A former nurse was charged with murder Monday after telling prosecutors that he has killed 30 to 40 severely ill patients in Pennsylvania and New Jersey, U.S.  since 1987 by injecting them with drugs.

Charles Cullen, 43, told investigators that he administered the drug overdoses to put "very sick" patients out of their misery, prosecutor Wayne Forrest said.

Charles Cullen, 43, of Bethlehem, Pa., a former nurse who claims to have killed 30 to 40 patients since 1987, was charged with murder in Superior Court in Somerville, N.J. Monday Dec. 15, 2003.  [AP]

If Cullen's claims prove true, it would be one of the biggest hospital murder cases in U.S. history.

Cullen was charged with one count each of murder and attempted murder, but more charges could follow. Investigators are examining records at 10 hospitals where Cullen worked as they try to document his claims about the other killings.

"The evidence that we have indicates that may very well be the case," Forrest said.

During a court appearance Monday, Cullen stood and told the judge, "I am going to plead guilty. I don't plan to fight this." Cullen said he did not want a lawyer, and was held on $1 million bail.

Cullen, from Bethlehem, Pa., was charged with murder in the death of a Roman Catholic clergyman and the attempted murder of a 40-year-old woman at Somerset Medical Center. Investigators believe 12 to 15 of the deaths occurred at the hospital in Somerville.

The Very Rev. Florian J. Gall, vicar of Hunterdon County in the Roman Catholic Diocese of Metuchen, died June 28 at Somerset Medical Center. It was later determined that he had a lethal level of the drug digoxin, a heart medication, and had died from an unauthorized dose of the drug.

On June 16, the 40-year-old heart and cancer patient was discovered with an elevated level of digoxin. The woman recovered from the overdose and was released from the hospital, but died in September.

Somerset Medical Center said it fired Cullen Oct. 31 after an internal review found questionable lab results involving six of Cullen's patients. The lab findings prompted the hospital to notify prosecutors.

"The systems and processes we have in place were critical to our ability to quickly uncover the current problem," the hospital said in a statement.

Cullen also had a spotty record at some of his previous hospitals.

In 1997, he was fired from Morristown Memorial Hospital for "poor performance," said Joan Lebow, a spokeswoman for the hospital's parent company.

He worked at St. Luke's Hospital in Bethlehem from June 2000 to June 2002, and resigned amid allegations that he had at least twice hidden unopened heart and blood pressure medications in a safety bin for used needles, Lehigh County District Attorney James Martin said.

St. Luke's spokeswoman Susan Schantz said Cullen was immediately removed from contact with patients after the drugs were discovered.

A review of the records of 67 cardiac patients who died in the previous six months turned up no evidence that anyone had been harmed, said Dr. Charles Saunders, St. Luke's senior vice president for medical and academic affairs.

Martin said he hired a forensic pathologist in 2002 to determine whether Cullen had administered "inappropriate medication" to heart patients at St. Luke's.

The examination turned up no conclusive evidence of wrongdoing, Martin said, and on May 28 the prosecutor informed the hospital that the investigation was over.

The investigation into Cullen's conduct in Pennsylvania has now been reopened, Martin said.

Northampton County (Pa.) District Attorney John Morganelli also said his office is investigating whether Cullen was responsible for the death of a patient at Easton Hospital in Pennsylvania, where he worked for a few months in late 1998 and early 1999.

Cullen, a divorced Navy veteran, lived with a girlfriend who is a nurse in Pennsylvania, Forrest said.

Neighbors neighborhood described him as quiet and said he rarely interacted with them since moving to the area a few months ago.

Kristy Hendershot said her father recently spoke with Cullen, who gave no indication anything was amiss.

"When they were shoveling snow, (Cullen) talked to him like everything was fine," she said. "He seemed like a friendly guy. I didn't see him come out of his house a lot."

There have been several similar cases across the country in recent years. One of the largest involved a coronary care nurse who was convicted in 1984 for killing of 12 elderly patients in California.

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