Crime Library: Criminal Minds and Methods

Efren Saldivar: Hospital Executioner

The Investigation

When confronted by police, Brossus had suddenly decided that he didn't really know much and he wasn't at all sure of the information he'd been given. It appeared to the investigators that he just didn't want to have anything to do with cops. His call had been to the hospital in an effort to be paid off for keeping quiet, and he wanted no part of a formal investigation. Given his 15 years of run-ins with the police, they could see why, but they still needed reliable information in order to move forward.

Hospital administrators went through their lists and offered the possibility that Ursula Anderson had initially mentioned what Saldivar was doing. The investigators questioned her and she insisted that she'd said no such thing. Mr. Brossus had obviously made it up.

Another dead-end.

Yet to their credit, the investigators didn't give up. If someone was killing patients who had entrusted themselves to the care of this hospital, they were going to find out who it was. The year before, Bob Baker had mentioned the "magic syringe." Perhaps he knew something more. In fact, he did. He knew about the vials of muscle relaxant found in Saldivar's locker.

That observation sent Currie and crew to an expert, the director of the respiratory therapist unit, John Bechthold, who informed them about some of the rivalries in the unit—notably Baker and Saldivar. Baker could have made up his accusations to get Saldivar fired. That possibility had to be considered, which presented the investigators with a whole new problem. Bechthold mentioned that when Baker had first told them about Saldivar's late-night activities, they had run their own investigation but found no substantive proof. In light of the hostility between the two men, they had dropped it.

McKillop was disappointed. He reported what he knew—and what he didn't know—back to his chief. They decided to approach Saldivar himself to see what he would say. The hospital had shifted some schedules to keep him away for several days, so he was available on the afternoon that Will Currie invited him to come down to the station. If he was a killer, they hoped for a reaction but no one expected quite the one they got, or what would happen next.


Saldivar was introduced to a polygraph examiner, who asked him if he understood why he had been asked to come in. He responded that he expected to get his name cleared. He was confused about why he had not been back to work and he'd heard that some anonymous caller had fingered him as a killer. He wanted to talk so that people would know he was innocent.

The investigators asked him if he had ever done anything like what he was accused of doing. At first he denied it but then quickly admitted that he'd been injecting people since he'd started to work at Glendale. The first case occurred when he was 19 and fresh out of school.

He had been assigned an elderly female patient, he said, who was on a life-support system. She had a terminal case of cancer and there was no hope for her. In fact, she was almost over the edge. The doctors would soon turn off her machines and the family had already taken their leave. After everyone was gone, Saldivar looked in on the woman and saw that, although she was unconscious, she was still breathing. He felt sorry for her. Out of mercy, he claimed, he connected two tubes, effectively suffocating her.

Then he admitted that years later he'd injected Pavulon into one patient by shooting it through the IV tube. He'd found a discarded bottle of the stuff and had kept it.

Immediately, he was read his rights, but then he continued to talk freely. Lieberman indicated that Saldivar talked for two hours.

He said that his first lethal injection occurred in 1997. He'd only done that twice. Or that's what he said at first. Currie mentioned that he'd probably do some investigating on his own and Saldivar blurted out that he wasn't alone in this; there were others, too. They would sometimes go from room to room injecting people who shouldn't have to live any longer. He said he did it because he felt sorry for them.

Currie asked if this involved more than 500 patients and Saldivar assured him it was less than 50. He thought just over 40. So now within moments, he's climbed from two to 40-something. Possibly 50. He had been convinced they were "ready to die."

To a BBC reporter later, Currie said that Saldivar's criteria for murder were that the patient had a "do not resuscitate" order, he or she was "ready" and he or she was unconscious. "He prided himself on having a very ethical criteria as to how he picked victims."

Saldivar may have injected both succinylcholine chloride and Pavulon, which are difficult to detect in human body tissue at autopsies and would not show up unless a specific test was done. That meant finding the illegal drugs in his possession and possibly even exhuming bodies.

That evening, he was placed under arrest.

The next day the police searched his home and found plenty of pornography but no incriminating drugs. That was bad news for the investigators. Since a person cannot be held on what they say alone, no matter how much they confess or how brutal the crime, Saldivar was released after 48 hours to await the results of a more thorough investigation.

Based on this shocking information, however, Efren Saldivar was terminated on March 13, 1998, and just to be safe, the hospital suspended 37 other people in the respiratory department.

Then he recanted his confession and said he hadn't really killed anyone. He'd had a mental disorder along with depression, and had been pressured to confess. He'd just made it all up.

Michael Swango MD (AP)
Michael Swango MD

Now without his confession, the physical evidence would be important. McKillop formed a task force of six investigators and rented a house near the hospital for a command post. Then they consulted some experts on this phenomenon of "Angels of Death." Some do it out of mercy, they learned, some for profit, some to look like heroes when they revive the patient, and some from a pure sadistic delight in playing God. One doctor, Michael Swango, had gone from hospital to hospital, killing just to kill.

Despite what Saldivar said, the detectives learned that making someone die by using Pavulon was hardly merciful. Derived from an African drug, Curare, the patient went into a conscious paralysis and felt every minute of the death-by-suffocation process. It was no easy experience and they couldn't even scream for someone's attention. Their throat closed up and they had to lie there helpless until it was over.

Understanding all this made them realize that they had an enormous job ahead of them. They had numerous records to sort through, because over 1,000 patients had died at some point on Saldivar's shift during the eight years he had worked at the hospital. They couldn't very well exhume all of these people, so they began to narrow down the list to recent cases, specifically those deaths that appeared to be the most mysterious (the patient had seemed okay) and where the body was still available (not cremated). It took them a year at the command post to finally settle on 20.

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