The Nurse

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1:04Tell me a little bit about what an ICU nurse does. So as an ICU nurse, we are really taking care of the most sick patients in the hospital. They could be there because they had a heart attack. They could be there because they have problems with their lungs and breathing, and they need to be on special machines and special drips. They can have so many different IV bags hanging. They can have different apparatuses attached to them that only ICU nurses know how to manage. Amy Loughran had been working as a nurse for almost 15 years, when in 2001 she got a job at Somerset Medical Center in New Jersey, about four hours away from where she was living.

2:03and I made an arrangement with the hospital that I would come down, I would work only on weekends, and I would stay in the hospital. For that, I was paid an exorbitant amount of money, and also I needed that money because I was quite sick, and I needed a procedure that my insurance was not going to cover completely. Amy told us she'd had issues with her heart since getting into a car accident in 1993. She saw a lot of doctors, many of whom said her heart problems were stress-related. She worked night shifts. Finally, she got a diagnosis, electrical cardiomyopathy. At that point, they were talking about putting me on the transplant list.

2:56Did you tell the hospital that you had this condition? No. The hospital had my contract through a travel nurse company, and they could end my contract at any time. If they found out that I was that ill, they easily could have said that, you know, I was not appropriate to be working 12 and 16 hour shifts in the ICU. you. So at this point, you're commuting a great distance. You're living in the hospital as you're working. I mean, what was life like for you? What was life like at home? I was pretty exhausted. And when I was home, I had my two daughters. They were 11 and 6. So they're five years apart.

3:52And I was also directing my oldest daughter's sixth grade play. So on Tuesdays and Wednesdays, I had play practice with her entire class. And the rest of the time, when the girls were in school, most of the time, I just slept and tried very hard to take care of myself. And then, about nine months after she'd started, a new nurse started working at the hospital. I met Charles Cullen when he was orienting to the intensive care unit. I saw him in the hallway. He was standing with the nurse that was orienting him. And I knew this nurse to be perhaps not the best person to give him direction. And so I gave him a look and went up to him and told him if he had any questions that I'd be happy to help.

5:03And we started talking from there and became fast friends. He was very shy, and he was also brilliant. I'm very drawn to introverted people. He was also, it seemed like he may be depressed, and I really wanted to know who he was outside of what we were doing inside the ICU. And so we talked a lot. We talked a lot about his personal life, my personal life. And he really took care of me emotionally at that time. At that point, because everything seemed so hopeless for me, I was really frightened for my health. I was frightened to leave my daughters behind. I was frightened of being found out that I probably was not physically capable of doing my job and losing my contract.

6:15And then my, not just the fact that I would lose that contract. If I lost that contract, I would lose more than money. I would lose my health insurance, which meant that I could not be cared for. And also the way that the insurance worked at that time, I could have been denied insurance trying to get insurance after that if I had lost my contract. And I really also was holding on to that secret. And when I was sick and when I was at the hospital and struggling physically, Charlie noticed those things. I was able to hide it from other people, but not from Charlie. Amy says that Charles Cullen first noticed she was sick on a night when she felt something going on with her heartbeat, an arrhythmia.

7:16I became very weak. I started to pass out and I took myself into a room and hooked myself up to one of the monitors to try and discover which particular arrhythmia I was in. and he saw me go into the room and then the arrhythmia showed up on the monitor. He initially thought that it was a patient that was in that room, but it was an empty room that I went into. He then came in, saw that I was in that dysrhythmia. I did not have my medication with me and Charlie went to the medication dispensing machine and pulled out a medication for me and helped me by giving me that medication. And I assume that you're not really allowed to do that.

8:24No, it is quite frowned upon. And even at this time, it was definitely frowned upon and both of us could have been in really big trouble. Amy says that after that night, Charlie was always around to help her get through a shift when she wasn't feeling well. They both worked on the night shift. And when the hospital was quiet, they talked about their lives. Charlie was divorced and had two daughters, just like Amy. And we also had this unspoken language. We could look across the hallway at each other and just make a facial expression and be able to know what was on the mind of the other. We ended up working most of our shifts together so that we could support each other.

9:20We would do our care together. We would bathe our patients together. Whether if one of us wanted to go on break, we always helped each other by taking care of the other's patients. We definitely relied on each other every shift. Charles Cullen kept Amy's secret, but she didn't know that he was keeping his own secret, too. I'm Phoebe Judge. This is Criminal.

9:56When did you notice that something odd was happening at the hospital? I noticed that our lab results were coming back skewed. In the mornings, we would draw labs on our patients, send them off, and then we would get the results, computerized results. If those results were completely in critical zones, then we would receive a phone call from the lab itself. We were receiving a lot of those phone calls, mainly phone calls saying that our patients' blood sugars were extremely low and dangerously low, where our patients could seize or our patients could die. Amy thought there must be a lab error. It was, there was no possible way that our patients, all of our patients' labs would be off to the point that they were.

