Heather Irene Pressdee: The Pennsylvania Insulin Murders
Overview
Heather Irene Pressdee is an American former registered nurse who murdered and attempted to murder vulnerable patients at nursing and rehabilitation facilities in western Pennsylvania. Between December 2020 and May 2023, Pressdee intentionally administered excessive, potentially lethal doses of insulin to patients entrusted to her care. Many of the patients were not diabetic and had no legitimate medical reason to receive insulin.
Pressdee ultimately admitted that she acted with the intention of killing the patients. Authorities identified 22 victims between the ages of 43 and 104. At least 17 patients died after receiving insulin or while Pressdee was involved in their care. Prosecutors were able to establish the evidence necessary to convict her of three first-degree murders and 19 attempted murders.
On May 2, 2024, Pressdee pleaded guilty in Butler County, Pennsylvania, to three counts of first-degree murder and 19 counts of attempted murder. She received three consecutive life sentences without the possibility of parole, followed by an additional consecutive sentence of 380 to 760 years.
Background and Nursing Career
Heather Irene Pressdee was born on August 28, 1982, and lived in the Natrona Heights area of Pennsylvania. She obtained a nursing license and worked at numerous skilled-nursing, rehabilitation and assisted-living facilities throughout western Pennsylvania.
Beginning in approximately 2018, Pressdee moved through a succession of health-care jobs. Her employment at several facilities was brief. Investigators later learned that she had repeatedly been disciplined, dismissed or pressured to resign because of abusive conduct, conflicts with coworkers and troubling behavior toward patients.
Despite those warning signs, Pressdee continued obtaining positions that gave her direct access to elderly, disabled and medically fragile residents. She sometimes worked in supervisory or management roles, providing her with access to medication and the authority to make decisions concerning patient care.
Method of Murder
Pressdee used insulin as a weapon. Insulin is medically necessary for many people with diabetes, but an excessive dose can cause a catastrophic decline in blood glucose. Severe hypoglycemia can produce confusion, sweating, weakness, seizures, brain damage, unconsciousness and death.
Pressdee frequently administered the insulin during overnight shifts, when facilities had fewer employees, fewer visitors and less direct supervision. Medical emergencies occurring during those hours could initially appear to be natural complications involving elderly or seriously ill residents.
Many of Pressdee’s victims were not diabetic. Others had diabetes but were not prescribed the amount or type of insulin she administered. She sometimes gave injections without a physician’s order, failed to document the medication properly or administered doses that were inconsistent with a patient’s established treatment plan.
Because deaths are not uncommon in nursing facilities, several patients were initially believed to have died from natural causes. Autopsies were not routinely performed, and the signs of insulin poisoning could be mistaken for complications arising from a victim’s age or existing medical conditions.
Beginning of the Known Crimes
The earliest identified death associated with Pressdee occurred at Concordia at Rebecca Residence in West Deer Township in December 2020. Over the following two and a half years, suspicious medical crises and deaths occurred at several facilities where she worked.
The pattern followed Pressdee from one institution to another. Residents unexpectedly suffered dangerously low blood-sugar levels, became unresponsive or died shortly after she had been responsible for their care. Several victims had no history of diabetes, making their sudden hypoglycemia especially suspicious.
Investigators later found that Pressdee openly expressed contempt for certain patients. Coworkers recalled that she made derogatory remarks about residents and sometimes appeared to believe that particular patients were burdensome or no longer deserved to live.
Known Deceased Victims
The following patients were identified publicly as people who died after receiving insulin or during the series of incidents investigated in connection with Pressdee. Only three deaths resulted in first-degree murder convictions, while the remaining deaths formed part of the broader prosecution, investigation or related civil allegations.
- Ruth Erikson, 89 — Died on December 17, 2020, at Concordia at Rebecca Residence in West Deer Township, Allegheny County. Erikson was not diabetic. Her death is considered the earliest known fatality in the series associated with Pressdee.
- Sherry Stilitino, 58 — Died on August 9, 2021, at Belair Healthcare and Rehabilitation Center in Lower Burrell, Westmoreland County. She was not dependent on insulin for medical treatment.
- Marianne Bower, 68 — Died on September 28, 2021, at Belair Healthcare and Rehabilitation Center in Lower Burrell. Bower suffered from multiple sclerosis but was not diabetic. Her family later alleged that Pressdee administered a lethal insulin dose and that the facility failed to protect her.
- Jack Rogers II, 79 — Died on November 16, 2021, at Belair Healthcare and Rehabilitation Center in Lower Burrell. Rogers, a military veteran and Purple Heart recipient, was not diabetic.
- Norman Hendrickson, 88 — Died while residing at Belair Healthcare and Rehabilitation Center in Lower Burrell. His death was later included in litigation alleging that Pressdee administered insulin to residents who had no medical need for it.
