The Good Nurse: A True Story of Medicine, Madness, and Murder (48 page)

5
Documentation detailed in court proceedings and police investigation documents.

1
His references included Saint Luke’s nurse Pat Medellin, who would later alert Laughlin to a series of suspicious deaths on the unit that she believed were attributable to Cullen and ultimately take her concern to the police.

2
True to their word, the Saint Luke’s HR department gave Charlie “neutral” references, according to documents which were part of the police investigation. However, it took them three weeks to respond to the request from the Sacred Heart HR department.

3
From court documents. New Jersey Superior Court Judge Bryan D. Garruto, in his Memorandum of Decision on two motions—(1) Saint Luke’s Hospital’s Motion to Dismiss the Plaintiff’s Complaint, and (2) Somerset Medical Center’s Motion to Amend Its Complaint to Add Saint Luke’s as a Third-Party Defendant—rejected Saint Luke’s claim that they were both unaware of and not responsible for informing Somerset Medical Center about the danger posed by Charles Cullen, and could thus be sued by the families of Cullen’s victims at Somerset Medical Center. Garruto did not rule on the merits of those families’ cases.

In an opinion filed August 21, Garruto wrote, “The record reflects that St. Luke’s did not affirmatively misrepresent Mr. Cullen as a ‘model employee.’ However, because St. Luke’s chose to omit information about Mr. Cullen’s rehiring status to an inquiry by Somerset when at the same time St. Luke’s officials were calling other local-area hospitals to inform them of Cullen’s ‘do not rehire’ status, it is not immune from liability.”

Specifically, Garruto cited the March 21, 2005, memo between Dr. Saunders and Saint Luke’s executive vice president and CEO, Elaine Thompson, in which Saunders acknowledges the sub rosa phone calls warning area hospitals off of Charles Cullen; this citation is the only reason this document is known to exist.

Judge Garruto’s decision notes: “Specifically, Dr. Saunders writes that on or around August 2002, he phoned his counterpart at Lehigh Valley Hospital, Dr. Robert Laskowski, ‘to inform him about the medication diversion found at St. Luke’s Hospital; to see if there were any similar incidents in his employment file at Lehigh Valley; and to alert Dr. Laskowski not to hire this nurse because of his bizarre behavior.’ Saunders also indicated that he informed Dr. Laskowski that Mr. Cullen was listed as a ‘do not rehire’ at St. Luke’s. Dr. Saunders’s March 21, 2005, memo also notes that the then chief operating officer at Saint Luke’s, Vince Joseph, was making ‘similar calls to other area hospitals.’ ”

The “Memorandum of Decision on Motion Pursuant to R.1:6-2(f)” was filed August 21, 2007, and addressed “all cases and docket numbers arising out of the Cullen Litigation Case Type 270.”

4
On December 23, 2003, Pennsylvania state troopers interviewed Easton Hospital assistant CEO Deborah Borse and Easton’s risk manager, Georgianne Gerlach. Borse related that in August 2002, Gerlach, who was then the nursing recruiter for Easton, had been contacted by Paul Laughlin: “Laughlin advised that he could not tell them why, but they should not hire Charles Cullen.”

5
No notes acknowledging these calls would ever be found in Charles Cullen’s personnel file from Lehigh Valley Hospital, Sacred Heart Hospital, Easton Hospital, or Saint Luke’s Hospital.

6
In this same memorandum, Judge Garruto ultimately rejected Saint Luke’s motion, and granted that of Somerset Medical Center. “Here, the problem is that St. Luke’s assumed a duty to patients who would be under Mr. Cullen’s care,” Judge Garruto concluded. “But then took it upon itself to choose who will live and who will die.”

7
In ruling against Saint Luke’s Hospital’s request for summary judgment in five civil suits brought against it by patients’ families, the Trial Court of Pennsylvania offered the following opinion:

It would be shocking to contemplate a state of affairs where society would condone a hospital keeping silent while knowing, or being aware that it is highly probable, that a member of its staff killed a patient. Accordingly, the duty to disclose such information surely flows not merely as a concomitant of the express duties set forth in Thompson, supra, but is also understood more profoundly as one of the collection of duties that civilized people have come to expect of each other and their institutions. Therefore, while the court in this situation may be perceived as “imposing” a duty, it is in truth only recognizing an obligation that, it may fairly be said, persons would widely expect ought to apply, even in the absence of a more formal judicial pronouncement. It is, after all, the extent to which our principles of jurisprudence resonate with our collective convictions and shared notions of right and wrong that ultimately lend vitality to, and command respect for, our system of laws. To fail to recognize such an obvious duty on the part of a hospital in these circumstances would, by contrast, render the common law not only effete but a legitimate object of derision. (Superior Court of Pennsylvania Trial Court Opinion,
Krapf v. St. Luke’s Hospital
, July 9, 2009, at 25–26, upheld by the Superior Court July 27, 2010,
http://caselaw.findlaw.com/pa-superior-court/1533011.html
)

1
Four hospitals and Liberty Nursing and Rehabilitation Center.

2
Also, his Pennsylvania nursing license would expire in October 2002. Applying for a new one seemed like pressing his luck, especially in light of his inglorious removal from Saint Luke’s. Cullen had prepared for this eventuality and had applied to renew his New Jersey license while still working at Saint Luke’s Hospital.

3
His New Jersey state nursing license was in good standing; it would not expire until March 2003.

4
It’s named for England’s Somerset.

5
“It was once the country home of some of the 19th century’s wealthiest families, and modern-day residents now include pharmaceuticals and chemicals barons.” Sara Clemence, “Home of the Week: Peapack Palace,”
Forbes
, March 14, 2005,
http://www.forbes.com/2005/03/14/cx_sc_0314how.html
.

