SERIAL KILLER MIND

  Crime Classification Manual Part II Chapter 6 F 2 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Crime Scene Indicators Most of the crime scenes involved with the mercy killings were in the hospital. There were no signs of struggle or violent death with most of the murders, which was one reason that Harvey was able to kill year after year without being caught. Most the of time he used an instrument of death, one of opportunity, offered by the institutional setting where the offenses occurred. He would use plastic bags and pillows, oxygen tubing, and syringes full of air. When he decided to poison patients, he brought arsenic and cyanide to work and mixed it with their food.

  Crime Classification Manual Part II Chapter 6 F 1 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Harvey preyed on the elderly, infirm, or chronically ill, most of them in- volved in a caregiver-client relationship with him. Most of the confirmed deaths took place in an institutional setting, which would have been considered a low-risk environment for the victims. However, the victims’ debilitated condition that necessitated total dependence on a caregiver elevated their risk of becoming the victim of a violent crime. A few of Harvey’s victims were outside the institutional setting, but he targeted them for revenge, not mercy killing.

  Crime Classification Manual Part II Chapter 6 E 98 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   From 1975 to 1985, Harvey worked in the Cincinnati Veterans Administration (VA) Medical Center. He claimed responsibility for at least fifteen deaths at the VA hospital. He next moved on to Drake Memorial Hospital in Cincinnati in 1986, where he continued working as a nurse’s aide. Harvey killed at least twenty-one patients at Drake Hospital. He was employed there until his arrest in August 1987.

    Crime Classification Manual Part II Chapter 6 E 97 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Victimology Harvey claimed his first killings began in the early 1970s in Marymount Hospital, London, Kentucky. He confessed to murdering fifteen patients between 1970 and 1971. He then moved on to Cincinnati and worked in a factory for several years before returning to hospital work.

  Crime Classification Manual Part II Chapter 6 E 96 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION CASE STUDY: 128.01 MERCY HOMICIDE Background In early 1987 a Cincinnati medical examiner was performing an autopsy on the victim of a motorcycle crash. As he was examining the stomach cavity, he detected an odor that smelled like almonds. After further testing, the pathologist concluded the victim had been poisoned with cyanide. The ensuing investigation led to a thirty-five-year-old nurse’s aide, Donald Harvey. After his arrest, Harvey began confessing to numerous other murders, or mercy killings as he described them. Harvey enjoyed the lime- light so much that he continued to add to the list of victims. The toll reached as high as one hundred at one point, but Harvey could not supply details to many of the alleged killings. The actual number of victims is still uncertain, and Harvey’s later confessions have been held suspect.

  Crime Classification Manual Part II Chapter 6 E 95 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   : MERCY HOMICIDE Death at the hand of a mercy killer results from the offender’s claim or perception of victim suffering and his or her duty to relieve it. Most often the real motivation for mercy killing has little to do with the offender’s feelings of compassion and pity for the victim. The sense of power and control the offender derives from killing is usually the real motive. Case studies show that these offenders frequently commit serial murder.

  Crime Classification Manual Part II Chapter 6 E 94 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Search Warrant Suggestions Vials of medications at the residence of the offender and literature concerning drugs beyond the scope of offender’s practice (for example, the Physician Desk Reference) are among search warrant suggestions. Other suggestions include diaries, journals, and pictures. The mercy killer may keep obituaries of victims. For the hero killer, search warrants should include newspaper articles commemorating previous rescue efforts and implements of arson. The investigator should scrutinize the literature found, checking each page for underlining and modification.

  Crime Classification Manual Part II Chapter 6 E 93 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   For the hero killer, interviews of coworkers may reveal that the offender demonstrates an unusually high level of excitement or exhilaration while participating in the rescue or resuscitation efforts. Conversations may often involve the rescue or resuscitation incidents.

