A United States judge has agreed to allow New Jersey's worst serial killer to donate a kidney, but the killer and his doctors have to meet conditions.

Judge Paul Armstrong did not say when Charles Cullen might undergo the operation to remove one of his kidneys to be transplanted into the relative of a friend.

Cullen has admitted killing 29 patients with drug overdoses at nursing homes and hospitals in Pennsylvania and New Jersey in one of the worst murder sprees ever discovered in the US health care system. He has been sentenced to 18 life terms.

The judge's order, signed on Thursday, stipulates that all operation costs must be paid by the recipient's insurer.
 
Also, the surgery to remove Cullen's kidney must happen in New Jersey at a hospital certified by the state Department of Corrections, and the doctors who perform the operation must be certified by the state Board of Medical Examiners.

Cullen, 46, had tried for four months to reach an agreement with prosecutors to win permission for the donation.

His lawyer, Johnnie Mask, said the requirements made him "suspicious that someone in the Department of Corrections or at the attorney-general's office does not want this to happen".

New Jersey Attorney General's Office spokesman John Hagerty said the requirements reflect the fact that they are for "a serial killer who is not free to travel willy-nilly".

Cullen claimed to have killed 40 patients over a 16-year nursing career, and has said he killed out of mercy. Not all of his victims, however, were old or very sick.

A nurse who killed at least 29 patients was sent to prison for the rest of his life Thursday after his victims' loved ones angrily branded him ''vermin,'' ''garbage'' and a ''monster'' who ruined lives and shattered their faith in the medical profession.

Charles Cullen escaped the death penalty after making a deal with prosecutors to tell them which patients he killed with hard-to-detect drug injections.

Cullen, 46, pleaded guilty to murdering 22 people in New Jersey and trying to kill three others. He will be sentenced later for seven murders and three attempted murders in Pennsylvania. He has claimed to have killed up to 40 people during a career that spanned 16 years and 10 nursing homes and hospitals.

He received 11 consecutive life terms at a tense hearing in which he came face-to-face with his victims' families for the first time. Wearing a bulletproof vest under his sweater, Cullen sat quietly as relatives wept and yelled at him from a lectern about 15 feet away. Some said they wished Cullen could die as his victims did, by lethal injection.

''I want you to die tomorrow so that you can meet God tomorrow because guess what? There ain't no door out of hell, baby,'' said Debra Yetter Medina, the granddaughter of victim Mary Natoli.

Some had waited years, and defendant Charles Cullen had filed court papers trying to avoid the confrontation.

One by one, for nearly four hours, two dozen relatives of the dead told a New Jersey judge what Cullen had taken from them.

Some called Cullen names -- "Satan's son" or "monster" -- and told him to "burn in hell." Others simply remembered their lost loved ones.

Judge Paul W. Armstrong then handed down 11 consecutive life sentences. Parole is out of the question, since Cullen, 46, will not be eligible until he has served 397 years.

Cullen has pleaded guilty to committing 22 murders in New Jersey and seven in Pennsylvania. He also admitted attempting to murder six people.

Deaths not mercy killings

Cullen administered lethal doses of medication to patients under his care in nursing homes and medical facilities. He claimed at one point that he was an angel of mercy trying to end his patients' suffering.

But the judge rejected that notion. He said the court "would not countenance the characterization of these crimes as acts of human compassion."

Cullen said nothing during the hearing, sitting beside his attorney with his hands in his lap and his eyes lowered. His lack of visible emotion seemed to enrage some relatives of his victims.

They had plenty to say.

Dolores Stasienko called Cullen a monster for killing her father, Jack Toto, whom she described as a hard-working farmer, mechanic and war veteran.

"Burn in hell, Mr. Cullen, for all eternity," she said.

"Am I boring you?" asked Deborah Yetter-Medina, whose grandmother was killed. "Look at me," she demanded.

"Yes, I was the woman who coined the phrase 'Satan's son,'" she said. "You are Satan's son." Later, she told Cullen: "There ain't no doors out of hell, babe."