6
Details from Somerset Medical Center personnel files and police investigative documents.

7
Charlie had, for a time, taken great pains to make weekend plans when he had custody of his children, arranging trips to museums, movies, or even the beach. But since he’d moved in with Cathy he’d stopped making such plans and often found excuses not to take the kids.

8
“For her part, Risk Manager Rader testified at deposition that Attorney Laughlin indicated to her at that point that he could not find “a scintilla of evidence that there was any foul play involved [.]” (Pl.Ex. UUU at 114.) In any event, as a result of this review, Risk Manager Rader and Nursing Supervisor Koller identified neither any suspicious administration of Vecuronium nor any suspicious deaths. (Pl.Ex. UUU at 138.) Accordingly, the additional inquiries ordered by General Counsel Traub failed to unearth Cullen’s involvement in patient deaths and, thereafter, the Hospital’s Chief Executive Officer concluded this part of the investigation by referring Cullen to the State Board of Nursing for follow up as it saw fit. (Pl.Ex. III.)… After notification by the District Attorney that the matter had been referred to law enforcement, the Hospital undertook further investigations, including patient-chart review by an outside physician; however, this, too, failed to lead Saint Luke’s to conclude Cullen had harmed any patients. (See Pl.Ex. NNN at 51-55, 125-27.)” (From the opinion [Mundy, JJ] of the Superior Court of Pennsylania on
Krapf v. St. Luke’s Hospital
, July 27, 2010)

9
For purposes of narrative expediency, another of Charlie’s friends on the unit is not mentioned—Donna Hardgrieve, now Donna Scotty. Donna was also a good friend of Amy’s; together they formed a group the other nurses referred to as “the Three Musketeers.” Some of the stories that Amy initially heard about Cullen in fact came to her indirectly, relayed through Donna. Donna had no part in the investigation and never learned of Amy’s involvement.

10
Amy was thirty-eight at this time; she’d received her nursing degree from Saint Elizabeth College in 1988.

11
January 14.

12
This was Cullen’s language; if he ever knew Mrs. Han’s name, he did not remember it by December, when he would be questioned about it.

13
Each unit is 2 cc, or 0.5 mg; according to Dr. Shaleen, Ms. Han had been given only 0.125 mg on June 12 and 0.125 mg on June 13.

14
Gall’s blood work showed low blood proteins, symptomatic of his immune system’s impaired ability to fight infection (hypogammaglobulinemia).

15
Gall died on Saturday, June 28. According to police investigation reports, nurse Marty Kelly asked to meet with Risk Manager Mary Lund regarding the situation on Monday morning. Lund called a meeting for the following day. Participants included William Cors, MD, chief medical officer; Sharon Holswade, chief operating officer; Anthony D’Aguillo, MD, chairperson of Pathology; Kathy Puder, Laboratory Services; Stuart Vigdor, director of Pharmacy; Nancy Doherty, Pharmacy; MaryJo Goodman, RN, director of Critical Care–Cardiology; Valerie Smith, RN, manager of Critical Care; Darilyn Paul, RN, Critical Care; and Linda Vescia, RN-C, manager, Quality and Risk Improvement. One of the several measures taken as a result of that meeting for that pharmacy was to check Pyxis access to the digoxin in the Critical Care unit and around the times of the abnormal lab values. Pharmacy was also requested to contact Poison Control to, among other things, obtain information on the dose of digoxin necessary to cause a serum digoxin level of 9, as found in Gall’s blood work. The focus was on patients 4 and 3: Reverend Gall and Mrs. Han. The Pyxis reports were studied, with special concern over the canceled drug orders.

1
From transcript of recorded call. These passages have been abridged for length and clarity. All calls between Somerset Medical Center and New Jersey Poison Control were recorded by NJPC, though Somerset Medical Center staff were unaware of this until much later.

2
Ruck was the director of drug information and professional education, and holds a doctorate in clinical pharmacy.

3
According to a time line later submitted to the Department of Health by Dr. William Cors, Kelly and Doherty contacted Mary Lund regarding these patients on June 19.

4
From police investigation records.

5
From police investigation reports and author interviews with Dr. Marcus.

6
It did—Vigdor was in fact named on all the civil suits against Somerset Medical Center, along with Somerset CEO Dennis Miller, William Cors, and Mary Lund.

1
Police investigation records. For this conference, Somerset Medical Center had assembled Risk Manager Mary Lund, Senior Vice President for Medical Affairs Dr. William Cors, Quality Manager Linda Vashed, Pharmacist Director Stuart Vigdor, and Pharmacist Nancy Doherty. The New Jersey Poison Control side was represented by Pharmacist Bruce Ruck and now his boss, running in late, Dr. Steven Marcus.

2
State regulations required hospitals to report to the Department of Health any events occurring within hospitals that jeopardized the health and safety of patients. The reportage was to be immediate; the cause of these events did not need to be known by the hospitals in order to be reported.

3
In addition to copies of the original recordings of the conversations here relayed, there are two other conversations of note; in the first, Steven Marcus talks to Marty Kelly, asking her what it was about calling back with a life-or-death situation she didn’t understand. In the second, Marcus called New Jersey’s Department of Health and Senior Services to report the situation at Somerset.

4
Witness statements from police investigation records and DOH records.

5
Police investigation records and DOH records.

6
Police investigation records and interviews with Dr. Marcus.

7
The e-mail, dated Thursday, July 10, 2003 and contained in the police records, reads in part:

I spoke to the risk manager of the hospital, the director of pharmacy, the chief operating officer, and the chief medical officer, and they told me that they were not planning on reporting these incidents to anyone, not the NJDHSS or the police, until after they mount a thorough investigation.