Former Nurse Sees Raft of New Charges in Murder Investigation

A former Pennsylvania nurse already charged with killing two patients confessed last week to attempting to kill another 19, according to authorities.

In late May, Heather Pressdee was accused of intentionally overdosing patients with insulin and charged with two counts of homicide and one count of attempted murder, according to Pennsylvania Attorney General Michelle Henry. The two patients who died in December 2022 were residents of Quality Life Services, a skilled nursing facility in Chicora, Pennsylvania, where Pressdee worked as a registered nurse.

Last week, Henry issued new charges against Pressdee related to the attempted murder of 19 more patients at five separate facilities from 2020 through 2023. Specifically, Pressdee was accused of “administering excessive amounts of insulin” to alleged victims, only some of whom were diabetic. Pressdee admitted to the investigators her involvement in each of the 19 cases; she had previously admitted in May to her involvement in the initial two deaths and the attempted murder.

Of the 19 cases, 17 patients died, but investigators only brought murder charges in two of those. Besides those two additional counts of first-degree murder, Pressdee was charged with 17 counts of attempted murder, and 19 counts of “neglect of a care-dependent person.”

The victims ranged in age from 43 to 104. The new charges suggested “a pattern” of alleged criminal conduct: Pressdee would “often work the medication cart” and administer insulin during the night shift, which meant victims typically weren’t discovered until the next morning, according to the criminal complaint.

In cases where Pressdee “sensed the victim would ‘pull through,'” she allegedly took “additional measures” to prevent a hospital visit where her actions might be discovered, the investigators noted.

Pressdee, a former veterinary technician, received her nursing degree at the Community College of Allegheny County in Pittsburgh. Her nursing license was issued on July 31, 2018 and suspended on July 26, 2023. She was investigated for “abusive behavior” and either resigned or was terminated from roughly a dozen positions from 2018 to 2023. At her first nursing job in 2018, she was suspected of “intentionally harming patients” and “reprimanded for making up her own insulin doses,” according to the second criminal complaint.

On at least two occasions, Pressdee listed a “fictitious name” of a past colleague as a reference, along with a phone number that investigators linked to a relative. The relative confirmed they had served as a reference. A forensic investigation of Pressdee’s cellphone revealed nearly 20 text messages to her mother involving threats of violence against aides, nurses, facility residents, and fast-food workers.

“The allegations against Ms. Pressdee are disturbing. It is hard to comprehend how a nurse, trusted to care for her patients, could choose to deliberately and systematically harm them,” Henry said in a press release.

The crimes occurred during Pressdee’s tenure at a range of Pennsylvania facilities, including Concordia at Rebecca Residence; Belair Healthcare and Rehabilitation Center; Quality Life Services Chicora; Premier Armstrong Rehabilitation and Nursing Center; and Sunnyview Rehabilitation and Nursing Center.

Separately, a wrongful death lawsuit was filed against Belair Healthcare and Rehabilitation Center in October, accusing Pressdee of killing Marianne Bower, 68, in 2021, according to TribLive.

MedPage Today spoke with Steven Marcus, MD, a medical toxicologist and the former director of New Jersey’s poison control center. Marcus’s concerns over reports of patients with digoxin toxicity sparked an investigation which ultimately led to the arrest of Charles Cullen, a former nurse who admitted to killing as many as 40 patients.

Pressdee’s case feels like “déjà vu,” Marcus said. He expressed frustration that healthcare workers keep ignoring signs of patient harm. One reason might be denial, because the crimes themselves are “unthinkable,” and job security is another — workers may worry about the repercussions of reporting a colleague, he said.

As for specific warning signs, Marcus noted that many recent healthcare-related murders have involved insulin. When a patient has unexpected hypoglycemia, “look to see if there’s insulin” involved, he urged. “If there is, you’ve got to track it back to where it came from.”

When the body produces insulin naturally, it also makes C-peptide, he explained, but after a large dose of insulin the body stops producing C-peptide. “So, when you see somebody with high levels of insulin and low levels of C-peptide, you say, ‘Aha, it got there from outside.'”

He added that “somebody with a few bucks” should gather a coalition of experts who have dealt with serial killers in healthcare to identify themes and commonalities. “Too many people are dying because we’re not preventing these murders,” Marcus said.

James DePasquale, JD, a member of Pressdee’s defense team, told WPXI.com “[s]he has remorse, yes.” DePasquale and Phil DiLucente, JD, told MedPage Today their goal from the beginning has been to avoid the death penalty.

Pressdee waived a preliminary hearing on the new charges and is currently in custody at Butler County Prison without bail.

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