Richard Stoecker, whose mother, Eleanor, also was a victim, told Cullen: "Maybe you thought you could play God that day by injecting her, but she planned on living, she was a fighter."

As many as 40 victims

As part of his plea agreement, Cullen has been working with law enforcement officials to identify additional victims. He originally told authorities he killed up to 40 patients during the course of his 16-year nursing career.

Last month, when a deal to allow Cullen to donate a kidney to a friend fell through, he filed court papers seeking to waive his appearance at sentencing. (Full story)

The move outraged victim family members, some of whom have said addressing Cullen is an important part of their grieving process.

"He has to hear that we're human beings and that our father, son, mother, whoever, were human beings," said John Shanagher, whose father, Jack, was killed by Cullen. "Hopefully it will give us some sense of justice that it's, after all this time, finally done."

The judge ruled Cullen had to be present for victim impact statments and sentencing. Cullen will be allowed to donate his kidney now that he has been sentenced.

Judge rules that killer nurse can't skip sentencing hearing

Serial killer Charles Cullen must listen to statements by relatives of his victims when he is sentenced for 22 murders, a New Jersey judge ruled Friday.

Cullen, a former nurse, had asked the court to waive his appearance at the sentencing March 2.

The move outraged victims' family members, some of whom said addressing Cullen is an important part of their grieving process.

"He has to hear that we're human beings and that our father, son, mother, whoever, were human beings," said John Shanagher, whose father, Jack, was killed by Cullen.

"Hopefully it will give us some sense of justice that it's, after all this time, finally done," he added.

Superior Court Judge Paul W. Armstrong also ruled Friday that Cullen will be allowed to donate a kidney to a friend after he is sentenced.

Where the organ will be harvested remains an issue. Cullen wants to have the operation performed in New York. New Jersey officials say it must be done in that state.

Cullen has pleaded guilty to murdering 29 hospital patients in Pennsylvania and New Jersey, and attempting to murder six others, with drug injections.

As part of his plea agreement, he has been working with law enforcement officials to identify additional victims. He originally told authorities he had killed up to 40 patients in the course of his 16-year nursing career.

Armstrong ruled Friday that Cullen "possesses no fundamental right" by law to be absent from his sentencing, when the court will hear statements by the victims' families.

Cullen had withdrawn his request, but the judge went ahead with a ruling to prevent Cullen from changing his mind later.

A carefully constructed deal between the authorities and the convicted serial killer Charles Cullen to allow him to donate a kidney to a friend in exchange for showing up at his own sentencing has fallen apart, his lawyer said yesterday.

The authorities had hoped this month to sentence Mr. Cullen, a former nurse who has confessed to murdering up to 40 patients in New Jersey and Pennsylvania. Many relatives of his victims have been waiting for the day they can face him in court.

But that day, once again, seems far off. At a meeting yesterday, New Jersey authorities and Mr. Cullen's lawyer could not agree on the specifics of the kidney donation, and Mr. Cullen will now fight to skip his sentencing, his lawyer, Johnnie Mask, said.

"There is no deal now," Mr. Mask said. "We're nowhere."

Under New Jersey legal procedures, defendants can apply to skip their sentencing. Mr. Cullen initially indicated he would do this, provoking the ire of prosecutors and relatives of his victims.

But in December, Peter C. Harvey, then New Jersey's attorney general, announced that he had worked out a plan in which Mr. Cullen could donate his kidney if he agreed to come to his sentencing first. A memorandum of understanding was signed, and a transplant team at Stony Brook University Hospital on Long Island, where Mr. Cullen's friend is a patient, agreed to do the surgery.

But Mr. Harvey left office in January, after New Jersey's new governor, Jon S. Corzine was sworn in. Officials at the attorney general's office and in the Corrections Department have now decided that Mr. Cullen cannot leave the state for the kidney operation because New Jersey officials do not have the authority to provide security in New York.

Mr. Mask said that prosecutors had yet to come up with a viable plan for the operation to be done in New Jersey. Until they do, Mr. Cullen will do everything in his power, including filing numerous appeals, to avoid his sentencing, he said.

