Nurses have a vital role in health care, particularly inpatient care. In most cases, they spend more time with their patients than doctors do, they translate medical jargon to help patients understand their diagnoses and treatment options, and they often serve as their patients’ most powerful advocates. It’s not surprising that most people who’ve spent time in inpatient care sing the praises of the nurses who cared for them.
This is likely a key reason why so many found Kristen H. Gilbert’s story so unnerving when it publicly unfolded in 2000. As a nurse and a member of the community, Gilbert was respected and trusted. Ultimately, she was convicted on four counts of murder, though police suspect that she was responsible for the deaths of far more people.
Who Is Kristen H. Gilbert?
Kristen H. Gilbert was born in 1967 in Fall River, Massachusetts, a large city about 50 miles south of Boston. Her father was an electronics executive while her mother was a part-time teacher and homemaker, and she had a younger sister. As she entered her teenage years, friends and family noticed that she began to show manipulative and dishonest tendencies. Even so, she was a gifted student who earned high grades and was a member of her school’s math club. Ultimately, she decided to pursue a career in health care after graduating from high school a year and a half early.
Gilbert stayed close to home for college, attending Bridgewater State College to study nursing. While there, she began to experience psychiatric episodes in which she’d make violent threats against others and herself. Court records revealed that when she was a student there, she’d lied to a former boyfriend about a suicide attempt to manipulate him. After this, school officials ordered her to undergo mental health treatment. She withdrew from Bridgewater State College and transferred to Mount Wachusett Community College and then to Greenfield Community College, where she graduated in 1988 with a nursing degree.
Medical Background: Exploring Gilbert’s Nursing Career and Healthcare Role
While Gilbert was a premed student, she accepted a job as a home health care worker with a visiting nurses association. During her short career as a home health aide, she once scalded a mentally disabled child with a hot bathtub, burning over 60% of his body, though she was never prosecuted. After earning her nursing degree, she was hired at the Northampton Veterans Affairs Medical Center.
At this point, Gilbert married and about a year later, gave birth to her first child. After her maternity leave, she took on the 4 p.m. to midnight shift. She initially had a reputation for being hardworking and dedicated to her patients’ recovery and well-being. However, during her shifts, the number of deaths in her ward nearly tripled over the previous years. Initially, coworkers didn’t see the connection, and with each incident, they admired Gilbert’s ability to stay calm and level-headed.
String of Suspicious Deaths: Gilbert’s Involvement in Hospital Patient Deaths
While working at Northampton VAMC, Gilbert earned the nickname “The Angel of Death” because an unusually high number of deaths took place under her watch. While most nurses didn’t believe that Gilbert had direct involvement in those deaths, a few nurses began to watch her a little more closely and monitor the supply of drugs that could produce cardiac arrest.
Under Gilbert’s care, three patients experienced near-fatal heart failure and four patients died. This was combined with a puzzling shortage of epinephrine, a drug that’s commonly used to treat life-threatening allergic reactions or to stimulate the heart. While many of the patients who died under Gilbert’s watch were elderly and in poor condition, numerous patients were young, medically stable and had no risk or history of heart problems.
Finally, in February of 1996, three nurses filed a formal inquiry based on their suspicions of Gilbert’s hand in two patient cardiac arrest deaths along with the decrease in the supply of epinephrine. This kicked off an investigation into the uptick in deaths in Gilbert’s ward.
Over the course of the investigation, Gibert became increasingly unpredictable. At one point, she bought a gadget to disguise her voice and called in a bomb threat to the hospital. She was arrested, tried and found guilty of calling in a false bomb threat to a federal institution, earning her a 15-month sentence in federal prison. During this time, the rate of deaths in her ward dropped back to the normal level.
While Gilbert was incarcerated, some of her former patients’ bodies were exhumed to further the investigation into the mysterious deaths. Toxicology reports showed that all the bodies had epinephrine in their tissues even though none of the patients had been prescribed the drug.
Motives and Methods: The Possible Motivations and the Manner of Killings
Shortly after the birth of her second child, Gilbert became infatuated with a newly hired security guard at the hospital named James Perrault. Like Gilbert, Perrault worked the late shift at the hospital, and after their shift ended, the two would often go out with fellow coworkers for drinks. Their relationship grew and eventually, after an ultimatum from Perrault to leave her husband, Gilbert moved out of her home and into her own apartment and began an affair with Perrault.
Perrault was the security guard who would be called to the intensive care unit every time a patient died. According to prosecutors, Gilbert would administer the epinephrine to induce a massive heart attack in her patients so that Perrault would be summoned to the ward. Once he was there, she had the opportunity to impress him with her nursing skills. Many nurses reported that she also took the opportunity to flirt with him.
Gilbert had a history of using drastic measures to attract attention. While receiving psychiatric treatment during her incarceration for the bomb threat, and she was diagnosed with borderline personality disorder. Without effective treatment, this disorder can lead to violent and unpredictable behaviors, impulsiveness and wild mood swings. This may partially explain her extreme method of creating opportunities to interact with the security guard. Ultimately, prosecutors concluded that she created medical emergencies that often resulted in her patients’ deaths to be close to Perrault.
Legal Proceedings and Outcome: Gilbert’s Trial, Conviction, and Sentencing
In 1998, when Gilbert was just 30 years old, she was indicted for murdering four patients and attempting to murder three others by injecting them with epinephrine. Her trial began in November of 2000 and lasted four months. The case against her was air-tight, with over 70 witnesses and more than 200 pieces of evidence. Perrault, who’d since ended his relationship with Gilbert, testified against her in court by saying that she’d confessed to him while in prison that she’d killed her patients.
In 2001, Gilbert was convicted of three counts of first-degree murder, one count of second-degree murder and two counts of attempted murder. For that, she was sentenced to four consecutive life sentences without the possibility of parole, plus an additional 20 years. She’d filed a federal appeal in 2003, but because of a new Supreme Court ruling, losing the case could have resulted in her receiving the death penalty, so she dropped the appeal. Currently, she’s serving her time at FMC Carswell in Fort Worth, Texas.
While Gilbert was only convicted of four murders, authorities believe that she may have been responsible for the deaths of as many as 350 people during her career at the hospital. If she was behind as many deaths as police suspect, she’s one of the most prolific serial killers in American history.