Nurse killed 'up to 400' helpless patients in sick murder spree after 'needing to do something'

Charles Cullen is one of the most prolific serial killers in modern history, having murdered patients across multiple hospitals a over a 16-year period

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For 16 years, Charles Cullen worked as a nurse across multiple hospitals, secretly killing patients by administering fatal overdoses of medication into their IVs.

It's estimated that Cullen may have murdered up to 400 people, making him one of the most prolific serial killers in modern history.

Cullen had a difficult childhood. His father died when he was an infant, his mother was killed in a car accident while he was in high school, and two of his siblings also passed away soon after. For years, he cared for his brother, who eventually died of cancer.

After dropping out of high school, Cullen enlisted in the U.S. Navy, but his time there was brief. He later attended the Mountainside Hospital School of Nursing in Montclair, New Jersey, graduating in 1987. Not long after, he married and had two daughters.

In January 1993, Cullen's wife, Adrienne Taub, filed for divorce, telling police that she was terrified of him. She alleged that Cullen had spiked people's drinks with lighter fluid and, disturbingly, had once called a local funeral home to inquire about their rates. Given his access to dangerous drugs through his work, she feared for her safety and that of her children.

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In her domestic violence complaints, Taub described a series of bizarre and violent incidents at home. Cullen allegedly stuffed the family's pet ferret into a trash can, burned one of his daughter's books in the fireplace, and left his daughters with a babysitter for a week without returning. Believing he might harm their animals, she gave the pets away. Before these disturbing acts, she said, Cullen had never behaved so erratically.

Taub sought a restraining order, but the judge denied her request, saying Cullen had shown "only odd behaviour, not threatening violence".

After the divorce, Cullen's life spiralled. He turned to alcohol to cope, struggled financially, and fought - unsuccessfully - for custody of his daughters.

He tried to die by suicide several times, the first of which came just days after Taub made domestic violence complaints, and he battled with mounting financial problems and mental illness.

Two months later, he broke into the home of a fellow nurse, Michelle Tomlinson, prompting Taub to finally be granted a restraining order.

Later that same year, Cullen murdered three patients at Warren Hospital in Phillipsburg, New Jersey - Lucy Mugavero, Mary Natoli, and Helen Dean - by injecting them with digoxin, a heart medication that is deadly in large doses.

Before she died, Dean told her family that a male nurse had injected her with something. Despite this, the pathologist ruled her death as cancer-related, and no investigation followed. Cullen quietly resigned from the hospital.

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He then began working at Hunterdon Medical Center in Flemington, New Jersey, primarily on the night shift. Over the next nine years, Cullen moved between several hospitals across New Jersey and Pennsylvania, killing patients wherever he went.

Sometimes he was fired, and other times he resigned. However, due to poor communication between hospitals and the silent nature of poisoning, his crimes went unnoticed for years.

Cullen continued to struggle with his mental health. In 2000, he made another suicide attempt by bringing a hibachi grill filled with charcoal into his bathtub. However, a neighbour smelled smoke and called the police, saving his life.

In 2002, a nurse at St. Luke's Hospital became suspicious of Cullen and contacted the police, providing a list of 69 patients she believed he had killed. Despite her detailed concerns, the investigation stalled after nine months, and Cullen was never questioned.

Cullen wasn't arrested until December 2003 when bosses at Somerset Medical Center spotted that a shocking number of patients had perished with elevated levels of digoxin in their systems.

They sacked Cullen following an internal investigation which uncovered a wealth of dodgy lab results linked to his patients. They then alerted prosecutors to their discoveries and Cullen was put under watch.

Whilst being monitored, police had Amy Loughren, who worked as a nurse at Somerset Medical Center, wear a recording device and meet with Cullen.

They chatted at a pub in Bridgewater, New Jersey, where Loughren challenged him about the suspicious deaths that had occurred during his shifts.

Loughren tried to coax a confession from Cullen. "I know you did it. Let's go to the police station. We can call them together," she said. "I can't, I can't," he responded, before leaving the pub.

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Detectives were positioned outside in the car park and the secret recording provided sufficient evidence for a probable cause of arrest.

After Cullen's arrest, he confessed to a number of murders, providing investigators with an estimate of how many people he had killed at each hospital. He was presented with a plea deal in which he escaped the death penalty in return for his admissions.

Cullen had employed a range of medications to fatally poison his patients, including digoxin, insulin, dobutamine, nitroprusside, norepinephrine, and pavulon.

Some of his victims survived the initial poisoning, prompting Cullen to attempt repeatedly and even switch the deadly medications to complete his evil task.

He confessed to prowling the wards to locate a potential victim and examined medical records to identify patients who were suffering from multiple organ failure and those who had a "do not resuscitate" order.

He turned up in court and pleaded guilty to 22 murders and three attempted murders in New Jersey. Throughout his time in court, Cullen declined to face the families of the victims, frequently feigning sleep at the defendant's table.

"You don't even have the guts to look this way, do you? That's a shame," said the son of one of his victims. Cullen received 11 consecutive life sentences and he subsequently admitted to an additional seven murders and three attempted murders in Pennsylvania.

While only 29 murders could be verified, Cullen alleged that he killed up to 40 people during his nursing career, which stretched over 16 years. Investigators, however, suspect that the figure could be much higher, potentially even around 400.

Regarding his motives, Cullen justified his actions by claiming he was ending suffering and preventing the dehumanisation of his victims.

"Mercy killing is a common defence," said Dr. Michael Welner, a psychiatric teacher at New York University Center. "But that is a rationalisation a person employs to convince themselves they're doing the right thing."

But not all of Cullen's victims were terminally ill. one was merely 21 and had been in hospital for routine spleen surgery.

As the daughter of one of his victims declared after Cullen was sentenced: "He was supposedly some sort of angel of mercy, ending peoples' suffering. Well, he should look around the courtroom."