"We're not going to give up what little leverage we have until we know this kidney operation is going to happen," Mr. Mask said. State officials, he said, "have been throwing up roadblocks ever since Harvey left."

John Hagerty, a spokesman at the attorney general's office, said that Mr. Cullen's sentencing has been scheduled for March 2 but that there are issues that could delay that. A presentencing hearing has been set for next week.

Mr. Hagerty said state officials "continue to work with local prosecutors so the sentencing can proceed."

First, he wrangled a way to avoid the death penalty, even though he confessed to murdering up to 40 people. Then, he tried to dictate the terms of his final court appearance. Now, he is refusing to cooperate.

Apparently, Charles Cullen, a New Jersey nurse who confessed to sneaking into hospital rooms late at night and injecting patient after patient with deadly amounts of drugs, is trying to exert his last bits of leverage from a solo cell in the Somerset County jail before he is sent away for life.

His maneuvering is infuriating the families of his victims and delaying their long-awaited rendezvous in court. It is also making a strange case even stranger, partly because of what was, until now, a little-known legal wrinkle in New Jersey that allows defendants to skip their sentencing.

"Can't we just get this over with?" said Lucille Gall, whose brother Mr. Cullen has admitted killing. "This is a sick little game he's playing."

Most of the prosecutors in the case seem unfazed or, at least, they talk that way.

"We don't need him anymore," said Wayne J. Forrest, prosecutor for Somerset County, N.J., where Mr. Cullen confessed to 13 murders. "We've completed our investigation. We got our guilty pleas. We're done."

John Morganelli, district attorney for Northampton County, Pa., where Mr. Cullen admitted killing one patient, said, "I could go to court right now and get a conviction, with or without his cooperation."

But in Essex County, it is a different story. Mr. Cullen told investigators he thinks he killed five patients at a hospital near Newark. The problem is, he does not remember whom. Until recently, he had been meeting regularly with Essex investigators, studying old charts, peering into old photos, trying to jog his memory.

So far, Mr. Cullen, 45, has pleaded guilty to murdering 29 patients in New Jersey and Pennsylvania medical facilities. Most of his victims were old and sick.

After he was arrested in 2003, he agreed to help investigators identify all of his victims - he estimated there were up to 40 - in exchange for avoiding the death penalty.

But the deal began to fray last month, when Mr. Cullen announced he wanted to donate a kidney to an ailing friend. The authorities said he could do it only after his sentencing, which Mr. Cullen threatened to miss.

Many lawyers said that this was the first time they had ever heard of a serial killer trying to skip his sentencing. Earlier this month, prosecutors indefinitely delayed Mr. Cullen's sentencing, saying they needed more time to investigate the Essex cases and one mysterious death in Morris County. A few days later, Mr. Cullen struck back, saying through his public defender that he was finished cooperating.

"This isn't about a power trip, this is about a kidney," said his lawyer, Johnnie Mask. "Charlie's worried that if the sentencing keeps getting pushed back, it may be too late. He really cares about saving this life, ironic as that may seem."

On Friday, Peter C. Harvey, New Jersey's attorney general, said a new possibility had emerged: Mr. Cullen could be sentenced for the crimes to which he had already confessed, he could donate his kidney and then he could continue cooperating with the authorities on any open cases. "Our goal is to bring finality," Mr. Harvey said.

He added that prosecutors were mulling the options. If talks break down, there is an outside chance the plea agreement could be nullified and Mr. Cullen tried in court, exposing him to the death penalty.

What is giving Mr. Cullen his 11th-hour leverage is New Jersey's criminal procedure rule 3:21-4 (b), which says, "Sentence shall not be imposed unless the defendant is present or has filed a written waiver of the right to be present."

Mr. Mask and other defense lawyers say the law is on their side and that precedent upholds a defendant's right to opt out of sentencing.

Prosecutors, on the other hand, say judges have the ultimate discretion and can order sheriff's deputies to drag Mr. Cullen to court. Both sides vow to press their case aggressively, which only raises the specter of a long appeals process.