11:04Some of us were getting blood sugars of 3 or 12. Anything under 60 is something that we would treat. And these were patients that were not diabetics, were not on an insulin drip, and were not receiving insulin from us. So we knew that there was something going on. The insulin then started to be locked up and put in the narcotics drawers. And my direct manager had told us that we had to start signing for the insulin. and the way that they had it set up in the dispensing system, we needed to account for the amount of units that was left in the bottle once we drew out our own dosages for our patients.

11:59And to me, there was no possible way to know how many units were left in the bottle. and they were going to tell us that we had to sign saying that we knew exactly how many units were in that bottle. And I said this was completely illogical and I was refusing to do that. And Charlie was very concerned that I was making such a big deal about it. He pulled me aside and is said, just sign for it. Just stop. And I wouldn't. Did you notice that any patients were having different outcomes than you might expect, you know, apart from the labs? The lab numbers are skewed, but were you also seeing patients having major problems?

12:50We had so many codes. We had sometimes multiple codes a night. I saw that as we had quite a few very critical patients. What is a code? So a code is when someone's heart stops or when they stop breathing or their oxygen level is so low that we need to adjust something. Usually what it means is that someone is in the process of dying and we need to save their life. There were surprises in some of the outcomes, people that I did not expect to go downhill so quickly, although it's a critical care. And it's never something that you can predict. I definitely did not feel that it was completely out of the ordinary.

13:55I just remember we were going through many, many codes quite often. In the middle of all this, Amy found out that Charlie had been fired. Being fired was scary to me to think that the best nurse that I worked with had just been fired. And it sent shockwaves through the entire ICU. Because for us, it meant if Charlie could be fired, all of us could be fired. And it was a very, very dark time. Did you immediately think about yourself hiding this medical condition, him giving you the drugs that one time to help? Did you think, oh gosh, what are they going to find out about me or they're trying to figure something out?

14:57Absolutely, I thought about that. And I was scared for myself in the sense that I no longer had my partner to work with and wondering what that meant for me. I was also very scared for Charlie. He had so many bills, and I was really scared for him. At work, everyone was talking about Charlie. And everyone there was very curious to find out what had happened. And when I called, he explained to me he had been fired because he hadn't been honest on his application. this didn't really make sense to me. Charlie had been working at Somerset for more than a year and he was respected by his colleagues.

15:56He'd been featured in a nurse recruitment pamphlet. It had his photograph and said, Charles appreciates the technology. Amy wondered why the hospital would be looking back at his application now. Charlie said that someone he used to work with must have seen the recruitment pamphlet and called Somerset to talk about him. Amy asked Charlie about it. He explained to me that there were some medications that were not disposed of properly, and he was a scapegoat for those medications. And I assume, you know, there's so many, rightfully so, regulations and safety checks within a hospital and ICU that someone could make a mistake like that.

16:49And you could see how that could happen. It doesn't mean they're a terrible person or a bad medical practitioner. You know, there are ways in which we can screw up in this profession. Yes, there were ways that any of us could make a mistake at any time. And it is one of the reasons why specifically critical care nurses are so precise in delivering care because it's so easy to overlook something. A few days later, Amy heard that detectives were asking to talk to some of the nurses. Rumors started going around that all of this had something to do with Charlie. The only reason in my mind detectives would be in the hospital investigating anything had to have been narcotics.

17:50That was the only thing that I could imagine. So to me, there was no possible way that Charlie had been taking drugs. There had been no time in my interactions with him that I would have thought that he had been taking drugs. So I thought that it was a witch hunt. And then Amy heard that the detectives were especially interested in talking to her. I was really scared. And knowing that Charlie had already been fired and they were asking about him specifically, Everyone knew that Charlie and I worked together and we were best friends. So I was really frightened. Amy avoided her interview with the detectives as long as she could.

18:44She even called in sick every time they made an appointment. But after a couple of weeks, her manager sent her in. She met with Detective Danny Baldwin from the Somerset County Prosecutor's Office. The hospital's risk manager was also in the room. When I first went in the room to speak with the lead detective, Danny Baldwin, I told him what I thought. I said, this is absolute bullshit, and this is a witch hunt, and if he thought that I was going to be throwing Charlie under the bus, he was barking up the wrong tree. then the risk manager got pulled out of the room for some reason and we were in the room alone me and danny baldwin and he said he wanted me to look at something he pushed some papers across the desk and it was the Pyxis printouts, which is our medication dispensing records.

19:59And it was the history of Charlie's interactions with that machine. And when I saw some of the medications that he had been taking out, also not hiding that he was taking out, some medications that were lethal. I also saw very quickly that there was a pattern of canceling medications and a pattern of taking out a couple of things that seemed completely innocent, like toothpaste, mouthwash, A &D ointment, those types of interactions with the Pyxis, no one would know unless they saw the drawer. But next to those very innocent items, there were deadly medications. Digoxin. There was potassium, phenylephrine, nitroprusside, things that could kill people.

