Name some famous serial killers?

1
Name some famous serial killers?

• Jack the Ripper
• Jeffrey Dahmer
• John Wayne Gacy
• Ted Bundy

2
Do You Know?

• Jack the Ripper (7)
• Jeffrey Dahmer (31)
• John Wayne Gacy (33)
• Ted Bundy (20)

3
Harold Shipman, M.D.
4
Graph showing death rates by physicians
5
Why dont we know these names?

• Harold Shipman, MD
• Michael Swango, MD
• Michel Pettiot, MD (63 murders in 1940s)
• John Adams, MD (40 murders in 1950s)
• Orville Majors, Donald Harvey, Genene Jones,

6
First Exposure

• 22 y/o mother of 4 transferred after 19 days at
  another hospital
• Initially, 2 week N/V/D, cough, rash, weakness.
• Was pancytopenic, pneumonia ascending peripheral
  paralysis
• Day18 seizure and ventricular fibrillation
  (Torsades de pointe)
• Multiple episodes VF, /- response to lidocaine
  and Mg2.
• Neuropathy worse

7
Case continued

• Neuropathy worse, needs ventilator to breath
• D 54, family priest comes in with story of
  confession about arsenic-laden OJ given to
  patient at party.
• Testing yielded normal urine but severely
  elevated hair levels in a pattern that suggested
  acute-on-chronic exposure
• 1984 - while a resident on Dr. Baumans
  cardiology rotation.

8
CHICAGOS POISONING HISTORY

• Johann Hoch - The Stockyards Bluebeard
• 1892-1905 murdered 12 of 24 wives with arsenic.
  Collected assets. Hanged 2/23/1906
• HH Holmes
• Dr Holmes built a drugstore empire based in
  SouthSide of Chicago. Remains of gt 200 people
  found in his castle. Spree lasted from 1893-1896.
  Considered the first sensational crime trial in
  American crime history
• The devil and the White City
• Tille Gburek
• Chicago psychic, known for predicting exact
  date of 5 husbands and 3 neighbors deaths -
  arsenic

9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
MODERN CHICAGO

• Tylenol murders
• 9/29-10/1/82, seven deaths from cyanide-laden
  Tylenol capsules
• Never solved, appears purely random act of
  poisoning
• After publicity of case, following month had 270
  reports of product tampering, 36 were proven true
  in the U.S.
• Lead to development of two innovations
• Dosage form?
• Packaging?

13
(No Transcript)
14
CHICAGO Summer 2002

• July- 12 y/o severe Cerebral palsy, non-diabetic,
  found unresponsive by family member (no family
  member was diabetic, EMT found glucose 0
• Multiple D50Ws and dextrose infusions over next
  16 hours to maintain glucose of 40-60
• Blood insulin 400 (20 x nl), no c-peptide
• 9/9/02 67 ovarian cancer with mets, presents
  with A fib. Admitted to CICU. Digoxin 0.25 iv
  ordered, 2.5 mg given experienced RN (?)

15
ILLINOIS HISTORY

• Michael Swango (30) 00-Swango
• Born 1974 Quincy
• Medical school at SIU didnt graduate
• 1984 Quincy paramedic - co-workers always got
  sick when he brought doughnuts, soda, iced tea
  (Ant poison Arsenic found mixed with sugar in
  home. Charged and convicted aggravated battery 5
  yrs prison.
• Lied about graduation and licensure, worked in
  hospitals in 5 states (inc Harvard) and Zimbabwe.
  Always large number of deaths noted during his
  duty
• Blind Eye by James B. Stewart

16
Toxicomaniacs

• Michael Swango
• Helene Jegado 1800s (23)
• arsenic to families she worked as maid for.
• Jane Toppan (31)
• Boston 1840s, private nurse with special
  cocktails except too many died
• Graham Young
• 1980s. 2 deaths, many poisonings, many
  compounds.On arrest enough poison to killgt 300 in
  home
• Young Poisoners Handbook movie

