I am the retired special agent in charge of the US Department of Veterans Affairs OIG. There are a number of ongoing cases in the news about doctors and nurses who are accused of murdering their patients. I am the coauthor of Behind The Murder Curtain, the true story of medical professionals who murdered their patients at VA hospitals, and how we tracked them down.

Ask me anything.

Photo Verification: https://imgur.com/CTakwl7

Comments: 2508 • Responses: 62  • Date: 

OkBoat3436 karma

How on earth did you find yourself doing this for a living?

bts18114868 karma

After the successful investigation of Dr. Swango, I began getting calls from all over the world about these types of cases. The most recent one in Germany where a nurse killed over 100 of his patients

VonDub1249 karma

3 or 4 years ago a case about an anesthesiologist blew up in northern Italy. Did you get call for that case too?

bts18111635 karma

I did not. Italy for some reason has had more than its share of cases. Goggle it and you will see some interesting ones

the-ATM-machine91 karma

A similar thing happened in Woodstock, Ontario, Canada where a nurse was killing patients in an old age home. Did you look into that one by chance?

bts1811206 karma

No, but I fear that nursing homes have been the scene of much fowl play

StackinStacks2775 karma

What has stuck with you the most throughout your career?

bts18114767 karma

The ability of these killers to convince staff and patients families that they were actually competent caring professionals

bluemitersaw1217 karma

How close does these Dr's mentalities, attitude, and mode of operation align with some one like Dr Larry Nassar. He's the Dr who molested hundreds of young girls over decades by convincing every one he was doing legit therapy.

bts18111667 karma

That's an interesting question I would have to leave to the psychologist. Dr. Nassar, although not a murderer, certainly is someone who should remain in jail for many years

LifeIsDeBubbles147 karma

Do you think they're any different though than other "charming" serial killers like Ted Bundy?

bts1811202 karma

I think is a good comparison, yes

thxxx13371212 karma

Is there any clues that all these cases have in common?

bts18112960 karma

Many of these murders suffer from Munchausen Syndrome by Proxy. They intentionally harm a patient, call a code, and then try dn play the hero to revive them to impress their coworkers.

BuildItMakeIt21 karma


bts181148 karma

It varies from institution to institution

slartbarg1118 karma

What policies do you think could be implemented to help prevent cases like these in the future?

bts18111996 karma

I have detailed 26 red flags in my book. It is important for medical centers to track death rates by ward and caregiver.

shinecone892 karma

Do you get the sense that people who kill while in these authoritative/caretaking positions were always predators and got into the medical field to find vulnerable people? Or something happens after they get into their career to turn them?

Also, I'm sure you've worked with other kinds of crimes/criminals- do these people who prey on the ill and vulnerable feel more sinister to you, or do you just see a criminal as a criminal?

bts18111061 karma

I think, as a group, with exceptions, most do not start killing until they are in a hospital setting. They prey of the trust of their coworkers and the victims families to escape investigation and conviction. The most sinister of crime imaginable.

RamOmri782 karma

What are your thoughts on euthanasia? With the patient's consent of course.

bts18111124 karma

I am a supporter

eye_spi322 karma

What about when the patient consents but the law itself disagrees?

bts1811783 karma

You have to follow the law

technicolored_dreams727 karma

Has your career made it difficult for you to trust medical professionals and hospitals?

bts18111885 karma

No, because the overwhelming majority are very hardworking dedicated professionals

Jackrwood666 karma

Were any of them surprised when you caught them?

Have you caught any of them in the act?

bts18111132 karma

Never caught any in the act. They are not surprised because they know its only a matter of time until it happens

DLGroovemaster152 karma

So interesting. How messed up is their thinking that they know that they are going to be caught yet continue to do it? I wonder whether they are relieved, sad, glad, when they are caught?

