![A photo of a syringe and a vial laying on a judge’s gavel.](http:http://assets.medpagetoday.net/media/images/109xxx/109955.jpg?width=0.8)
A Pennsylvania nurse who purposely administered lethal doses of insulin to more than 20 patients at skilled nursing facilities received a life sentence after pleading guilty to three counts of murder and other charges, the state's attorney general on Thursday.
Heather Pressdee, 41, could have faced a death sentence, but as part of a plea agreement will serve three consecutive life sentences, without the possibility of parole, for three counts of first-degree murder plus up to 760 years of consecutive incarceration for 19 counts of attempted murder.
The guilty plea relates to Pressdee administering lethal or potentially lethal doses of insulin to at rehabilitation centers across Western Pennsylvania from 2020 to 2023, of which 17 of the individuals died.
"The defendant used her position of trust as a means to poison patients who depended on her for care," said Pennsylvania Attorney General Michelle Henry, in a statement. "This plea and life sentence will not bring back the lives lost, but it will ensure Heather Pressdee never has another opportunity to inflict further harm."
During the plea hearing, family members of the shared their stories. One told the former nurse she had wrongly tried to play God. Another told the court: "She is not sick. She is not insane. She is evil personified.... I looked into the face of Satan myself the morning she killed my father."
The former nurse didn't look at the speakers or react to their comments, even when one shouted an expletive at her that led the courtroom gallery to break out in applause, according to news reports.
Betty Hutchinson, one of a handful of patients who survived Pressdee's attempted murders, has lost function in one arm, has limited use of the other, and is now barely able to speak, according to Hutchinson's sister.
Pressdee was in May 2023 with two counts of homicide and one count of attempted murder, along with other charges. Then in early November 2023, new charges were filed for the attempted murder of 19 more patients. In most cases, patients died very soon after the insulin dose or some time later. Some of the victims -- who ranged in age from 43 to 104 years -- were diabetic and required insulin, while some were not.
Steven Marcus, MD, a medical toxicologist and the former director of New Jersey's poison control center, told app in November 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."
Prosecutors said 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 , Pressdee had knowledge of treating diabetes and assisted her own mother in managing the condition. The documents also showed that Pressdee would send her mother text messages discussing killing patients, colleagues, and people she encountered outside of work:
- "I may kill this resident"
- "I'm gonna murder my aides"
- "She's going to get pillow therapy"
- "If this Arby's guy says 'one more minute' one more time he will get stabbed"
A former veterinary technician, Pressdee received her nursing degree at the Community College of Allegheny County in Pittsburgh and her nursing license in July 2018. She was investigated for "abusive behavior" toward staff and patients and either resigned or was terminated from roughly a dozen positions from 2018 to 2023.
The Associated Press contributed to this report.