBC News, 27 June 2005
8. Nurse who killed 29 sentenced to 11 life terms (Associated Press)NBC News, 2 March 2006
9. Fast facts: victims of N.J. nurse (Associated Press)Fox News, March 2006
10. Court gags killer nurse during sentencing (Associated Press)NBC News, 10 March 2006
11. Killer nurse gets 12th life sentence (Associated Press)CBS News, 10 March 2006
12. Serial killer nurse allowed to donate kidney (Associated Press)NBC News, 2006
13. New Jersey killer nurse donates kidney (Associated Press)Fox News, 30 August 2006
14. Settlement in killer-nurse case (Associated Press)The Philadelphia Inquirer, 20 February 2008
15. Victims’ families settle with hospital in serial killer nurse case (Associated Press)Fox News, February 2008
16. Jury awards $95 million in killer nurse case (Associated Press)ABC7, March 2010
17. Officers of the Month, July 2004: Sergeant Timothy Braun and Detective Daniel BaldwinNational Law Enforcement Officers Memorial Fund
18. Detectives on catching serial killer Charles CullenCBS News (60 Minutes), April 2013
19. First serial killer on 60 Minutes in 45 yearsCBS News, 25 April 2013
20. NJ ‘Angel of Death’ gives first interview to 60 MinutesCBS New York, April 2013
21. ‘Angel of Death’ friend on learning his secretCBS News (60 Minutes), April 2013
22. The Good Nurse, by Charles GraeberHachette Book Group (Twelve), 2013
23. Patient Safety Act, P.L.2004, c.9New Jersey Department of Health
24. Netflix’s The Good Nurse and the true story of Charles CullenThe Philadelphia Inquirer, 27 October 2022
25. From ‘Capturing the Killer Nurse’ to ‘The Good Nurse’, here’s the true story of Charles CullenSalon, 15 November 2022
26. The Good Nurse: the true story behind the film (Sky News)Yahoo News UK, October 2022
27. Killer nurse Charles Cullen: colleague who helped put him away recalls ‘darkness’Fox News, December 2022
28. What ‘The Good Nurse’ left out: Netflix documentary on the NJ killerNew Jersey 101.5, October 2023
29. Charles Cullen: the killer nurse with an estimated 400 victimsCrime+Investigation UK

The facts on this page come from public records and the published sources above. If you find an error, write to hello@truecrimeart.com and it will be corrected.

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