For years, the nurse from Natrona bounced from county to county, nursing home to nursing home, and vulnerable patient to vulnerable patient.
Heather Pressdee worked for six different nursing facilities in less than three years, and she was at her seventh in May when she was charged with murder. She crisscrossed the region from West Deer and Lower Burrell to Kittanning and Butler.
She left in her wake 22 patients that authorities say she’s admitted to either killing or trying to kill.
Her attorneys say her actions were motivated by mercy — the actions of a caregiver who wanted to spare patients she saw as far too infirm.
“She felt sorry for these people, and she was trying to alleviate their suffering,” attorney James DePasquale said.
He continued: “We recognize that’s not a legal defense.”
Seventeen patients died after receiving care from Ms. Pressdee, though she currently faces murder charges related to four patients — those for whom investigators could concretely prove a cause of death. She’s charged with attempted homicide in connection with the 13 other deaths as well as in the cases of five patients who survived.
All told, Ms. Pressdee faces four counts of homicide, 18 counts of attempted homicide and 22 counts of neglect of a care-dependent person.
In two criminal complaints spanning more than 40 pages, agents from state Attorney General Michelle Henry’s office wrote that Ms. Pressdee confessed her actions in regard to each victim.
One woman “looked at her like an animal would,” she told investigators. One man “had no quality of life,” she said, and she “felt bad” for another. One “needed to die.”
That was a frequent refrain at Sunnyview Nursing and Rehabilitation in Butler, coworkers told investigators. She’s been linked to six patient deaths during her time there. Ms. Pressdee, one fellow nurse told police, was always saying that residents “just needed to die.”
Her attorneys, again, say it came from a place of mercy. And she feels bad about it.
“Look, there’s a lot of dead bodies here. Obviously she should be remorseful — but she really is remorseful,” Mr. DePasquale said. “She’s sorry that this ever happened. She knows how it started but doesn’t know why it started.
“We are where we are,” he said.
Right now, that’s the Butler County Prison, where the hope is to strike a plea deal with the state AG’s office to avoid the death penalty, said attorney Phil DiLucente.
Ms. Pressdee, he said, “has been dealing with it as best as possible.”
“When you’re facing 17 counts — [first degree felonies] for either murder or attempted murder — it’s hard to take in,” he said.
Ms. Pressdee, 41, did not begin her nursing career until 2018. She attended the Community College of Allegheny County in 2003 and 2004 but never finished her degree. She went on to work 14 years as a veterinary technician at the Pittsburgh Veterinary Specialty and Emergency Center. She told police that she provided critical care to animals, including anesthesia, and practiced euthanasia.
CCAC officials confirmed that Ms. Pressdee returned to the school from 2016 to May 2018, when she graduated with an associate’s degree in nursing. From there, she worked at 12 nursing facilities between then and her arrest in May.
The attorney general’s office said its tip line for this case remains open: 888-538-8541
Not the first
It’s among the large, looming questions surrounding the case.
How did a woman who allegedly spoke openly about her disdain for residents — and who often provided care directly before their health began to fail — move from facility to facility with few questions asked?
Conditions are ripe, said Beatrice Yorker, a California State University professor focused on crime in health care — specifically for so-called health care serial killers.
“You have to understand that we had COVID, that there is a nursing shortage, that it has been exacerbated by COVID,” said Ms. Yorker, who holds, among others, a law degree and nursing degree. “And so we’re back in a place that we were in the past.”
Ms. Pressdee is not the first health care professional accused of killing patients, but she is the latest in a line of cases that Ms. Yorker said are dwindling.
Charles Cullen worked as a nurse in Pennsylvania and New Jersey from the late 1980s until his arrest in 2003. Investigators have confirmed he killed 29 patients, though he’s confessed to at least 40. Ohio orderly Donald Harvey confessed to 87 murders during his 17 years at facilities across that state and in neighboring Kentucky. He was convicted in 37 of those.
Kristen Gilbert worked at a VA hospital in Massachusetts, where colleagues nicknamed her the “Angel of Death.” She was convicted of four killings between 1995 and 1996.
And Reta Mays, a nursing assistant at the Veterans Affairs Medical Center in Clarksburg, W.Va., pleaded guilty in 2020 to seven counts of second-degree murder and one count of assault with intent to murder in connection with eight deaths at the facility. Mays used insulin to induce hypoglycemic episodes in the patients between 2017 and 2018.
Much has changed since the 1970s, ‘80s and even ‘90s, Ms. Yorker said, and safeguards implemented over the decades seem to be working.
“Since then we have barcode medication administration systems, we have whistleblowing systems for nurses to share their concerns, we have more monitoring, we have more cameras in hospitals — we have a lot of things that make it more difficult to get away with killing patients in the United States,” she said.
But, she said, with increased safeguards come people who will work to skirt them. Alleged health care killers, she said, will find new methods. Insulin, Ms. Pressdee’s alleged drug of choice, is chief among them.
“Insulin is ubiquitous,” Ms. Yorker said. “So many patients, especially in long-term care, are diabetic. Many nurses are diabetic. They can get insulin from home — it’s not a controlled substance.”
Another question that only Ms. Pressdee can answer — or perhaps maybe she doesn’t even fully know — is why?
The explanation she’s given, per her lawyers, is that these were mercy killings — that she felt bad for them, that their quality of life was such that she felt compelled to “spare them.”
That’s not an uncommon explanation among convicted health care killers, said Joni E. Johnston, a California-based forensic and clinical psychologist who, among other roles, has conducted competency to stand trial evaluations and risk assessments for offenders up for parole.