Could it be like the ultimate 'high' for them? The thrill of getting caught, the ecstasy of getting away with it?

bts1811159 karma

Good question, I hope that is asked to the psychiatrists at the conference

TurboEntabulator453 karma

Can you tell us some details or a short story about your smartest offender that you caught, and how you caught him/her?

bts1811730 karma

Not sure I would use the term smart, perhaps the luckiest wasDr. Michael Swango who killed people in both the USA and Africa. He was able to get away with murder for about a decade until he was finally convicted for killing 3 veterans on Long Island. These cases take years to resolve and are very complicated. Require a team of medical and legal professionals to do the investigation

ggbrown74374 karma

Exactly how do you track them down?

bts1811995 karma

It usually beings with statistics....every time nurse Jones is on duty, the death rate goes up, Nurse Jones taels a vacation the death rate goes down

ggbrown74162 karma

So what is your title. Are you a police officer or a special agent? What agency is it that employed you since you worked for the VA? I'm assuming Government.

bts1811378 karma

I served as the Special Agent in Charge of the Northeast Field Office of the Veterans Affairs OIG. Retired in 2005 and now work as a private investigator

heroinsteve31 karma

So how often is someone investigated and it turns out they have a higher death rate for unintended reasons? Incompetence or awful luck? I imagine if every dr was absolutely morally perfect you would still have some who are outliers with higher death rates.

bts181155 karma

Correct, that is why statistics alone will never convict anyone of a crime

SuperBex285 karma

Do you have to interview the families of the fallen victims? I imagine it could help corroborate the notion that they wanted to live.

If yes, can you describe how that goes? Do they ever freak out or tell you to drop it because it’s too hard reliving it?

bts1811435 karma

The families for the most part have been nothing short of terrific. It is of course shocking but they appreciate what we are doing to bring these murderers to justice

estefaniah258 karma

I know that with serial killers they liked to collect trophies from the people they killed. What is the weirdest trophies you’ve ever seen these people collect?

bts1811558 karma

In Italy, a nurse took selfies with herself and the patient after she murdered them

mattiaKbah199 karma

Weirdest case? Hardest one?

bts1811399 karma

Hardest one..Nurse Richard Williams indicted for killing 13 veterans but never convicted. The charges were dropped as a result of problems with the toxicology

crossfitjill112 karma

Was the case thrown out by the judge? Or did a jury not convict? Was this even in the US?

bts1811274 karma

Nurse Williams was a nurse at the VA hospital in Columbia Missouri. The prosecutor dropped the charges after the toxicology proved inconclusive. A decision I opposed but accepted begrudgingly.

FleecyRhombus174 karma

Have you found the criminals to be remorseful in their actions or did they some how justify themselves?

bts1811423 karma

They are never remorseful about what they did, only about getting caught

Ben__Diesel173 karma

Feel free to answer any of these questions.

  1. Do you have any opinion on Dr Christopher (Death) Duntsch?

  2. What was your background in medicine or healthcare before you started investigating violence by healthcare practitioners?

  3. After everything you've learned over the years, what changes would you like to see to the way healthcare is provided (such as practitioner oversight; systems to report problematic practitioners)?

bts1811221 karma

I don't know anything more about the Duntsch case than what I have read in the news so I'm inclined to wait to more of the fact surface. I did not have any medical background but was fortunate to work with the of the greats including Dr. Michael Baden.
One of the great things to come from the Swango case was a huge increase in the amount of resources provided to medical credentialing to prevent someone like him from ever practicing again. I think there are good strides being made but there is still room for improvement.

thepipesarecall45 karma

There’s a great podcast you should check out if you’re into podcasts, called Dr. Death. It’s all about Christopher Duntsch.

bts181175 karma

Thanks I will. You can select a few podcasts that I have been on at www.behindthemurdercurtain.com

bj_good23 karma

Thank you. I will look into these. One of the difficulties with the case of Christopher duntsch was the fact that neurosurgery is inherently difficult and risky. As is any surgery I would imagine - I am not in the medical field.

Given that, how difficult is it to get convictions for doctors who do things like this?

bts181142 karma

Extremely difficult and time consuming for a team of investigators, prosecutors, forensic pathologists, toxicologists and forensic nurses

PaperHanger83144 karma

What was the case that bothered you the most?

bts1811363 karma

Paul Kornak but veterans into medical research by altering their medical records to show they were eligible for experimental drugs when in fact they were not...A number died as a result

shesagoatgirl141 karma

Broad question, but what are the biggest red flags that a medical professional is intentionally murdering patients?

bts1811304 karma

I've listed 26 in my book, but it usually starts with statistics. The death rate is highest when a particular nurse of physician is on duty, that the patients deaths were not expected by staff or family, the patients died during a code, usually around 3:AM, sometimes the patients were unruly to staff, and there are many others

mypacheckisspent133 karma

What made you get into this line of work?

bts1811357 karma

Watching too many Columbo Crime shows on TV

jacxy193 karma

But did you ever invite a suspect to an interview with the line "There's just one more thing..."

bts1811329 karma

Funny, I think I actually did

rain_off117 karma

Have you cought any serial killers?

bts1811241 karma

Michael Swango, Kristen Gilbert and Charles Kornak

iH8ToW8butDontW8ToH877 karma

Thirst to catch another?

bts1811202 karma

I must confess yes. I do enjoy provided suggestions and guidance to police departments involved in these cases

el_muerte2897 karma

Do these people join the medical profession so they can enact their deeds?

