The true story of Charles Cullen, serial killer portrayed in Netflix’s ‘The Good Nurse’

The man now known as New Jersey’s deadliest serial killer graduated from nursing school in 1986. Two years later, he killed his first victim. And nearly 20 years after that, he pleaded guilty to committing 29 murders during a 16-year nursing career that spanned 10 hospitals and nursing homes in New Jersey and Pennsylvania.

When Charles Cullen was arrested in 2003, he told investigators he may have killed as many as 40 of his patients — and some estimates put his total number of murders as high as 400. As Cullen told police after his arrest, he killed by injecting deadly doses of medication into IV fluid bags — primarily the heart disease medication digoxin, insulin, and lidocaine, a local anesthetic.

Cullen, who became known as the “Angel of Death,” claimed he killed out of mercy, wanting to alleviate the pain and suffering of his mostly elderly and infirm victims. But his victims were as young as 21, and some were not terminally ill, according to a 2006 Inquirer report.

Today, Cullen, 62, is in New Jersey State Prison in Trenton, where he is serving 18 consecutive life sentences. His earliest possible parole date would be June 2388.

Now, Cullen’s story is a feature film. Netflix’s The Good Nurse hit the streaming service Wednesday. Based on author Charles Graeber’s 2013 book of the same name, the film stars actor Eddie Redmayne as Cullen and actress Jessica Chastain as nurse Amy Loughren, who was instrumental in ending Cullen’s killing spree.

A fictionalized account of Cullen’s story, The Good Nurse focuses mostly on the months just before his arrest. The Inquirer reported on Cullen during his trial, uncovering details about his history and murders, as well as the fallout in Pennsylvania and New Jersey. Here is what you need to know:

Born in 1960 and raised in West Orange, Cullen dropped out of high school in 1978 before joining the Navy. After he was discharged, he graduated from Mountainside Hospital Nursing School in Montclair in 1986.

The following year, Cullen started his nursing career in the burn unit of Saint Barnabas Medical Center in Livingston. In June 1988, he committed his first murder at that hospital by injecting Municipal Court Judge John W. Yengo Sr., 72, with lidocaine, causing his heart to stop, according to an Associated Press report.

Cullen left Saint Barnabas in 1992 as the hospital was investigating a rash of contaminated IV bags, and went to Warren Hospital in Phillipsburg. There, he killed three women with overdoses of digoxin before moving to Flemington’s Hunterdon Medical Center in 1994, and Morristown Memorial Hospital in 1996, The Inquirer reported in 2003.

In 1998, Cullen crossed the Delaware River into Pennsylvania, where he worked at several Lehigh Valley-area medical facilities, including Liberty Nursing & Rehabilitation Center, Lehigh Valley Hospital, and Sacred Heart Hospital in Allentown, as well as Easton Hospital in Easton, and St. Luke’s Hospital in Bethlehem. Cullen is known to have killed seven people in Pennsylvania by 2002.

In fall of 2002, Cullen returned to New Jersey to work at Somerset Medical Center, where he killed a majority of his known victims. One murder there, that of the Rev. Florian J. Gall, 68, in 2003, resulted in Cullen’s arrest, and launched the investigation that led to his 2006 conviction. In total, Cullen confessed to and was convicted of killing 22 victims in New Jersey.

“Maybe some days he actually believes he was an angel of mercy,” said Dolores Stasienko, daughter of 89-year-old victim Giacomo Toto at Cullen’s 2006 sentencing. “Let us correct that: He was a demon from the lowest depths of hell. Burn in hell, Mr. Cullen, for all eternity.”

At the time of his arrest, Cullen had been fired from four of his previous seven jobs, The Inquirer reported in 2003. Several hospitals reportedly fired him for poor performance, and one let him go over accusations that he gave drugs at unscheduled times. Sacred Heart, meanwhile, terminated him after 16 days “because he could not get along with the staff,” according to an Inquirer report. He was investigated at least twice, including once for patient deaths, and another time for theft of medication.

