‘Angel of Death’ Held in 6 Glendale Fatalities

Almost three years after respiratory therapist Efren Saldivar told authorities he was an “angel of death” who had killed as many as 50 patients, the former Glendale hospital worker was arrested Tuesday and accused of murdering at least six people under his care.

Glendale Police Chief Russell Siverling said that six murder counts will be filed today against Saldivar, 31. The charges are based on the discovery by Lawrence Livermore National Laboratory of paralyzing drugs in the bodies of patients who died at Glendale Adventist Medical Center. The six were among 20 patients whose bodies were exhumed as part of a painstaking investigation set off by Saldivar’s own 1998 statements.

Police did not publicly disclose the names of the alleged victims, but informed relatives. One victim, 77-year-old Eleanora Schlegel of Pasadena, was on the verge of leaving the hospital, police told relatives.

Siverling suggested that the case could grow, saying police could continue to investigate other deaths at Glendale Adventist and have had an “initial inkling” that Saldivar may have killed patients at other hospitals where he worked part time.

Siverling would not identify the drug found in the six bodies, but detectives told families of several victims that it was Pavulon, a muscle relaxant that suppresses natural breathing.

“We believe we have found the truth, as disturbing as it is,” Siverling said in announcing that Saldivar had been arrested without incident at 5:45 a.m. as he drove to a construction job in the San Fernando Valley from the home he shares with his parents in the foothills of Tujunga.

Glendale Police Sgt. Rick Young said Saldivar was “very sullen, very quiet” when his car was stopped at the Balboa Boulevard offramp of the Ronald Reagan Freeway in Granada Hills.

“He’s very distraught. He’s very shocked and distressed,” said Woodland Hills attorney Terry M. Goldberg, who has been representing Saldivar in a series of wrongful death lawsuits filed against the former respiratory therapist and against Glendale Adventist.

Saldivar Could Face Death Penalty

In 1998, after his alleged confession, Saldivar was arrested and held for two days. At the time, he said he had killed 40 to 50 patients over a five-year period with Pavulon and succinylcholine chloride, another drug that stops natural breathing. But he was released because prosecutors said they needed independent evidence to corroborate his statement.

Saldivar retracted his story soon after, saying he had concocted it because he was depressed and wanted to get the death sentence.

The pudgy, bespectacled hospital worker now could, in fact, be eligible for the death chamber--and lethal injection.

By midmorning Tuesday, Goldberg and Saldivar’s mother had arrived at the Glendale police station. Isaura Saldivar, 52, appeared somber and refused to comment.

Goldberg was angry that he was not allowed to see his client until 10:40 a.m., nearly five hours after the arrest.

Because police would have been required to inform Saldivar of his Miranda rights to remain silent and see his attorney, the long time alone with detectives raised the possibility that he had, once again, chosen to give a statement.

Saldivar was initially held without bail in Glendale City Jail. Later in the day, after complaining of chest pains, he was diagnosed with high blood pressure and was transferred to County-USC Medical Center’s jail ward for observation, a Glendale police spokesman said.

His arraignment is scheduled for Thursday in Glendale.

The key evidence against him so far was developed at the Livermore lab near Oakland, which authorities reportedly chose in part to head off potential defense attacks on the credibility of police laboratory findings.

The choice of the Livermore lab was one of several ways in which the three-year investigation into Saldivar was shaped by prosecutors’ experience with Los Angeles’ highest-profile murder case--the trial of O.J. Simpson.

In that case, Simpson’s attorneys, led by Johnnie L. Cochran Jr., devastated the prosecution case in large part by focusing on flaws in how Los Angeles police and coroner’s officials handled evidence.

The deputy district attorney assigned for more than two years to Saldivar’s case, Brian Kelberg, is a medical expert who presented much of the technical testimony at Simpson’s 1995 trial.

Officials did not “want this to go as the O.J. Simpson case,” Glendale’s city manager, Jim Starbird, said early last year.

To develop the independent evidence Kelberg said would be necessary to charge Saldivar, police and prosecutors studied the files of 171 patients who died during Saldivar’s shifts in the last two years he worked at the hospital. After 54 were eliminated because the bodies had been cremated, a physician consultant helped review the other 117 deaths to determine which were most suspicious.

Police indicated previously that they intended to test the exhumed bodies for both Pavulon and succinylcholine chloride. But several prominent figures in the forensic testing community said recently that Livermore scientists believe that succinylcholine chloride degrades too quickly into normal body chemicals to detect with available tests.

Both drugs are generally used to make it easier to insert a breathing tube in a patient or to put a patient on a respirator during surgery. But only a doctor or nurse would be authorized to administer them, not a respiratory therapist such as Saldivar.