Do they show/have tendencies common amongst serial killers, such as animal abuse when younger?

bts1811197 karma

Many of them do have the common traits like animal abuse or setting fires, but many do not. I believe that most did not enter the profession with the intent to kill but events in their life and their psychological make up cause them total advantage of the ability to easily kill and get away with it

ValidatingUsername70 karma

Are there any tip lines available to help those who were potentially targeted?

bts1811202 karma

Always have a advocate with you in the hospital. Someone who politely and respectfully records and questions what treatments you are receiving. Its much easier to victimize someone who is alone

wilyamn57 karma

How often did you have to suppress your gut feeling and did you ever regret doing so?

bts1811149 karma

Gut feelings are important but not enough to convict anyone. You need solid proof which is very difficult to obtain in these cases

obeythewafflehouse56 karma

How do you get started on a case? Like is there a history where's the doctors patients keep dying?

bts1811113 karma

It began when I got a call from the Director of Psychiatry at the VA medical center on Long Island that a physician was working there who spent time in prison for poisoning his coworkers...and the rest is history

technicolored_dreams56 karma

How in the world did that person get a medical license or clear background checks to work at the VA? Was he using a false identity?

bts1811100 karma

That is the question that I asked when I first heard he was working at the VA. Yes he did change his name and supplied bogus documentation that showed he was convicted of only a misdemeanor and his civil rights had been restored by the Governor of his state

riotblade7653 karma

Have you ever found yourself in a situation that they want to murder you as well?

bts181196 karma

I'm sure they thought about it, but never articulated it to anyone

MeanDrGonzo49 karma

Was there motivation beyond simple godlike fantasy?

bts1811142 karma

Donald Harvey was quoted as saying that after he killed the first 15 patients and no one questioned it, he thought he was ordained by G-D to continue murerding

isobane48 karma

I saw your're a supporter of euthanasia, what about so called "slow codes" when it comes to resuscitation of someone who would have no quality of life after being revived? Would you classify the lack of effort put forth to reviving someone who would spend the rest of their life in a coma on a ventilator in the same boat as euthanasia? Or would that be more of a criminal thing?

My grandmother recently passed and, though they COULD have revived her and brought her back, the effort would have only lead to her suffering so I am grateful that they did not.

bts181165 karma

I understand. I don't want to see anyone suffer, but caregivers must follow the law in this regard. I hope the legal systems eventually work out something that is best for the patients and the caregivers

Mistress_Of_Mischeif43 karma

Hi Bruce! My aunt almost died a few years ago because someone was putting meth in her IV. She lost her sight and eventually had to be put in a medically induced coma to help her heal, but the whole ordeal took close to a year for her to get back to her "normal" life.

Nothing ever came of it because the nursing home didn't keep any security logs and didn't have cameras, so the police kind of hit a dead end. I'm convinced it must've been someone working there, because there's no way she could've (immobilized from an infected knee surgery).

Anyway, do you have any recommendations on how to proceed? She ended up footing the months of medical bills that followed, since we could never prove it was negligence or ill intent. Money aside though, I still think someone needs to be brought to justice with this.

bts181160 karma

I sympathize with your frustration. Did you contact an attorney about suing the home? Remember the burden of proof in a civil case is a lot less than a criminal case

mjokeym43 karma

What made you want to do this?

bts181189 karma

It was just something that sort of fell into my lap. After being successful with the first case, others just began to surface

Jertob42 karma

I had no clue murderous doctors were this big of a thing.. Few questions:

As a patient of the VA what were your odds of being killed by your Dr. compared to non VA during your time working these cases?

What percentage of Dr.s within the VA system during your time ended up being guilty of this and what is that number compared to outside the system?

bts1811112 karma

The overwhelming number of medical professionals are honest hardworking dedication people who perform miracles everyday. This is why it is so hard to believe that one of them is intentionally murdering patients.

