Crime Library: Criminal Minds and Methods

Charles Cullen: Healthcare Serial Killer

The Hospital Dilemma

The Somerset Medical Center said they did not know that Cullen had been investigated elsewhere. When they'd checked his credentials, they learned nothing that would have made them hesitate to hire him. All they'd received, reports USA Today, were his dates of employment. It was at this facility where Cullen may have done his deadliest work, admitting to killing between 12 to 15 patients in only 13 months. Had concerns been passed along from previous institutions, things would have been different, and that upsets hospital officials. They were faced with a massive investigation, damage to their reputation, and civil lawsuits.

The Pennsylvania hospitals had additional concerns. During the 1980s, employers had learned that they could be sued for passing along negative evaluations or a refusal to recommend, which is tantamount to saying that someone is guilty before they've been fairly tried. They were understandably gun-shy about putting themselves on the line. To say nothing at all seemed the best course.

Still, there had been indicators about Cullen that could figure into damages. Nurses at St. Luke's had warned anyone they could find that Cullen could be a killer. By their count, Cullen had worked just over 20% of the total hours available in critical care but was present for over 56% of the deaths there. Nurses at two nearby facilities had also demanded that Cullen be dismissed and investigated. However, hospital administrators had declined to pass the word along.

Yet they found themselves in a Catch-22: If they didn't warn, they could be sued, and if they did, they could be sued. Even worse, Cullen's confession made the incidents clearly murder, and the insurance companies had indicated that they would not cover intentional killings. While the cases have not yet been settled, and St. Luke's in particular is legally challenging the threat of lawsuits, it's clear that this is a significant dilemma for healthcare institutions around the country, because Cullen will surely not be the last such killer.

Dr. Michael Welner
Dr. Michael Welner

Dr. Michael Welner, a New York-based psychiatrist and founder of the Forensic Panel, wrote an editorial at this time for the Philadelphia Inquirer, criticizing the current climate of managed care. He points to the assembly-line type of illness management that allows a predator to hone his skills, along with the difficulty of detection in a hospital setting as primary factors in the dilemma: No one had cried for help, there were no wounds, and the suspect had no criminal record. The solution rests in training clinicians and in refashioning personality testing for employment purposes to skew toward compassionate types. "Such professionals," he says," will nurture the rest of us rather than their own need for omnipotence."

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