  Crime Classification Manual Part II Chapter 6 E 92 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Inspection of a suspect’s employment history is important: the investigator should look for frequent job changes with a corresponding increase of mortality associated with the suspect’s employment. Other consideration includes a significant rise in cardiopulmonary arrests or deaths in a particular patient population, cardiopulmonary arrests or deaths inconsistent with the patient’s condition, cardiopulmonary deaths localized to a particular shift, or postmortem examinations revealing toxic levels of an injectable substance.

  Crime Classification Manual Part II Chapter 6 E 91 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   In the medical realm, an unusually high rate of successful cardiopulmonary resuscitation in conjunction with the unusually high death rate should be examined. Multiple cardiac or respiratory arrests in the same patient also should raise suspicion. Most unwitnessed cardiopulmonary arrests or patients who have multiple arrests do not respond to resuscitative measures. This could indicate that a hero killer happens to be among the first to the scene as well as knowing the exact measures to remedy the problem.

  Crime Classification Manual Part II Chapter 6 E 90 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Investigative Considerations Suspected mercy murders can be indicated by a rise in the number of deaths, especially if at all suspicious. Suspicious deaths should be checked for correlation between the suspect’s shift and patient assignments. In nine cases of mercy killers cited in an article in the American Journal of Nursing, the correlation between suspect presence and a high number of suspicious deaths was deemed sufficient to establish probable cause and to bring indictments by grand juries.

  Crime Classification Manual Part II Chapter 6 E 89 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Liver biopsy, thorough blood-chemistry analysis, complete drug screen of blood and urine, and hair analysis for arsenic and drugs (especially digoxin, lidocaine, and smooth-muscle-paralyzing drugs) should be performed. Asphyxiation should be checked for by petechial hemorrhage, taking an X-ray for broken ribs, and so on. In the case of the hero killer, the post- mortem examination should look for toxic levels of injectable drugs such as digoxin, lidocaine, and potassium hydrochloride.

  Crime Classification Manual Part II Chapter 6 E 88 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Common Forensic Findings. Since the case may not have been reported as suspicious, detailed investigation is mandated. Exhumation may be required with analytical toxicology. Many times an autopsy is not performed if the death appears natural, but later scrutiny reveals poisoning, broken ribs, or other signs of suspicious death.

  Crime Classification Manual Part II Chapter 6 E 87 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Staging. In a sense, staging is the central element of this homicide. The mercy killer arranges the body to represent a peaceful, natural death. The death is most often staged to look like a natural death, but it is possible that accidental or suicidal death is staged. For the hero killer, it is a miscarried at- tempt to stage a scenario, a life-threatening crisis, in which the offender has the starring role as the hero. The fireman or arsonist sets the fire, only to rush back for the rescue. The nurse or emergency medical technician makes a timely response to the person after inducing the state of crisis. The target is made to look like a victim of a natural calamity (for example, a cardiac arrest), an accident (faulty wiring that starts the fire), or perhaps criminal activity (hit and run, mugging, arson).

  Crime Classification Manual Part II Chapter 6 E 86 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Crime Scene Indicators Frequently Noted. For the mercy killer, the instrument of death is one of opportunity, often common to the institutional setting (drugs, syringes for air injection, or toxic substances, for example). Signs of struggle are minimal or absent. In an institutional setting, the hero killer creates the crisis, usually with drugs. Syringes, medicine vials, and similar items should be collected for analysis of medications or substances peculiar to that patient’s case or condition. In cases involving an emergency, the hero killer is conveniently present. If the suspicious death involves a fire, elements of arson may be found.

  Crime Classification Manual Part II Chapter 6 E 85 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Offender risk varies with institutional setting, depending on amount of autonomy or supervision, shift, and quantity of staff. The victims of the hero killer may include the critically ill patient since a medical emergency, such as a cardiac arrest, would not appear suspicious. Infants are also included as likely victims of the hero murderer because of their mute vulnerability. When the crime scene is an institutional setting, the victim is one of opportunity with an increased risk factor due to the vulnerability that illness or age imposes. Outside the institutional setting, the hero killer’s victim is a random target who has become a victim of opportunity by being in the building the arsonist torches or in the zone where the emergency medical technician works.