The number of murders is so small that I could not even put a percentage on it

TonySsoprano_41 karma

Were you involved or aware of the Christopher Dunstch case profiled in the Dr. Death podcast? Have you met him?

If so, The way they positioned the story seems so unique to me, a man so hell-bent on being the best can't see that he's actually awful. Was he actually just unable see the harm he was doing do to his Lazer focus on achieving medical stardom or was it more a case of a sociopath running a muck in a broken system?

bts181150 karma

It could be both, it is a most unusual case never met him or had any dealing with it.

Wildarms7k39 karma

The VA were responsible for a stroke that made my Father “locked in” and eventually lead to his death. Have you ever investigated a similar situation and what was the outcome?

bts181154 karma

I have not investigated malpractice cases or a case identical to what you are stating, sorry.

bts181139 karma

The VAOIG has an office of Healthcare Inspections consisting of doctors and nurses who investigated those types of situations

Tashul31 karma

Have you heard about the case of Ayinde Clarke from just a few days ago?

In this screenshot he confesses to murdering elderly people who are Trump supporters, thinking his reddit username would protect him.

Since you are in this field of work, can you give us an update on this case?

And if you're not familiar with the case- what do you make of this 'confession'? Do you think the person who wrote it was telling the truth?

bts181155 karma

I had not heard of this until you just posted it...Hope it is fully investigated. There was a case of a respiratory therapist named saldovar who confessed to killing patients then recanted. It took a long time to prove he was actually guilty

phlebRN30 karma

Thoughts on the situation at Mt Carmel?

bts181146 karma

Again, I don't know anything more than what I've read in the papers but I hope more information is released shortly

theyv30 karma

How often this happens?

bts181159 karma

Impossible to answer because only a small amount of cases are reported.

MHM503529 karma

Does the evidence you need tend to come from murder a they’ve already committed? Or is someone suspected and then procedures are put in place to catch them (like more/earlier/different chemical tests)?

bts181163 karma

I would not want to put any patient in harms way in an attempt to catch a killer. Our investigations have always been historical

9yroldupvotegiver28 karma

Did any cases you worked on involve someone who would kill their patients painfully?

bts181162 karma

Death my succinylcholine, a paralytic, can be a very painful death

Fire-Kissed27 karma

If one were to suspect a medical professional of intentionally harming patients, who should they go to and how should they begin collecting evidence?

bts181152 karma

It depends if you are a coworker or family member. Most of the time its the coworkers who observe the high death rate associated with a particular caregiver. If you are a family member its important to document all treatments provided. Most hospitals have patient advocates and quality of care people. That can be a good start. But if your evidence is strong I would contact an attorney and then the police

tattarfnattinn24 karma

I have always wanted to know what actually happens to them bc atleast i have never seen it in the news or anything, I know some do get to keep their job but what about the rest do they just loose their license or do they get sent to jail/prison?

bts181144 karma

If convicted they go to prison for a long time. If not, they are at least prohibited from working in the medical field

dingledorb22 karma

What has been the most interesting excuse or admission someone has made for committing this type of crime?

Thanks :)

bts181150 karma

Many times they will claim that they are ending the suffering of the patients, but in reality that's not true. They couldn't care the least about the patients well being

lilymtyson16 karma

I'm sure you've seen and heard some awful things during your career, but is there anything in particular that has shocked you to the core?

bts181155 karma

I still get upset about Dr. Kornak altering medical records to put people into research..very Frankenstein like

ThrowawayQuiGon15 karma

Hello Bruce,

I am an inspiring public servant with a background in criminal justice. My dream would be to join a federal agency to investigate white collar and other crimes involving minority populations. Without becoming a law enforcement officer, what paths do I have to achieve my dream? Thank you for your service. It does not go unnoticed.

bts181135 karma

I would suggest looking into the Federal inspector general offices like the VA OIG and the Health and Human Services OIG

eaglescout198414 karma

Based upon your experience, do the cases at Johnson VA medical center in Clarksburg, WV fit the pattern of an intentional murderer, or simply malpractice/incompetence?

bts181122 karma

Again I only know what I have read in the media, but it looks like it might fit the pattern of my other medical serial murders

nogord2 karma

Thank you for your service! It's terrifying that there are people out there that do this (I work in a hospital).

To what extent do they try to cover up their crimes? Do they use medical knowledge at all?

bts18111 karma

They use their medical knowledge to kill. They know what drugs are difficult or impossible to test for in embalmed and exhumed bodies.