Hospitals are supposed to be places where people go to receive care, protection, and a chance to recover. But for more than a decade, patients in hospitals across New Jersey and Pennsylvania were unknowingly placed in the path of a serial killer.
Charles Edmund Cullen, a former registered nurse, spent approximately 16 years working in medical facilities while secretly murdering patients. His crimes eventually made him one of the most notorious healthcare serial killers in American history.
Cullen confessed to killing as many as 40 patients, although investigators have long suspected that the true number of victims could be considerably higher. At least 29 murders have been confirmed.
His story became widely known again following the release of The Good Nurse, but the real Charles Cullen true story is even more disturbing than the movie suggests.
Who Was Charles Cullen?
Charles Edmund Cullen was born in West Orange, New Jersey, on February 22, 1960. He eventually trained as a nurse and began working in hospitals during the 1980s.
Cullen's career lasted from the late 1980s until 2003 and took him through numerous hospitals and healthcare facilities in New Jersey and Pennsylvania.
That career provided him with something particularly dangerous: access to vulnerable patients, medications, and medical records.
Cullen did not look like the stereotypical image of a serial killer. To coworkers, he could appear quiet, helpful, and compassionate. His position as a nurse also placed him in an environment where unexplained patient deaths could initially be attributed to illness or natural causes.
That combination helped him remain undetected for years.
When Did Charles Cullen Start Killing?
The first confirmed Charles Cullen murder occurred in 1988 at Saint Barnabas Medical Center in Livingston, New Jersey.
Cullen had begun working at the hospital after completing his nursing education. According to accounts of the case, he became involved in suspicious incidents involving patients and intravenous medication. His first confirmed victim was John W. Yengo Sr., who died in June 1988.
Cullen eventually left Saint Barnabas in 1992.
Rather than ending his nursing career, however, he simply moved on to another medical facility.
That pattern would repeat itself for years.
Charles Cullen Hospitals: Where Did He Work?
One of the most disturbing aspects of the case is the number of healthcare facilities through which Cullen passed.
Over approximately 16 years, Cullen worked at hospitals and healthcare facilities throughout New Jersey and Pennsylvania. At several locations, concerns were reportedly raised about his behavior or his handling of patients and medications.
Yet Cullen continued finding employment.
Contemporary reporting noted that he had worked at 10 hospitals and that several facilities had either fired him or forced him to resign. Despite those warning signs, information about his previous employment and suspected misconduct was not consistently passed along to subsequent employers.
Saint Barnabas Medical Center
Cullen began his nursing career at Saint Barnabas Medical Center in Livingston, New Jersey.
His first confirmed murder occurred there in 1988.
Suspicion eventually surrounded Cullen's handling of intravenous medication, and he left the hospital in 1992.
Warren Hospital
Cullen next worked at Warren Hospital in Phillipsburg, New Jersey.
He was eventually dismissed after concerns arose about his behavior and access to medication. Investigators later connected additional deaths to his activities.
Hunterdon Medical Center
Cullen subsequently worked at Hunterdon Medical Center in Flemington, New Jersey.
The facility would later become important to the investigation into his crimes.
Morristown Memorial Hospital
Cullen also worked at Morristown Memorial Hospital.
Like several other stops in his career, his employment there ended before his eventual arrest.
Liberty Nursing and Rehabilitation Center
Cullen later worked at a nursing and rehabilitation facility in Pennsylvania.
Concerns surrounding his handling of medication eventually contributed to him losing that position.
Easton Hospital and Lehigh Valley Hospital
Cullen continued moving between Pennsylvania medical facilities, including Easton Hospital and Lehigh Valley Hospital.
Investigators would eventually identify suspicious deaths and attempted killings associated with several of these locations.
St. Luke's Hospital
Cullen also worked at St. Luke's Hospital in Bethlehem, Pennsylvania.
By this point, suspicions about him were becoming increasingly serious, but he still managed to continue working in healthcare.
Somerset Medical Center
Somerset Medical Center in Somerville, New Jersey, would ultimately become the hospital where Cullen's killing spree came to an end.
It was the suspicious death of a patient there that finally triggered the investigation that led to his arrest.
Charles Cullen Victims
The exact number of Charles Cullen victims remains one of the most disturbing unanswered questions surrounding the case.
Cullen told investigators that he had killed between 30 and 40 patients. Prosecutors and investigators subsequently worked through medical records and other evidence to determine which deaths could be connected to him.
He ultimately pleaded guilty to murdering 29 people and attempting to murder six others.
That makes 29 confirmed victims the most commonly cited figure.
However, 29 should not necessarily be interpreted as the total number of people Cullen actually killed.
How Many People Did Charles Cullen Kill?
The answer depends on what is meant by "killed."