- Mary Colwell, 92 — Died on December 28, 2021, at Belair Healthcare and Rehabilitation Center in Lower Burrell. Colwell was not diabetic.
- James Fair, 92 — Died on August 6, 2022, at Quality Life Services–Chicora in Butler County. He was not diabetic and was among the patients later connected to Pressdee’s administration of insulin.
- James “Matt” Bartoe, 55 — Died on December 4, 2022, at Quality Life Services–Chicora. Pressdee admitted intentionally administering insulin to Bartoe and pleaded guilty to first-degree murder for causing his death.
- Louise Skinner, 90 — Died on December 18, 2022, at Premier Armstrong Rehabilitation and Nursing Center in Kittanning, Armstrong County. Skinner was not diabetic.
- Joseph “Leo” Campbell, 83 — Died on December 25, 2022, at Quality Life Services–Chicora. Campbell was not diabetic. His death was one of the first fatalities included when criminal charges were initially filed against Pressdee.
- Alice Stewart, 85 — Died on December 27, 2022, at Premier Armstrong Rehabilitation and Nursing Center in Kittanning. Stewart was not diabetic.
- Marguerite “Peggy” Laskovich, 80 — Died on January 21, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township. Her family later described the devastating realization that her death had not been natural.
- Ann Victain, 104 — Died on March 21, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township. Victain was not diabetic.
- Irene Simons, 78 — Died on March 24, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township. Her family later said that Pressdee contacted them and sent flowers and a condolence card after the death.
- Gerald R. Shrum Sr., 90 — Died on March 25, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township. Shrum was a farmer, military veteran, church member and licensed private pilot. Pressdee pleaded guilty to first-degree murder for intentionally causing his death with insulin.
- Sandra Lincoln, 82 — Died on April 17, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township after becoming one of the patients associated with Pressdee’s insulin injections.
- Nicholas Cymbol, 43 — Died on May 1, 2023, at Sunnyview Rehabilitation and Nursing Center in Butler Township. Cymbol was the youngest known fatal victim and the final patient Pressdee was convicted of murdering. She admitted administering an excessive and lethal dose of insulin to him.
Surviving Victims
Not every patient injected by Pressdee died. Several survived severe hypoglycemic episodes but experienced significant physical and cognitive damage. Publicly identified surviving victims included Betty Hutchison, Betty McQueeney, Elmer Allbee and other residents whose complete medical information was not publicly released.
- Betty Hutchison, 95 — Survived an insulin overdose but subsequently suffered a stroke. Her family reported that she lost the effective use of her hands and could no longer speak or read her Bible without assistance.
- Betty McQueeney, 99 — Survived an incident connected to Pressdee’s administration of insulin.
- Elmer Allbee — Survived after being identified as one of the patients Pressdee attempted to kill with insulin.
The criminal case treated the nonfatal incidents as attempted murders because Pressdee admitted that the doses were administered with the intention of causing death. Some surviving patients continued experiencing serious medical consequences long after the immediate hypoglycemic crisis had ended.
Suspicion Among Coworkers
Pressdee’s behavior had raised concerns well before her arrest. Employees at various facilities described her as aggressive, domineering and openly contemptuous of residents. She reportedly made cruel comments about patients and complained that particular residents were difficult, demanding or burdensome.
At some facilities, staff members became suspicious of the number of deaths or medical emergencies occurring during her shifts. Employees at Belair Healthcare reportedly referred to her as a “killer nurse,” demonstrating that concerns about her conduct existed before law enforcement uncovered the full pattern.
Despite repeated disciplinary problems, Pressdee was able to leave one facility and obtain employment at another. This movement between institutions allowed the crimes to continue across four counties and several independently operated care facilities.
Text Messages and Evidence of Intent
Investigators examined text messages Pressdee exchanged with her mother between April 2022 and May 2023. The messages contained angry complaints about patients, coworkers and other people she encountered. In some messages, Pressdee discussed harming or killing individuals who irritated her.
Shortly before her arrest, she complained that a resident was following her and “driving” her crazy. She then wrote that she might kill the resident and needed to establish a boundary. The messages supported the prosecution’s argument that her actions were intentional rather than medication errors or negligent nursing practices.
Pressdee also made incriminating statements during interviews. She acknowledged administering insulin to patients and indicated that she believed some residents had poor quality of life. Her explanations suggested that she had appointed herself to decide whether vulnerable patients should continue living.
Initial Investigation and Arrest
The criminal investigation intensified after suspicious incidents at Quality Life Services–Chicora. Three male residents experienced severe hypoglycemic emergencies while Pressdee was working at the facility. Two of the men died, while a third survived after being hospitalized.
Medical records showed that the men had received insulin that was either unauthorized or medically inappropriate. Investigators examined Pressdee’s medication access, work schedule and behavior before and after the incidents.