17
(No Transcript)
18
Mercy Killers

• Nurses
• K Gilbert (4) 96-7 NC epinephrine
• Richard Diaz (12) CA succinylcholine
• Orville Majors (70-130) 1993-5 Indiana epi, KCL
• Don Harvey (37-80) 1970-1987,
• Edson Guimares (5-131) Sao Paulo RN tech KCL, C
  Malevre (4-30 Paris 1997-8) Queen of euthanasia,
  W. Wagner gang Austria (45-200) 1983 MSO4/water
• Others
• E Saldivar resp therapist (50) Glendale
  1989-1997pancuronuim,
• A Nessitt nursing home administrator Norway 22
  curare
• Midwife (36 women) gang, Hungary (80-300 men)
  1914-1929 arsenic

19
U.S. Mercy Killers 1980-1990s

• Nurses, alone or in groups, arrested for 172-240
  suspicious deaths in 7 U.S. hospitals during
  1980s
• 4 Nurses arrested for 123-195 deaths in 1990s in
  4 U.S. hospitals
• Kevorkian? , Philip Nitschke? (Aussie), Christine
  Malevre (French)?

20
Mercy Killers 2000s

• Hungarian Nurse (Black Angel) 30-40
• Dutch nurse 14 deaths mostly elderly or vry
  young children, avidly read biographies on serial
  killers
• Japanese nurse 10 deaths in his care, all
  children (vecuronium)
• Nurse, Texas arrested 7/2002 for 15 deaths 11
  days mivacurium
• West Palm Beach nurse used propofol, charged with
  1 death. Investigating others

21
Extortion

• Usually isolated poisoning, product tampering
  with lawsuit against manufacturer desired result.
• Australia 1999 - Dennis Donald Fountain arrested
  for lacing strychnine into tampering OTC
  painkillers, three people hospitalized.
• Companies pulled product off shelves, est 72 M
  lost revenue
• Then threatened two manufacturers he would use
  their product next for 1 M in cash

22
Pharmacist Poisoners?

• No known current (at least to me)
• Closest thing to it The non-Poison killer,
  Robert Courtney
• Kansas City MO, pharmacist caught by sales
  representative who was reviewing billing ordering
  records for chemotherapy
• He was diluting products Gemzar and Taxol

23
Nanjing China

• At least 40 dead (up to 100)
• Breakfast shop serving middle school kids and
  migrant workers
• Rival shop owner contaminated food with tetramine
  (banned rodenticide since 1991)
• At least 150 dead over past 12 months in similar
  events

24
(No Transcript)
25
CURRY POISONINGS

• 1998 - 4 deaths and 63 ill after eating food at
  picnic. Arsenic found in curry.
• Two years to find suspect
• In interim over 40 copycat poisonings and product
  tampering events in same year.
• Cyanide laced Coke, disinfectant
• Repetitions (poison pizza) continue in Japan

26
(No Transcript)
27
Curry Poisoning (cont)

• Masumi Hayashi 37 y/o insurance saleswoman
  married to fumigator husband arrested.
• Had sold insurance policies to festival
  attendees, average 11 k.
• Tip was from visitor who got ill after signing
  policy in her home and being given drink and food
  that immediately made him ill

28
Current Food Poisoning (cont)

• 3 arrested in Jerusalem September 2002 for
  plotting to poison customers in Café where they
  worked, targeted pitchers of Coke
• 60 grade school children Joliet Illinois
  hospitalized for food poisoning from eating
  chicken tenders
• Ammonia spill in meat packing plant, product
  already packaged, decided okay to still use but
  sprayed with pesticide first

29
Conclusions

• Malicious poisoning far more common and deadly
  than casual perception
• Healthcare professionals who poison are
  frequently identified by casual epidemiology or
  coworker concerns
• Unusual death rates and or discrepancies in
  stocks for KCL, paralytics, cardiac meds should
  be compared to deaths and work shifts
• Easiest to catch within the in-patient acute care

30
Harold Shipman, M.D.
31
Major internet sites

• Mayhem.net
• Crimelibrary.com
• Karisable.com
• Cybersleuths.com

32
Now this is bioterrorism!
33

• Paloucek_at_uic.edu