Confirmed murders: 29
Murders Cullen admitted to: up to approximately 40
Possible total: potentially much higher
Investigators and people familiar with the case have suggested that Cullen could have killed substantially more patients than those whose deaths were conclusively established.
Some estimates have reached into the hundreds, although those higher figures remain estimates rather than proven victim counts. TIME, for example, has reported that Cullen was suspected of killing as many as 400 people.
Because many hospital patients die from serious illnesses, establishing that a particular death was actually a homicide can be extraordinarily difficult.
That uncertainty is one of the most chilling elements of the Charles Cullen serial killer case.
Charles Cullen Victims List
A complete list of every suspected victim cannot be established with certainty. However, numerous victims were identified through Cullen's confession, medical records, and subsequent investigations.
Among the patients associated with the case were:
John W. Yengo Sr., 72
Lucy Mugavero, 90
Mary Natoli, 85
Helen Dean, 91
LeRoy Sinn, 71
Earl Young, 76
Matthew Mattern, 22
Irene Krampf, 79
William Park, 72
Samuel Spangler, 80
Daniel George, 82
Edward O'Toole, 76
Eleanor Stoecker, 60
Joyce Mangini, 74
Giacomino Toto, 89
John Shanagher, 83
Dorthea Hoagland, 80
Melvin Simcoe, 66
Michael Strenko, 21
Florian Gall, 68
Christopher Hardgrove, 38
Krishnakant Upadhyay, 70
These names represent only a portion of the victims identified in connection with Cullen's crimes.
How Did Charles Cullen Kill His Victims?
Cullen primarily exploited his access to medications as a nurse.
He administered dangerous or lethal doses of drugs to patients, including medications that could cause fatal cardiac complications.
Digoxin was particularly associated with the investigation into his crimes. Other medications were also involved in individual cases.
The hospital environment made the killings difficult to detect. Patients were often already seriously ill, and a sudden deterioration or death could initially appear to be the result of their underlying medical condition.
That gave Cullen an opportunity to hide his crimes in the ordinary tragedies of hospital life.
What Was Charles Cullen's Motive?
Cullen claimed that he killed patients to end their suffering.
During his initial questioning, he described his actions as mercy killings and said he wanted to prevent patients from suffering. Prosecutors and investigators, however, questioned this explanation.
Not all of the people Cullen killed were terminally ill.
One particularly notable victim was Reverend Florian Gall, a patient at Somerset Medical Center who had not been considered terminal and was reportedly expected to recover before his sudden death.
Cullen later acknowledged that he was a murderer and accepted the description of himself as a serial killer.
Whatever Cullen's stated motivation, his actions robbed patients and their families of the opportunity to make their own decisions about life and death.
How Was Charles Cullen Caught?
Cullen's crimes finally began unraveling in 2003 at Somerset Medical Center.
The suspicious death of Reverend Florian Gall attracted attention because his medication levels did not match what doctors expected.
Investigators began examining the circumstances surrounding Gall's death and eventually focused on Cullen.
Cullen was arrested on December 15, 2003. At the time, he was accused of murdering Gall and attempting to kill another patient. Investigators then began examining his history and the deaths of patients at other hospitals where he had worked.
The investigation quickly became much larger than a single murder.
Cullen eventually began telling investigators about other killings.
Charles Cullen's Confession
After his arrest, Cullen claimed that he had killed between 30 and 40 patients during his nursing career.
That confession sent investigators back through years of hospital records.
The challenge was enormous.
Hospitals had thousands of patient deaths over the years, and Cullen had moved between facilities. Investigators had to determine which deaths could potentially be linked to him and distinguish suspicious cases from deaths caused by genuine medical conditions.
As investigators pieced together the evidence, Cullen became connected to murders across multiple healthcare facilities.
His confession ultimately helped authorities establish numerous killings, although it never completely answered the question of how many people he actually murdered.
Why Was Charles Cullen Able to Keep Killing?
Perhaps the most troubling question surrounding the case isn't simply how Cullen killed his victims.
It is how he was able to continue working as a nurse.
Cullen had already encountered disciplinary problems and suspicion at several points during his career. Yet he repeatedly found employment at other healthcare facilities.
CBS reported that Cullen worked at 10 hospitals over 16 years and that he had been investigated, fired, or forced to resign at several of them. The failure to effectively communicate concerns about him allowed him to move from one facility to another.
His case exposed serious weaknesses in the way hospitals handled suspicious employee behavior and employment references.
The Cullen case therefore became about more than one serial killer.
It became a warning about what can happen when institutions fail to act on warning signs.
Charles Cullen Arrest and Trial
Cullen was arrested in December 2003 after investigators connected him to the death of Reverend Gall and began investigating his wider history.