  Crime Classification Manual Part II Chapter 6 E 84 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Defining Characteristics Victimology. The victims of mercy/hero killers are similar. The mercy killer targets most often the critically ill, elderly, or infirm. They are usually patients in a hospital, nursing home, or other institutional setting. The victim is engaged in a client-caregiver relationship with the offender. The victim is rarely a random victim but is known to the offender. The victim’s environment and lifestyle are low risk, but his or her dependency or state of health elevates risk.

  Crime Classification Manual Part II Chapter 6 E 83 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   128: MERCY/HERO HOMICIDE Mercy and hero homicides usually are committed on victims who are critically ill. The mercy homicide offender believes inducing death is relieving the victim’s suffering. The hero homicide offender is unsuccessful in attempts to save the victim from death.

  Crime Classification Manual Part II Chapter 6 E 82 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Outcome Carmela was diagnosed with borderline personality disorder and a brief psychotic episode in the context of separation. Because she was capable of appreciating the wrongfulness of her actions but was mentally impaired at the time of the crime, prosecutors offered her the opportunity to plead guilty to manslaughter, which she accepted.

  Crime Classification Manual Part II Chapter 6 E 81 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   During the investigation, Carmela was very secretive about her Brujeria, not unlike many other practitioners of the faith. Likewise, she remained tight- lipped about her feelings for and reactions to Luis and what he would reveal to her in their telephone conversations. Only input from friends and close acquaintances revealed the extent of her engaging Brujeria to win Luis back. When questioned about the dumped dirt, smashed pots, attack on Rose, and spreading of coffee on the floor, Carmela offered rational explanations and vehemently denied associations of any of these with Brujeria. Consultation with experts of this practice, however, revealed the spiritual significance of the coffee grounds and smashed pots.

  Crime Classification Manual Part II Chapter 6 E 80 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Carmela, feeling rejected, grabbed Rose by the head and struck her on the corner of the wall, preventing her from exiting, and did not stop her assault until Rose was dead. Closer examination of Carmela’s apartment revealed icons, candles, and other symbols of devout practice of Brujeria. This Afro-Caribbean church was different from her own. Interviews with friends indicated that shortly before the killing, Carmela sought out a Bruja, or priest of the religion, to cast a spell on her behalf.

  Crime Classification Manual Part II Chapter 6 E 79 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   The next morning, Carmela went out onto her fire escape and began dumping plants and soil to the ground below, then tossing the pots down as well. She made her way down from the third floor to the second floor on the fire escape. She entered into Rose’s apartment through the window leading into the kitchen. No one was there initially. After about fifteen minutes, Rose entered her apartment and told Carmela, “You don’t belong here . . . get out of the apartment.”

  Crime Classification Manual Part II Chapter 6 E 78 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   In early August, her priest noted that Carmela was more ritualistic and more isolated during her prayer and attended mass more frequently. The night before the killing, Carmela asked an acquaintance to assemble an exercise bike for her. As Carmela recalled, “I was upset, I wanted to take off weight. I was thinking about just being alone.    I was confused, and couldn’t put all my thoughts together at one time.    I couldn’t calm myself down.” The teenager became frightened when Carmela climbed aboard the bike he had assembled and began pedaling it furiously. He ran all the way home, telling his mother that Carmela was “possessed.”

  Crime Classification Manual Part II Chapter 6 E 77 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Luis had remarried but nonetheless remained in contact with Carmela, writing her letters that suggested a romantic interest. When Carmela found out that the day after she had visited Luis in jail with a birthday gift that his wife had visited him for a conjugal visit, she was devastated.

  Crime Classification Manual Part II Chapter 6 E 76 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Carmela had a history of repeatedly assaulting her grandmother, particularly when her grandmother would not give her money for Luis. In the most serious attack, she broke five of her grandmother’s ribs on one side and seven on another by stomping on her back.