She pointed to a litany of text messages sent by Ms. Pressdee between April 2022 and mid-May 2023.
“Can I kill this man at Taco Bell?” “She’s gonna die!!!!” “I’m gonna murder my aides.” “I drugged him already and I don’t know how he is awake.” “I can’t with this lady tonight. She’s going to get pillow therapy.” “I may stab a nurse already.” “And now a pizza man may die.”
While most come across as hyperbole, Ms. Johnston said that, when coupled with reports to police that she was mean to both patients and coworkers, they show just how much rage Ms. Pressdee might have been carrying inside.
“One of the things that struck me … is this lack of empathy and just this anger and this sense of egocentrism — like an immature egocentrism,” she said. “This inability at all to see beyond her own viewpoint as well as just the sense of taking everything personally.”
She said, based on the information from the police reports, “there is this pervasive sense of perceived mistreatment, and she’s somehow entitled to punish these individuals for their perceived slights.”
Ms. Johnston said health care killers in the past have killed out of convenience, and there could be an aspect of that in this case, but there also seems to be a level of sadism.
She pointed to one anecdote from the criminal complaint in which a nurse at Butler’s Sunnyview Rehab and Nursing Center was speaking sweetly to a patient one Friday about how he needed to take his medication “because she loved him and wanted to see him again.” The nurse told investigators that Ms. Pressdee called the conversation “gross.”
That patient, a 43-year-old diabetic man with a brain injury, was dead by Monday, allegedly at the hands of Ms. Pressdee.
The nurse who’d spoken with the man the Friday before said that when she came to work Monday and learned the man had died, Ms. Pressdee “smacked her on the back and said, ‘Sorry to hear about [the patient], but at least you got to say your final goodbye.’”
“Now, is that a coincidence?” Ms. Johnston said. “I don’t think so. So not only is she killing somebody … but she’s also now making sure that this nurse knows that the person she cared about is dead.”
There were other red flags surrounding that patient, according to the criminal complaint, which referred to the man as “N.C.”
Coworkers told investigators Ms. Pressdee hated the man, called him names and once remarked that people with his quality of life did not deserve to live and was “going to be the next one to die.”
Earlier in her time at Sunnyview, she expressed disgust after seeing another nurse help a 104-year-old resident with her dentures and food tray, calling the resident herself “disgusting.” The resident died the next day. Coworkers said Ms. Pressdee had previously remarked the woman “should not be alive” and questioned “when is she going to die already?”
As early as 2018, some of Ms. Pressdee’s conduct raised questions among coworkers. At Encompass Health Rehabilitation of Harmarville, where she worked from Oct. 1, 2018, through April 21, 2019, she was disciplined for administering insulin outside of a physician’s orders.
Investigators said her employee file noted she was counseled Dec. 7, 2018, after an insulin error. A corrective action plan dictated she meet with supervisors to review insulin protocols. A supervisor at Encompass told investigators she was concerned Ms. Pressdee was harming residents and “took actions internally.” It’s not clear what those actions were.
After Encompass, Ms. Pressdee went from one short stint to the next. She worked at Allegheny Valley Hospital from April to September 2019. She was hired at Platinum Ridge Center for Rehabilitation in Brackenridge in September 2019. Investigators found she listed a fake name as a reference, and the phone number listed belonged to a relative.
She allegedly used a similar fake reference when she was hired at Concordia at Rebecca Residences in West Deer, where investigators have linked her to one patient death.
She began at Lower Burrell’s Belair Health in April 2021, and investigators have linked her to the five patients, four of whom died. One woman was treated at Allegheny Valley Hospital before succumbing to the incident, and the man who survived was treated there as well.
The doctor who treated the man took note of the fact he was the second low blood sugar patient seen at the hospital that had been treated by Ms. Pressdee at Belair. He made a referral to the state Department of Health after he treated the second person.
It wasn’t clear what, if anything, the Department of Health did with that referral.
Her coworkers, too, sounded an alarm after a fourth patient died after receiving care from Ms. Pressdee. One official with Guardian Healthcare, which operated Belair, told investigators that the woman’s coworkers noticed the pattern of deaths and took the concerns to superiors. Ms. Pressdee was briefly suspended but an internal investigation turned up “no identifiable evidence.”
A lawsuit filed by the family of one of the victims alleges a culture of cover-up at the facility, claiming administrators went so far as to discipline nurses who discussed Ms. Pressdee’s behavior and resident care.
Coworkers at Belair called her “The Killer Nurse,” according to the lawsuit.
Ms. Yorker, the health care serial killer researcher, said any number of those concerns could have and should have been a breaking point.
“The way that these cases do get detected is when there’s a suspicious epidemic of adverse patient incidents, whether it’s deaths or cardiac arrests or respiratory arrests,” she said. “The data all of a sudden goes from a baseline — which is two or three per month or per year of whatever it is for the [facility] — and all of a sudden, they notice a spike.”
If facilities aren’t collecting that data, she said, they won’t notice such a spike. She acknowledged that the nature of the facilities — nursing homes, some of which offered hospice care — can make questionable deaths less noticeable, but she blamed the facilities for not looking closer at the number of hypoglycemic incidents among non-diabetics.
“That is on the lack of forensic and toxicology thinking in health care,” she said. “People need to consider any toxic amounts — they need to consider ‘this is evidence of a crime, this should not have happened.’”
First Published: November 12, 2023, 10:30 a.m.
Updated: November 13, 2023, 8:03 p.m.