21:17So, you know, in this system, you input what you're taking out from the bank of all of the supplies and drugs. but it's easy to open the door, say you're taking some toothpaste, but actually take potassium. That's correct.

21:40We'll be right back.

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22:53Amy agreed to see Detective Danny Baldwin and his partner Tim Braun at her house the next day.

23:20house in the middle of nowhere. And when they did arrive, they brought a lot of paperwork with them that they had received from the hospital. And they decided to just put it all out there for me. And I started to point out things that I noticed in Charlie's Pixis printouts and some of the documentation that they brought with them. And there were definitely signs that were so obvious that he had been doing something sinister that I couldn't speak. I just couldn't speak. Did you recognize any of the patients in the documents that they were sharing with you? I did. I recognized many of the patients that I had taken care of and the patients who died in my care and on my watch.

24:21Yes. Once you started to place people, patients with these dogs, did you start to go back in your mind thinking, well, that night I was there at 10.52 and Charlie, what did you start to remember? I started to really drive myself crazy trying to find a time when I had overlooked something or that maybe my intuition had been kicked in and there just wasn't. I had so much guilt that I could not think of a single moment where my intuition said something is wrong. There was one particular code that Charlie and I had done together, and I had walked in on him injecting a patient. And I do recall that that particular medication was not the medication that we should have been using to treat that particular dysrhythmia.

25:36And I eventually had covered up for him. I had said that it was me who ordered that particular medication and later I found out that that patient had been allergic to that medication and probably it was that medication that killed her and that I had walked in on him being the code leader I was responsible for everything that happened in that code and I wondered in that code why he chose that particular medication. I assumed because of who he was and that he was making an executive decision or perhaps he didn't have the correct medication. And the medication that he gave really wasn't wrong. It was just a medication that we didn't necessarily use anymore.

26:38So I kept to thinking that perhaps I was just making this all up in my head and I was seeing something that I was being told to see. I could not reconcile that my friend Charlie, this gentle and kind person, could have done these terrible things. During the detective's visit, Amy's phone rang. It was the hospital's risk manager calling. And essentially told me that I was not to be talking to the detectives without having some type of a hospital administrator or someone that was representing me because it could be dangerous for me. she also wanted me to talk to her if the detectives did reach out now during that phone call tim was on one side of me and danny was on the other side and i was talking on one of those old school wall phones with the cord and here these two huge detectives were sitting on either side so they heard everything that she said.

28:02And when I hung up the phone, I simply said to the detectives, let's get him. Because I knew at that moment that the hospital was going to do everything that they could to support themselves and not to take care of those patients. And I was angry. I was really angry. When the detectives asked Amy if she would agree to talk to Charlie on the phone while they listened in, she said yes. So what would you talk to Charlie about when you would speak with him? I would talk to him mostly about what was happening at home. I would talk to him about whether he was looking for a job. I wanted to know if he was okay emotionally.

28:58And I just made it very clear that I was still his friend and that we were still going to stay in touch and that I wasn't going to lose him as a friend. Was it hard to act normal? Well, it was hard, and yet it was also easy because I did miss him. I did want to hear his voice. I did want to know how he was doing. I wasn't afraid of him. I wasn't angry with him. I was sad for him. And all of those things, those were not emotions that I would be able to, let's say, fake or play. Those were real. And so it was easy to talk to him. What was he like on the phone? Quiet, funny, sad, very, very sad. He was scared.

30:08He was scared that he wouldn't find another job. Mostly he was pretty darn depressed. And then Amy found out that Charlie had found another nursing job. When we found out that Charlie had gotten a job, we decided we couldn't wait. We needed to keep him away from patients. And at that point, the only way that we felt that we could get him behind bars and make it stick was to get a confession. My understanding was that it was up to me to get this confession or we could lose this entire case. The detectives asked Amy if she would meet up with Charlie in person, and they asked her if she would wear a wire.

31:07Amy agreed and called Charlie and asked if they could have lunch. That must have been terrifying to... I mean, doing investigating on your own and looking at documents and helping behind the scenes, but to now put on a wire? Yeah. And yet to me, I was trained as a code nurse. I was trained as a trauma nurse. I was trained to be disassociated from my feelings during some of the worst times in anyone's life. and to stay calm and to really have my head around what I needed to do in the moment. And that was the place that I went. When I agreed to wear the wire, when I agreed to meet with Charlie, I knew the place to go within myself and that dissociative place.

32:15And I knew how to talk to Charlie. I mean, would this be the first time you'd be face-to-face with him since he'd been fired? Yes, it would be the first time.

32:35We'll be right back.

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