  Crime Classification Manual Part II Chapter 6 E 75 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Carmela had financial problems. She feared losing her disability benefits because she remained out on leave. She continued to remain deeply attached to an ex-husband, Luis, who was incarcerated. She provided Luis with many gifts, hoping he would return to her. Luis would also call Carmela collect, resulting in a several-hundred-dollar phone bill each time.

  Crime Classification Manual Part II Chapter 6 E 74 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Carmela had a history of destroying her own apartment, being “anxious,” throwing things around her apartment, and episodes in which she hallucinated and spoke incoherently. She had no history of substance abuse.  

  Crime Classification Manual Part II Chapter 6 E 73 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Investigation Carmela, who worked as a nurse’s aide in a Manhattan hospital, took leave in spring 1997 to undergo successive surgeries in the ensuing months. Also, around this time, she was brought to Beth Israel Medical Center by ambulance after walking naked through her neighborhood.

  Crime Classification Manual Part II Chapter 6 E 72 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Forensic Findings Rose suffered a variety of deep bruises and several rib fractures; the principal cause of death was listed as strangulation and a compound fracture of the related hyoid bone. The bruise pattern on the body reflects that only some of the blows came from Rose’s own cane. The rest resembled punches or kicks or another blunt instrument. There was no sign of sexual trauma.

  Crime Classification Manual Part II Chapter 6 E 71 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Blood spatter indicated that the door to the refrigerator was opened before she died. This demonstrates that the assailant was attacking Rose after she had already occupied herself in some way with the refrigerator. No weapon was identified at the scene. While the location of her body, on the kitchen floor next to the refrigerator, was quite messy, there was no sign of activity elsewhere in the one- bedroom apartment and no evidence of robbery or items otherwise removed.

  Crime Classification Manual Part II Chapter 6 E 70 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Rose was found lying in a pool of what appeared to be blood, fully clothed. Strewn about Rose’s body were a number of articles of food. In addition, coffee grounds were spread on and around Rose’s body. Coffee grounds were streaked by the movement of the dying Rose’s leg over food that had been thrown on the floor prior to her falling on it.

  Crime Classification Manual Part II Chapter 6 E 69 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Crime Scene Indicators There was no sign of forced entry, and indications were that the perpetrator had entered the apartment through the back window, using the fire escape. A number of potted plants lay smashed on the ground below.  

  Crime Classification Manual Part II Chapter 6 E 68 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Earlier that year, Carmela had ransacked her own apartment during a fit of rage, and a relative told Rose about this. Subsequently Rose grew uncomfortable about having Carmela in her apartment and told her not to come around anymore. Despite this, Carmela would still occasionally walk down- stairs to Rose’s apartment when other guests were there. A friend recalled, “Carmela would ask her for money    When Rose would say no, she would act weird.    Rose would let her come into the apartment, because she was a gentle woman, but she was scared of her.” To another friend, Rose expressed her feelings that Carmela, “must think she had money because she had sold her apartment.”

  Crime Classification Manual Part II Chapter 6 E 67 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Victimology Rose lived alone for many years in the same apartment, a second-floor walk- up. Carmela and Rose were initially friendly neighbors; Carmela would visit Rose’s house frequently and sit and have coffee.

  Crime Classification Manual Part II Chapter 6 E 66 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   Police investigating the building knocked on the door of an upstairs neighbor, Carmela Cintron. There was no answer when they knocked on Carmela’s door; police then made their way up the fire escape to look into her apartment. When an officer looked into Carmela’s back window, she ran into the bathroom, and he called to detectives in the front stairwell, who entered through an unlocked front door. Carmela subsequently confessed, in a rambling and disjointed statement, and was charged with Rose’s killing.

  Crime Classification Manual Part II Chapter 6 E 65 A STANDARD SYSTEM FOR INVESTIGATING AND CLASSIFYING VIOLENT CRIMES SECOND EDITION   When the niece was canvassing the building, she learned little from the neighbors; the niece sought out the building manager, who looked into Rose’s apartment through a window accessible to the fire escape. There they saw her lying on the floor, dead.