And now there's another potential complication. Christopher Bateman, a Republican assemblyman from Somerville, is pushing a bill that would force defendants to come to their sentencing. "It's only right that the families get to inflict a little pain, so to speak," he said.

But all the back and forth seems to be only compounding the pain.

"We want to know how Cullen, a criminal, a murderer, thinks he has so much power to decide what he can do and cannot do?" Tom and Mary Strenko wrote in an e-mail interview. "He is a killer and he has no right to decide anything!"

The Strenkos' 21-year-old son, Michael, was hospitalized in 2003 with a serious but curable blood disease. Mr. Cullen has confessed to killing him. "We are not giving up on this! No way!" the Strenkos continued. "It is as important to us as breathing air to have Charles Cullen once again look into our loathing eyes to personally see and hear the pain and suffering he has caused us for the rest of our lives!"

The New Jersey nurse who confessed to killing 29 people and has spent nearly two years cooperating with investigators decided abruptly on Tuesday that he would no longer help them.

The nurse, Charles Cullen, 45, was so upset about his sentencing being canceled last week that he is pulling out of a carefully constructed plea deal in which he had agreed to help identify his victims in exchange for not facing the death penalty, his lawyer, Johnnie Mask, said.

The authorities said that his refusal to cooperate could mean that prosecutors will seek the death penalty. It could also mean that many mysterious hospital deaths will not be resolved, leaving family members to forever wonder if their loved ones died naturally or were murdered.

Mr. Cullen has told the authorities he killed up to 40 people, many of them old and ailing patients whom he injected with lethal doses of heart drugs. But he did not remember all their names. So investigators have been struggling to identify them and, until Tuesday, were working closely with Mr. Cullen, sifting through mountains of medical records in the effort to jog his memory to determine exactly whom he killed.

The cooperation may now be coming to an end because of a kidney. In a strange concession to coax Mr. Cullen to come to his own sentencing and face dozens of grieving family members, New Jersey authorities agreed in December to allow him to donate a kidney to an ailing friend, as long as the operation was performed after his sentencing. But last week the authorities delayed the sentencing indefinitely, saying they needed more time to investigate hospital deaths in Morris and Essex Counties that Mr. Cullen may have caused. Mr. Cullen lost his patience, his lawyer said, and decided he would no longer help investigators.

"The deal is off," Mr. Mask said. "He's done. No more cooperation. Period."

"Now it's on the prosecutors' shoulders whether somebody else dies," Mr. Mask added, referring to the man who is waiting for a kidney donation.

Peter C. Harvey, New Jersey's attorney general, called that notion "ridiculous" and said it was not the prosecutors' role to find a new kidney for Mr. Cullen's friend.

"Our job is to protect the victims," Mr. Harvey said.

He also said, "It's strange that all of a sudden this guy has become a humanitarian after killing 22 people in New Jersey."

Paula T. Dow, the prosecutor for Essex County, where Mr. Cullen has admitted to killing several people, said Mr. Cullen's refusal to cooperate was "a clear breach of the plea agreement" and that "it now exposes him" to being brought back to court to face trial and possibly the death penalty.

But the reality of his ever being executed, at least in New Jersey, is slim because the state has not put anyone to death since 1963, and this week the Legislature passed a temporary moratorium on capital punishment. However, Mr. Cullen has admitted to seven murders in Pennsylvania, which does have the death penalty.

The authorities said on Tuesday that they were not sure if Mr. Cullen's action was a ploy to speed up donation of the kidney, or if he truly intended not to cooperate ever again. They added that they were unsure of what they would do next.

The development was the latest twist in a long case that began in 1987 at St. Barnabas Medical Center in Livingston, N.J. Mr. Cullen had a history of mental illness and suicidal behavior and gravitated to the night shift, where he was known among colleagues as solitary and strange, with a cold bedside manner.

In 1993 he was accused of killing a 91-year-old woman with a single injection of digoxin, a powerful heart drug that became his weapon of choice. But somehow he slipped through the cracks of the medical system and went on to work at 10 places in New Jersey and eastern Pennsylvania before he was arrested in 2003.

