Charles Edmund Cullen was born February 22, 1960, but it was not until October 2003—43 years later—that authorities arrested the man who would become known as the "Angel of Death." By then, he had spent 16 years methodically ending lives across hospitals in New Jersey and Pennsylvania, a killing spree that may rank among the most extensive in American criminal history.

Cullen's path to murder began in the late 1980s. After a medical discharge from the U.S. Navy in 1984, he entered the nursing profession, eventually securing a position at Saint Barnabas Medical Center in Livingston, New Jersey. On June 11, 1988, he administered his first confessed lethal overdose—a patient given a fatal dose through intravenous line. Over the next four years at Saint Barnabas alone, Cullen killed repeatedly, and investigators suspected him of poisoning IV bags, likely causing dozens of unexplained deaths. Despite these suspicions, he was never prosecuted and departed in January 1992 while under internal investigation.

What followed was a pattern of movement and concealment. Between 1992 and 2003, Cullen worked at several hospitals—Saint Luke's University Hospital in Bethlehem, Pennsylvania; Somerset Medical Center in Somerville, New Jersey; and others—accumulating a shadow record of firings, forced resignations, and accusations of drug theft. He had killed at least 11 patients before arriving at Saint Luke's, where he murdered five or more additional victims. Hospitals caught him stealing medications but failed to alert police or maintain coordinated warnings. Cullen's white coat and access to drugs granted him near-total freedom.