Cullen also had a tumultuous personal life, going through what The Inquirer described as a “bitter divorce” in the 1990s before declaring bankruptcy in 1998. He was hospitalized at least three times for depression and suicide attempts in the decade before his arrest.

Despite his career and personal issues, Cullen continued to find employment — primarily because confidentiality rules and the fear of lawsuits prevented hospitals from learning about his history. Cullen had not been convicted of a crime or disciplined in New Jersey or Pennsylvania, so his record appeared clean. As the Inquirer reported in 2003, hospitals couldn’t find out if potential employees were the subject of a complaint or criminal investigation unless they resulted in charges.

As then-New Jersey Sen. Jon Corzine put it in 2003, with Cullen’s record, “you would think the system would be able to put together that this was a troubled individual.” Not doing so, Corzine and fellow New Jersey Sen. Frank Lautenberg said, was “a complete and utter failure of the healthcare system.”

Cullen worked out a plea deal with prosecutors in which he would help investigators identify victims in order to avoid the death penalty, and pleaded guilty in 2004.

Cullen operated under that agreement until late 2005, when he sought to donate one of his kidneys to a relative of a friend on New York. Prosecutors said Cullen could not do so until after his sentencing, and postponed a sentencing hearing indefinitely to investigate additional suspected murders in his case.

Cullen, angered by the postponement, said he would no longer cooperate with police, and tried to avoid appearing for sentencing, according to a 2006 Associated Press article.

“We don’t care if Charles Cullen donates a kidney to anyone,” said New Jersey Attorney General Peter C. Harvey. “He’s either going to die in jail or pursuant to the death penalty. It doesn’t matter to us.”

Cullen ultimately relented, and was sentenced in March 2006. Victims’ relatives called him “a demon, a coward, a monster, a waste of life” and “Satan’s Son,” according to an Inquirer report. Cullen never looked at them, and appeared to be asleep at the defendant’s table.

While nearly silent during two years’ worth of court appearances, Cullen became frustrated at a later sentencing in Lehigh County court. There, he accused the judge of bias for granting a newspaper interview, and repeated the phrase “Your honor needs to step down” more than 500 times — even after he was gagged with a cloth and several pieces of duct tape. He did not explain or apologize to victims’ family members, and closed his eyes while they read victim impact statements.

“It represented his effort not to be present at the time of sentencing,” Cullen’s Pennsylvania public defender Gary Asteak said. “It showed a lack of dignity on his part.”

Cullen later donated his kidney to “a dying New York man,” as the Associated Press put it, in August 2006. Surgery went well and his kidney was “a perfect size because Cullen is so healthy,” his New Jersey public defender Johnnie Mask told the Newark Star-Ledger. He returned to prison later that month.

In 2008, families of Cullen’s New Jersey victims reached a confidential settlement with several New Jersey hospitals, as well as St. Luke’s in Bethlehem, which had failed “to warn Somerset Medical Center to hire Cullen,” according to the Associated Press.

Two years later, eight families filed a wrongful death lawsuit against Cullen in Lehigh County court. Cullen was not charged in the deaths of the patients named in the suit, but the families claimed their loved ones were among the dozens of patients Cullen killed. All eight patients died at St. Luke’s.

In March 2010, a jury awarded the families $95 million in damages after Cullen failed to mount a defense. The damages, the Associated Press reported, would allow the families to collect the money if Cullen ever decided to sell his story. Court documents indicated that Cullen had no money to pay at the time.

Cullen’s case also resulted in policy changes in Pennsylvania and New Jersey. In 2005, then-Gov. Ed Rendell signed legislation that protects Pennsylvania employers from being sued over work histories they disclose about current or former employees, largely as a result of the Cullen case. New Jersey, meanwhile, passed a so-called “Cullen Law” that requires state healthcare entities to report misconduct, incompetence, and negligence to the New Jersey Division of Consumer Affairs.

“We are hopeful that this bill will result in hospitals gaining access to information about whether a prospective employee was investigated for a crime,” Somerset Medical Center said in a statement following the bill’s passage, “and ensure that they do not unwittingly hire a healthcare professional with a questionable history like Charles Cullen.”