Rather than mounting a lengthy defense, Cullen agreed to plead guilty.
In 2004, he pleaded guilty to multiple murders and attempted murders as prosecutors continued building their case. Contemporary reporting stated that Cullen was expected to spend the rest of his life in prison.
Ultimately, Cullen was convicted of 29 murders and six attempted murders.
His sentence consists of consecutive life terms, making release extraordinarily remote. His parole eligibility is listed as June 10, 2403.
Where Is Charles Cullen Now?
Charles Cullen remains incarcerated in New Jersey.
He is serving consecutive life sentences for his crimes and is not expected to be released during any normal human lifetime.
His case remains one of the most notorious examples of a healthcare worker using professional access to murder patients.
Charles Cullen and The Good Nurse
Interest in Charles Cullen surged again with the 2022 Netflix film The Good Nurse, starring Eddie Redmayne as Cullen and Jessica Chastain as fellow nurse Amy Loughren.
The movie was based on the book The Good Nurse by Charles Graeber and focuses heavily on the investigation that eventually exposed Cullen.
The film dramatizes portions of the story, but the underlying case is real.
Cullen really was a nurse who moved between hospitals in New Jersey and Pennsylvania. He really did confess to killing patients, and authorities really did struggle to determine the full extent of his crimes.
The movie also brought renewed attention to one of the most important questions surrounding the case:
How many victims did Charles Cullen really have?
There may never be a definitive answer.
The Legacy of the Charles Cullen Case
The Charles Cullen murders changed the conversation surrounding patient safety, healthcare employment practices, and institutional responsibility.
His ability to move between hospitals despite concerns about his behavior demonstrated how dangerous fragmented employment records and inadequate reporting procedures could be.
The case also highlighted a unique problem with healthcare serial killers.
When a murderer operates in a hospital, the deaths of their victims can initially appear completely natural.
A patient may already be elderly, critically ill, or recovering from a serious medical condition. When that patient suddenly dies, suspicion may not immediately fall on the person who was supposed to be caring for them.
That is part of what made Cullen so difficult to detect.
He did not have to hide bodies.
He did not have to stalk strangers.
He worked in a place where death was already expected.
Frequently Asked Questions About Charles Cullen
How many victims did Charles Cullen have?
Charles Cullen was convicted of murdering 29 people and attempting to murder six others. He told investigators he had killed as many as 40 patients, while some investigators and experts have suspected that the actual number could have been substantially higher.
Who was Charles Cullen?
Charles Cullen was a New Jersey-born registered nurse who became a serial killer. He murdered patients at healthcare facilities in New Jersey and Pennsylvania over a period of approximately 16 years.
Why did Charles Cullen kill patients?
Cullen claimed that he killed patients to end their suffering. However, investigators found that not all of his victims were terminally ill, making his explanation controversial.
How was Charles Cullen caught?
Cullen was caught after investigators became suspicious of the death of Reverend Florian Gall at Somerset Medical Center in 2003. His arrest led authorities to investigate his previous employment and other suspicious patient deaths.
When was Charles Cullen arrested?
Charles Cullen was arrested on December 15, 2003, in connection with the murder of a patient at Somerset Medical Center.
Where did Charles Cullen work?
Cullen worked at numerous hospitals and healthcare facilities in New Jersey and Pennsylvania, including Saint Barnabas Medical Center, Warren Hospital, Hunterdon Medical Center, Morristown Memorial Hospital, and Somerset Medical Center.
Is Charles Cullen still alive?
Yes. Charles Cullen remains alive and incarcerated while serving consecutive life sentences.
Where is Charles Cullen now?
Cullen remains imprisoned in New Jersey. His sentence makes release effectively impossible under ordinary circumstances.
Was Charles Cullen a real person?
Yes. Charles Edmund Cullen was a real registered nurse whose crimes were investigated by authorities in New Jersey and Pennsylvania.
Is The Good Nurse based on a true story?
Yes. The Good Nurse is based on the real Charles Cullen case and the book by Charles Graeber. The film dramatizes events, but Cullen's crimes, confession, arrest, and conviction are real.
Final Thoughts
The story of Charles Cullen is disturbing not simply because a nurse became a serial killer, but because his crimes continued for years inside institutions designed to protect vulnerable people.
He moved from hospital to hospital, leaving suspicion and unexplained deaths behind him.
By the time he was finally arrested in 2003, he had already spent approximately 16 years working around patients.
Twenty-nine murders were ultimately established in court. Cullen claimed responsibility for more. And the possibility that other victims may never be identified leaves one of the darkest questions of the case unanswered.
How many people did Charles Cullen really kill?
We may never know.
What is certain is that the victims were not statistics. They were patients who entered hospitals expecting care—and whose lives were taken by the person they trusted to help them.
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