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Name some famous serial killers?

Name some famous serial killers?

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Name some famous serial killers?

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  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 don’t we know these names? • Harold Shipman, MD • Michael Swango, MD • Michel Pettiot, MD (63 murders in 1940’s) • John Adams, MD (40 murders in 1950’s) • 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 • Day#18 seizure and ventricular fibrillation (“Torsades de pointe”) • Multiple episodes VF, +/- response to lidocaine and Mg+2. • 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. Bauman’s cardiology rotation.

  8. CHICAGO’S POISONINGHISTORY • 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 > 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. 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?

  10. 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 D50W’s 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 – (?)

  11. ILLINOIS HISTORY • Michael Swango (30+) “00-Swango” • Born 1974 Quincy • Medical school at SIU didn’t 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

  12. 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 kill> 300 in home • “Young Poisoner’s Handbook” movie

  13. 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

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

  15. Mercy Killers 2000’s • 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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

  23. Harold Shipman, M.D.

  24. Major internet sites • Mayhem.net • Crimelibrary.com • Karisable.com • Cybersleuths.com

  25. Now this is bioterrorism!

  26. Paloucek@uic.edu