used with permission from
Source: used with permission from

As I write this blog, police are hunting a serial killer believed to be responsible for the death of at least two, and perhaps as many as 48, murders in a Japanese hospital. After two elderly men died within two days of each other on the same hospital floor, it was discovered that their IV lines had been spiked with bleach, the same disinfectant used to clean the hospital ward. Investigators subsequently found 10 unused intravenous bags (out of a total of 50) that had holes in the rubber seals and were contaminated with bleach, leading police to suspect the perpetrator may have medical knowledge and access to the floor in which these two men were housed.

Fears are growing that the problem is catastrophic after it emerged that 46 other patients have died on the same hospital floor since July 1. So far, no suspects have been named.   

Who Is a Likely Suspect?

Taking what is known (or assumed) about the crime scene, in conjunction with what the healthcare serial killer literature says, here’s my best guess about the kind of person most likely to have committed these crimes:

  • A member of the medical staff. This is based on the fact that the alleged perpetrator apparently is familiar with needles and IV lines and has access to the nurses’ station. Given that approximately ¾ of healthcare serial killers are nurses (both male and female), that would be a good place to start.
  • A man. The gender difference between men and women who murder in a medical setting is not that great; think Genene Jones, Kristen Gilbert, Charles Cullen, Donald Harvey. However, this feels like a crime committed by a man; given that the IV lines are tampered with before they are assigned to a patient suggests that the perpetrator’s victims are not specifically targeted for a personal reason. Female healthcare serial killers are more likely to specifically select their victims and they often have personal motives in doing so (to get rid of a troublesome patient, to become a “hero” by resuscitating the victim, etc.).
  • Between 30 and 40. This guess is based on a study of 16 healthcare serial killers between 1997 and 2009, which found that this was the most common age range.
  • Someone who has a grudge against the hospital or someone who works there. The random nature of this perpetrator’s victim selection reminds me of the product tamperer who seeks revenge for real or perceived mistreatment. Such individuals tend to feel powerless and victimized and have settled upon murder as a way to feel superior and powerful although s/he may inwardly justify each homicide as a “mercy killing” and a way to draw attention to “incompetence” of hospital staff.
  • Someone who doesn’t bond with others. The limited research on healthcare serial killers suggests that, before they are caught, coworkers don’t generally like them. They generally have a hard time getting along with others and dealing with everyday problems in a way that is expected by their colleagues. Others may perceive them as odd, secretive, rigid and hypersensitive; however, the perpetrator him or herself is typically unaware of how s/he comes across, and blames others for problems and limitations in their relationships and work environment. Their lack of insight into their inflexible and unhealthy modes of thinking, feeling and acting leads them to blame others for problems and limitations in their relationships and work environment, leading to a further sense of being unfairly victimized.

The Bottom Line

When it comes to vulnerability, few things level the playing field more than being in the hospital. No matter or typical size, strength or stamina, for that period of time, we are completely at the mercy of the caretakers assigned to watch over us. Fortunately, the vast majority of medical professionals measure up to the enormous trust we place in them; for the past 14 years, we Americans have voted nursing as the most honest and ethical profession in the U.S. 

Very rarely, one goes rogue. When it happens, coworkers are our first line of defense; 30% of healthcare serial killers are ultimately identified by a colleague. Hopefully, hospitals increasingly create a culture where it is okay for colleagues to speak up when something, or someone, seems wrong.  

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