Some Frustrated by Investigation’s Pace

In their limited public comments over the past three years, Kelberg and Glendale police said the investigation was taking so long in large part because of the work involved in weeding through thousands of case records at Glendale Adventist since Saldivar went to work there in 1989, when he was 19. Investigators had to make certain, for instance, that the amounts of Pavulon found in patients’ bodies could not be attributed to doses they may have received as part of their regular medical care.

But as the months turned into years, some Glendale officials became frustrated, apparently thinking that the studious Kelberg was being too cautious, asking for more and more evidence even after the “hits” were registered by the lab. Laboratory experts say detecting the Pavulon would have taken only a few weeks after the bodies were exhumed in the spring and summer of 1999. Meanwhile, Saldivar remained free, able to flee if he wished.

The critics apparently found a sympathetic ear after Dist. Atty. Steve Cooley won election in November, defeating Gil Garcetti. Cooley, who officially took office last month, reportedly agreed that his predecessor had sat on the case too long, perhaps still gunshy from the Simpson fiasco.

Cooley assigned a new prosecutor to the Glendale Adventist investigation.

Kelberg confirmed to The Times last week that he had been replaced by Pasadena-based Deputy Dist. Atty. Al McKenzie. Known as a streetwise prosecutor, McKenzie successfully handled another sensitive medical murder case a decade ago, winning a conviction of a Glendale physician, Dr. Richard P. Boggs.

Boggs was charged with killing a Burbank accountant and pretending the victim was another man--who supposedly died of natural causes in his office--in a complex scheme to collect $1.5 million in insurance.

“The matter has been reassigned,” said Kelberg, who for nearly two decades has been the head of a special medical unit of the prosecutor’s office. “Whatever my feelings may be, they’re irrelevant. . . . I wish him well.”

Cooley declined to comment Tuesday. But spokeswoman Sandi Gibbons denied there had been a switch in prosecutors.

“As deputy in charge of the medico-legal unit, [Kelberg] was assigned to assist the Glendale Police Department in their investigation of this case, which he has done,” Gibbons said. “There had never been a decision made on a trial lawyer. . . . When Steve Cooley was elected district attorney, he wanted some fresh eyes to look at a lot of things. . . . This case was one of the things. He assigned it to a lawyer who is also an expert in medical investigations and has successfully worked with Glendale police.”

At Glendale Adventist--a nearly century-old 450-bed hospital--officials said they would not discuss the arrest until formal charges are filed. But patients and visitors were given a one-page letter from Glendale Adventist President Fred Manchur, summarizing the hospital’s role in the criminal case--from contacting police almost three years ago to counseling families of those whose bodies were exhumed.

“Please be assured that we have taken extraordinary precautions to protect our patients and have devoted significant resources to implementing new quality improvement policies,” the letter said.

A spokesman for Arcadia Methodist Hospital said that Saldivar worked there from time to time between 1990 and 1992, but that Arcadia police “thoroughly investigated” the matter after Saldivar gave his statements in Glendale. “There was no evidence that anything had transpired,” spokesman Tom Casacky said.

Spokeswomen at two other hospitals where authorities said Saldivar had worked part time, Glendale Memorial and Pacifica Hospital of the Valley in Sun Valley, said Tuesday that they did not know if there had been any police investigations.

Saldivar’s arrest is likely to set off new scrutiny of whether Glendale Adventist--at least--properly monitored his work.

At that hospital, Saldivar had come under suspicion a year before police were called in, according to an affidavit filed with the state Respiratory Care Board after Saldivar’s initial arrest. The hospital conducted an internal investigation after another respiratory therapist reported rumors, following the death of a patient, that Saldivar had a “magic syringe.” Later in 1997, the same therapist discovered morphine and two vials of succinylcholine chloride in Saldivar’s locker, the document says.

The police task force did not begin investigating Saldivar until March 1998, when the hospital reported that an anonymous caller said a respiratory therapist might have “helped a patient die fast.”

Faced with a daunting task--reviewing more than 1,000 patient deaths during Saldivar’s shifts--the task force was set up with five full-time and two part-time investigators, Siverling said. It has cost more than $300,000, not including salaries, he said, and the team has studied more than 2,000 medical charts, making more than 300,000 photocopies.

Police ‘Got Fooled,’ Saldivar Says

According to the police affidavit used to revoke Saldivar’s state license in 1998, he insisted he had “very ethical criteria as to how he picked victims,” choosing ones who looked “like they were ready to die.”

But some hospital workers have questioned any description of him as an “angel of death.” So, too, did Larry Schlegel, the son of the 77-year-old woman who had been alert and looking forward to going home “possibly the day she died.”

“I’m familiar with his claims,” Schlegel said Tuesday of Saldivar, “and I wouldn’t see it that way.”

Others have questioned Saldivar’s stated motives, saying that although he worked long hours, he was basically lazy and easily irked by the demands of caring for seriously ill patients.