In 2004, he struck a deal with the authorities in both states to plead guilty and cooperate in exchange for at least two consecutive life terms, which in New Jersey meant he would not be eligible for parole for 126 years. But in December, as sentencing approached, problems arose, partly because of a little-known procedural rule that allows a defendant to skip his sentencing. Mr. Cullen said he might do that and deny his victims' families a chance to confront him.

Now it is not clear what will happen, with some prosecutors saying Mr. Cullen will be dragged into court, no matter what, while others are not so sure.

Romero’s sister, Catherine Dext, was killed with an injection by the former nurse and admitted serial killer in June 1996 at Hunterdon Medical Center, where she had been admitted with a ruptured spleen.

A sentencing hearing is scheduled to begin Thursday for Cullen, who pleaded guilty to 29 murders and six attempted murders during his 16-year nursing career in New Jersey and Pennsylvania.

Cullen, 44, has told investigators he might have killed as many as 40 persons, but authorities say that estimate appears to be inflated. Most of the victims were given an overdose of heart medication, usually digoxin.

The former critical-care nurse was able to move from hospital to hospital, despite suspicions he was killing patients, because the institutions did not report their fears to authorities.

The sentencing may stretch out over two days because so many victims’ relatives want to give victim-impact statements.

Cullen had filed papers to waive his right to appear at his sentencing, a move that outraged many of the families.

However, authorities had something Cullen wanted: the right to approve his request to donate a kidney to a relative of Cullen’s ex-girlfriend. With that leverage, authorities persuaded Cullen to agree to appear at the sentencing.

Cullen faces life for each of the New Jersey murders, and won’t be eligible for parole for at least 127 years. In exchange for his plea and agreement to help identify his victims, he escaped New Jersey’s death penalty.

State Attorney General Peter Harvey said he hopes to have all 22 New Jersey cases against Cullen resolved in this week’s sentencing. However, the sentencing could be postponed if no decision is made on whether to also bring charges in several open cases in Essex and Morris counties.

He also escaped death in Pennsylvania, where he still faces sentencing.

A judge there already has ordered him to be present.

Former nurse Charles Cullen, who admitted murdering at least 29 patients in the Lehigh Valley and New Jersey by injecting them with lethal doses of drugs, wants to donate his kidney to save a life.

Cullen has asked prosecutors to allow him to travel to New York so doctors can perform the surgery, his attorney said Tuesday.

Johnnie Mask, Cullen's public defender, said prosecutors have agreed to let Cullen undergo the operation in New Jersey, but not travel to New York for it.

''I don't know what the objections are'' to doing the surgery in New York, Mask said. ''Security and expense have always been thrown up as an obstacle.''

Doing the transplant in New Jersey would mean a new transplant team and months of additional tests, he said.

In exchange for permission to give the kidney in New York, Cullen is willing to appear in court when he is sentenced to life in prison, Mask said.

''We're pushing prosecutors to do the operation in New York because the [potential recipient] doesn't have seven months to wait,'' Mask said.

Mask would not identify the intended recipient of the kidney, but The Star-Ledger of Newark, citing unnamed sources, reported in Tuesday's newspapers that it is a relative of Cullen's ex-girlfriend.

The man is in his 30s, a father of four and in poor health, Mask added. He lost kidney function as a result of infection.

Mask said the request for a kidney came about two months ago.

''Initially, some parties opposed the whole thing on the basis that Cullen could die on the table,'' he said.

Cullen, formerly of Bethlehem, had previously filed papers to waive his right to appear in court for the sentencing — an action that had enraged relatives of his victims, who want to confront him one more time.

At one point after Cullen's 2003 arrest, Mask said Cullen wanted to be able to explain his actions to his victims' survivors. But his position changed, Mask said, because the victims' families and victim-rights groups have been hostile.

By appearing at a sentencing, Cullen could answer at least some questions about his crimes.

Mask said he hopes to get an answer in the next few weeks on the transplant and any deal related to Cullen's appearance at the sentencings, which could come in the next few months.

Somerset County Prosecutor Wayne Forrest would not comment Tuesday on the transplant offer or the deal Cullen has proposed.