Pressdee was arrested in May 2023. The initial charges concerned the deaths of James Bartoe and Joseph Campbell and the poisoning of a surviving patient. She was held without bail while the Pennsylvania Attorney General’s Office expanded its investigation.
Expansion of the Case
After the initial arrest, investigators reviewed Pressdee’s employment history, patient files, medication records and suspicious deaths at every facility where she had worked. They interviewed employees, administrators, surviving patients and relatives of deceased residents.
The investigation uncovered a series of similar incidents extending back to December 2020. In November 2023, prosecutors announced numerous additional charges involving 19 more patients. The expanded case alleged that Pressdee had administered excessive insulin to 22 people at five facilities in Allegheny, Armstrong, Butler and Westmoreland counties.
The victims ranged from 43 to 104 years old. Some were diabetic, but many were not. Most died shortly after the injections or at a later time following severe medical deterioration. Prosecutors filed first-degree murder charges in the deaths for which the medical and circumstantial evidence most directly established that Pressdee’s injection caused the fatality. The other incidents were prosecuted as attempted murders, including cases in which the patient later died but direct medical causation was more difficult to prove beyond a reasonable doubt.
Guilty Plea
Pressdee initially displayed conflict with her attorneys and indicated in court that she wanted to admit responsibility. A plea agreement was eventually negotiated under which prosecutors would not seek the death penalty.
On May 2, 2024, Pressdee appeared before Butler County Common Pleas Court Judge Maura Palumbi. She pleaded guilty to the first-degree murders of James Bartoe, Gerald Shrum Sr. and Nicholas Cymbol. She also pleaded guilty to 19 counts of attempted murder involving the remaining patients.
When one of her attorneys asked why she was entering the pleas, Pressdee replied that it was because she was guilty. The plea formally established that the insulin administrations were deliberate acts committed with an intent to kill.
Victim-Impact Statements
Nearly 40 relatives and representatives of the victims addressed the court during the sentencing proceedings. They described parents, grandparents and siblings whose final days had been violently taken from them by a person employed to provide safety and medical care.
Family members expressed anger that Pressdee had decided their relatives were expendable because they were elderly, disabled or seriously ill. Several emphasized that their loved ones still valued their lives and were not prepared to die.
The relatives also described the guilt and uncertainty they experienced after learning that deaths they had accepted as natural may have been intentionally caused. Some had thanked Pressdee for caring for their loved ones, communicated with her after the deaths or accepted condolences from the woman responsible.
Pressdee generally stared forward and showed little visible reaction as relatives condemned her. Family members characterized her as evil, accused her of playing God and demanded that she never again have access to vulnerable people.
Sentencing
Judge Palumbi sentenced Pressdee to three consecutive terms of life imprisonment without parole for the three first-degree murders. She imposed an additional consecutive sentence of 380 to 760 years for the 19 attempted murders.
The structure of the sentence ensured that Pressdee would never be released, even if one or more convictions were later challenged. Her nursing license was suspended, permanently ending her ability to work in patient care.
Pressdee was transferred into the Pennsylvania state prison system. Her convictions made her one of the most prolific known medical serial killers in the state’s history.
Failures of the Care System
The case raised serious questions about how Pressdee continued finding employment despite complaints, disciplinary actions and repeated allegations of abusive conduct. Several facilities allegedly knew that she had experienced problems at previous jobs but hired her into positions that provided access to vulnerable patients and controlled medications.
Wrongful-death lawsuits filed by victims’ families accused care facilities of negligent hiring, inadequate supervision and failure to investigate suspicious medical events. The lawsuits argued that administrators ignored warning signs that could have prevented later deaths.
The crimes also exposed the difficulty of identifying murder in nursing facilities. Residents commonly have multiple illnesses, and sudden deterioration may not immediately appear suspicious. Without toxicology testing, autopsies or detailed review of medication records, deaths caused by insulin can escape detection.
Legacy of the Case
Heather Pressdee exploited the authority and access given to her as a nurse. Her patients were elderly, disabled or medically dependent people who could not protect themselves and whose families trusted professional caregivers to preserve their dignity and safety.
The full number of deaths directly caused by Pressdee may never be established with absolute medical certainty. Prosecutors connected her to at least 17 fatalities, but only three deaths produced first-degree murder convictions because those cases contained the clearest proof of direct causation.
Her prosecution demonstrated the importance of examining unusual clusters of hypoglycemia, medication discrepancies and deaths occurring during the shifts of a particular health-care employee. It also illustrated the danger of allowing a worker with repeated allegations of abuse to move quietly between medical facilities.
Pressdee’s consecutive life sentences and additional centuries-long prison term ensure that she will spend the remainder of her life incarcerated. The surviving patients and the families of those who died continue to live with the consequences of a prolonged betrayal committed by a nurse whose fundamental duty was to protect them.