Yet many hospital workers seemed blase about the case Tuesday, even as news bulletins were announcing Saldivar’s arrest and a media helicopter hovered above the sprawling medical facility along the Ventura Freeway.

“That’s old news, isn’t it?” asked one employee, who declined to give her name because it is against hospital policy for workers to talk to the news media. “We all forgot about it,” said another.

Indeed, Saldivar had kept a low profile since recanting his confession. But in a conversation with a Times reporter at his home last month, he was well aware that the investigation was still alive. He belittled the police effort, saying Glendale detectives “got fooled” by other respiratory therapists, who made up stories about him.

The investigation “will not be over,” he said, “until Glendale police get the courage to admit they were fooled.”

One person who does not believe police were fooled is Cathleen McCoy, executive officer of the state Respiratory Care Board. Though it revoked Saldivar’s license in 1998, he was eligible to reapply after three years--meaning this spring.

“I’m very, very pleased,” McCoy said. “When I read a summary of his confession, it was too graphic for him not to have done this. He later recanted and said he has mental problems, which means he shouldn’t be in the profession anyway. But looking through the hundreds of cases we’ve done, from the confession, there’s no doubt in my mind.

“That’s not his decision to make, whether someone is terminal. Even if the patients were going to die in a month, that was their month. That wasn’t his month. That wasn’t his decision. That was their decision and their family’s decision, not the health care practitioner’s.”

Saldivar was fired from Glendale Adventist the day police released him in 1998. He has held odd jobs since then, including stints with a car rental agency, as a security guard and even with a phone sex line firm.

After the initial burst of attention, he stayed for a time with friends in a Woodland Hills apartment complex, then returned to his parents’ small white bungalow in Tujunga.

Saldivar said in December that he had most recently been working in construction and helping his father, a handyman, “doing what I can.”

*

Times staff writers Richard Fausset and Jean Guccione and researcher Maloy Moore contributed to this story.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

EFREN SALDIVAR

Born: Sept. 30, 1969, Brownsville, Texas

Residence since 1971: Tujunga

Personal: Never married, lives with parents and younger brother

Education: Attended Verdugo Hills High School. Obtained high school equivalency certificate June 8, 1988

Respiratory therapy training: Valley College of Medical and Dental Careers, North Hollywood; state-certified as respiratory care practitioner, June 2, 1989

Main employment: Glendale Adventist Medical Center, 1989-98

Part-time jobs over the years: Arcadia Methodist Hospital, Glendale Memorial Hospital, Pacifica Hospital of the Valley, Schaefer Ambulance Service, Thompson Memorial Medical Center

Case Timeline

1998

Feb. 16 Glendale Adventist Medical Center, below, receives a phone tip that an unnamed respiratory care therapist “helped a patient die fast.” Hospital officials determine that the tipster is referring to Efren Saldivar. He had been investigated internally a year earlier after a coworker reported rumors that he had a “magic syringe.”

March 2 Glendale police are asked to investigate.

*

March 11 Saldivar voluntarily comes to police headquarters and confesses he had caused between 40 and 50 deaths, starting in 1992--three years after he came to the hospital. Saldivar says he stopped in August 1997 when he learned that coworkers had found vials of morphine and succinylcholine chloride in his locker. Saldivar, then 28, is arrested.

*

March 13 Saldivar is released after a prosecutor says police need independent evidence to corroborate his confession.

*

March 30 Glendale police disclose that they have formed a task force to investigate deaths at the hospital, and may exhume bodies to test for drugs. Los Angeles County Dist. Atty. Gil Garcetti’s top medical expert, Brian Kelberg--a veteran of the O.J. Simpson prosecution team--is appointed to oversee the case.

*

April 9--10 Saldivar gives two television interviews and says, “I lied.” He claims he concocted his “Angel of Death” story because he was pressured by police and was so depressed he wanted to die himself. Lacking the courage to commit suicide, he says, he hoped his story would get him the death penalty.

*

1999

April 28 Police announce that they are ready to exhume 20 bodies of Glendale Adventist patients.

*

2000

May 19 An attorney for Saldivar asks a Superior Court judge in Burbank to compel police to release their evidence against his client. Police say the investigation is continuing, and the judge declines the request.

*

Dec. 4 Steve Cooley is sworn in as Los Angeles County district attorney, after trouncing Garcetti at the polls. Cooley replaces Kelberg with Al McKenzie, a Pasadena-based prosecutor, who in 1990 obtained a conviction against a Glendale physician, Richard P. Boggs, in a high-profile murder-for-profit case.

*

2001

Jan. 9 Saldivar is arrested at 5:45 a.m. in Granada Hills as he drives from his home in Tujunga to his current job as a construction worker in the San Fernando Valley.