In a series of court appearances in northern New Jersey and the Lehigh Valley, Cullen has admitted to 29 murders and six attempted murders over the course of his 16-year nursing career. In the latest plea Monday, he admitted to attempting to kill Somerset Medical Center patient Philip Gregor in 2003.

There could be more pleas in the future, though authorities and Mask agree that the investigations are winding down.

Cullen was arrested in December 2003 and charged with the murder of a patient at Somerset Medical Center and the attempted homicide of another. The next year, he pleaded guilty and agreed to help authorities determine exactly whom he killed in exchange for avoiding the death penalty.

In a proceeding lasting less than 10 minutes in state Superior Court, Cullen, 45, a former nurse, admitted before Judge Paul W. Armstrong to attempting to kill critical care patient Philip J. Gregor of South Bound Brook with an overdose of insulin on June 18, 2003.

"Yes, I did," said Cullen when asked by Assistant Prosecutor Timothy Van Hise if he had administered the insulin to the patient without a doctor's orders. "To cause his death" was Cullen's reply when he was asked why.

The answers have become increasingly rote for Cullen, who has pleaded guilty to killing 29 patients at hospitals in five New Jersey and two Pennsylvania counties and attempting to kill five more between 1988 and 2003.

"News of every heinous act he committed to a patient in his care still shocks and saddens us," said hospital spokeswoman Vicky Allen.

Cullen, shackled and clad in mustard-colored prison scrubs, was brought to the courtroom from the Somerset County Jail in Somerville, where he is being held pending his transfer upon sentencing to a maximum security prison.

He has appeared increasingly gaunt since his arrest and arraignment following a series of suspicious deaths at Somerset Medical Center in December 2003.

Compared with Cullen's earlier appearances, the courtroom was almost empty. although Gregor's widow and sister were present, they declined to comment. "When he's sentenced, I'll have a whole lot to say," said Linda Gregor.

Cullen's plea was part of an April 29, 2004, plea agreement in which he was spared the death penalty in exchange for cooperating with investigators in identifying victims. Investigators have since been reviewing files with him.

Nurses who worked with serial killer Charles Cullen at a Pennsylvania hospital apparently warned authorities long before his arrest that he was suspected of killing patients.

That's according to a report today in The Morning Call of Allentown.

But Lehigh County District Attorney James Martin says there just wasn't enough evidence at the time to prosecute Cullen for anything.

And the forensic pathologist who investigated agrees.The pathologist reviewed 26 cases of patients who died while Cullen was working at Saint Luke's Hospital in Bethlehem.

He says the only evidence beyond "vague suspicions" was medical histories of people who died -- but who were already very sick.

After leaving Saint Luke's, Cullen worked at Somerset Medical Center in New Jersey, where he has admitted killing patients.

The state's worst serial killer is offering authorities tips on how to thwart people who want to follow in his footsteps.

Killer nurse Charles Cullen met for eight hours over two days this week with state Attorney General Peter Harvey, who wanted to find out how to prevent future murders by medical professionals.

Cullen, who says he may have killed as many as 40 patients in New Jersey and Pennsylvania by injecting them with lethal doses of drugs, told Harvey that tracking who takes medications from dispensaries could prevent hospital workers from killing patients.

"He believes that the best deterrent is the certainty of detection," Harvey told The Star-Ledger of Newark for Friday's newspapers. "Using more video surveillance. Using a swipe card that would allow hospitals to easily track who is withdrawing what medication. These are security controls that can be placed on rooms that house medications."

Thus far, Cullen has pleaded guilty to murdering 24 patients and attempting to kill five others

The meetings Wednesday and Thursday were part of what Cullen agreed to last year when he promised to cooperate with law enforcement authorities in return for avoiding the death penalty. Harvey said he plans to speak again with Cullen.

"Once we complete our discussions with him, we are going to compile a series of recommendations that we're going to give to the Board of Medical Examiners and the nursing board with suggestions of how to better protect patients and hospitals," Harvey said. "We're going to ask for their input and action."

Cullen, a former registered nurse, worked at hospitals and nursing facilities in New Jersey and Pennsylvania over a 16-year career.

Harvey said the 45-year-old Cullen showed some remorse _ an emotion that he has not displayed in court.

"He accepts more responsibility than he expresses remorse, but he certainly does both," Harvey said. "I didn't expect it."

The children of a former Madison resident say they have compelling proof that Charles Cullen, serial killer nurse, killed their father with massive doses of digoxin in January 1997 at Morristown Memorial Hospital.

Lynn Popelka of Netcong and Wayne Sarrow of Readington Township paid to have the remains of their father, Henry Sarrow, disinterred from Saint Vincent’s Cemetery in Madison in February and examined, they said on Wednesday, April 13, at the office of their attorney, Anthony J. Macri of Denville.

Cullen, who is in the Somerset County Jail, denies killing the retired postal worker while he worked at Morristown Memorial from November 1996 to August 1997, according to the Morris County Prosecutor’s Office. He has admitted to killing 24 patients, from 1988 to 2003, but none at Morristown Memorial, authorities said.

So far, Popelka and Sarrow have sued Morristown Memorial, alleging wrongful death and negligence, said attorney Macri, who added that he expects “a long fight.”

Macri said that autopsy reports have been sent to the Morris County Prosecutor’s Office, an office the siblings claim was unresponsive to past concerns that Cullen was responsible for their father’s death.

Autopsy Results

Henry Sarrow had been admitted to Morristown Memorial on Jan. 9, 1997, because of shortness of breath, and on Jan. 15 he suffered a fatal heart attack, which the family said was not expected. He was 77.

When Mr. Sarrow’s remains were analyzed after the February exhumation, they were found to have digoxin levels of 230 nanograms per kilogram, when a normal level should be 2 nanograms per kilogram, according to Macri’s office.

The levels of digoxin, a heart medication, found in Mr. Sarrow’s body were 125 times the amount that would be found in someone who was being given therapeutic doses, the family and its attorney assert. Such a scenario would fit Cullen’s preferred method of killing – administering overdoses of digoxin.

Mr. Sarrow had worked as a school crossing guard for the Madison Board of Education after his retirement as a postal worker.

Recognized Nurse

After Cullen was arrested in 2003 on charges that he administered a lethal overdose to one patient and attempted to murder another at the Somerset Medical Center, Popelka reportedly recognized Cullen from news photos as a nurse at Morristown Memorial during her father’s hospitalization.

According to attorney Macri, hospital records show Cullen was on duty during overnight hours before two cardiac episodes Mr. Sarrow suffered at Morristown Memorial, the second one fatal.

Cullen is reviewing records from hospitals where he worked, including Morristown Memorial, cooperating with authorities in exchange for a waiver of the death penalty. He is expected to be sentenced to multiple life terms in prison.

CULLEN scans medical files to determine if any patients were his victims.
Life in the Somerset County jail is a little like life aboard the USS Woodrow Wilson, the submarine where Charles CULLEN spent months isolated in the deep waters of the Atlantic. In jail, CULLEN has limited space, a bunk to sleep in, and three square meals served with military precision. He has reading material, time on his hands, and no place to go: the cold steel walls of the sub (where CULLEN developed an interest in nursing by helping to inoculate his shipmates) have been replaced by the cold stone walls of justice.
The only times serial killer Charles CULLEN leaves the jail is to travel to various county courts to admit he murdered patients at the 10 medical facilities where he worked in New Jersey and Eastern Pennsylvania. CULLEN claims to have killed as many as 40 patients during his 16-year career.
CULLEN has made five such trips so far, pleading guilty to killing 24 patients and attempting to kill five others by injecting them with various medications that he stole from the hospital's drug supplies. There will be others.
In exchange for his cooperation and guilty pleas, authorities waived the death penalty and CULLEN instead must serve at least 127 years in a New Jersey state prison before he is eligible for parole. For now, CULLEN will remain inmate No. 71533 in the Somerset County jail, on the corner of Grove and High streets in Somerville and across from the prosecutor's office where he first admitted his deep, dark secret to detectives after being arrested last December.