Asking for forgiveness, self-described “Angel of Death” Efren Saldivar was sentenced to life in prison without parole Wednesday, even as a judge unsealed a second confession in which the defendant said he killed considerably more than 100 Glendale hospital patients with injections of paralyzing drugs, more than twice the number he had admitted to previously.
In the Jan. 9, 2001, confession, the 32-year-old Saldivar also said that he killed for a “shameful” and “flippant” reason--to reduce his workload.
“Oh, God, you can’t believe how flippant. It was not for personal pleasure. It was not a rush,” the former Glendale Adventist Medical Center respiratory therapist told two members of a police task force.
“We had too much work,” Saldivar said. “When I was only at my wits’ end on the staffing, I’d look at the [patient] board. ‘Who do we gotta get rid of? . . . OK, who’s in bad shape here?’ ”
Saldivar, who pleaded guilty March 12 to six counts of murder and one of attempted murder under a plea bargain that spared him the death penalty, also told police that he killed patients at two other hospitals where he moonlighted. He also said he “introduced” two other respiratory therapists to killing.
Saldivar made the statements just after his arrest on suspicion of murder. He also had confessed in 1998, but said then that he killed no more than 50 patients, and only at Glendale Adventist.
The second confession was among hundreds of pages of records unsealed by Superior Court Judge Lance Ito after an emotional sentencing at which Saldivar’s one known surviving victim said he should have received the death penalty.
“I’m a survivor. . . . I’m very lucky,” said Jean Coyle, 64, who was revived after a “code blue” emergency in February 1997 and now lives in a nursing home. She addressed the court haltingly, breathing with the help of a tracheotomy tube, while Saldivar sat at the defense table, his head bowed.
“I don’t know if he thought he was God or what. It wasn’t right,” Coyle said. “I think that he should die.”
Minutes later, Saldivar spoke as Coyle and relatives of several other victims listened from the back of the courtroom.
“I am deeply ashamed by the fear, frustration and the pain that these and other families have had to endure. I know there’s nothing I can say to soothe their anger,” he said.
“However I want to say that I am sorry. I am truly sorry. And I ask for forgiveness, though I don’t expect any.”
Comparing Killing to Shoplifting Gum
Saldivar, who lived in Tujunga, was taken into custody after his first confession in 1998, but freed two days later when prosecutors said they needed independent evidence to corroborate his admissions. Saldivar then recanted that confession, saying he fabricated the story of killing because he was pressured by a detective and was so depressed that he wanted to die.
To determine whether he had killed anyone, the police task force exhumed 20 bodies, chosen from among 1,050 patients who died at Glendale Adventist while Saldivar was on duty or within an hour of his shifts. Lawrence Livermore National Laboratory found traces of Pavulon--which stops natural breathing while doctors insert tubes down patients’ throats--in six of the 20.
In his first confession, Saldivar insisted that he injected lethal drugs in patients’ intravenous lines to end the suffering of terminally ill people. Last year, however, he spoke of having too much work and compared killing to shoplifting a pack of gum.
“You don’t plan it. After that moment, you don’t think about it for the rest of the day, or ever,” he said.
Saldivar was employed at Glendale Adventist from 1989 until March 1998, when a phone tip prompted the hospital to call in the police. In his second confession, he indicated that he began giving lethal injections early in his career, and got away with it for years.
“I lost count after 60. And that was back in ’94,” he said.
He estimated that he killed as many as 40 patients in each of the following two years, 1995 and 1996. He then “slowed down” in 1997, his last full year at Glendale Adventist, he said.
“We’re talking hundreds of people,” Sgt. John McKillop said.
“I know it’s over a hundred,” Saldivar replied, according to a transcript of the confession, which was first filed in court by police as part of a search warrant application.
Saldivar’s estimate, if accurate, would establish him as one of the most deadly serial killers in American history, and among the most deadly hospital killers on record.
Saldivar’s lawyer, Deputy Public Defender Verah Bradford, said after the sentencing that many of his comments to police were “exaggeration” and “hyperbolic.” Saldivar is “a very warm, caring and good-hearted man,” she said, but also self-destructive.
“I just think it’s a kind of unfortunate flip exaggeration that Efren might be subject to,” Bradford said.
Despite what one official characterized as the “chilling” statements in his second confession, both Glendale police and county prosecutors have said that they will not seek to tie more deaths to Saldivar, or to determine his actual toll. Killings early in his career--or at the other hospitals--would be difficult to document after all these years, they said.
“It will always be a mystery as to how many people died at the hands of Mr. Saldivar,” Deputy Dist. Atty. Al MacKenzie said Wednesday.
The prosecutor said Saldivar’s motive might remain a mystery as well, after his varying statements over the years.
“This crime is so abnormal . . . you can’t attribute one motive to Mr. Saldivar,” MacKenzie said, pointing to the grand jury testimony of a Verdugo Hills High School classmate of Saldivar’s, Cindy Barnard.
Even before he became a respiratory therapist, Barnard said, Saldivar spoke of wanting to “put people out of their misery.”
Barnard told the grand jury that Saldivar said he was thinking of getting into the medical field “to help, like, older people that were basically dying. . . . He had told me that . . . his faith believes that God doesn’t like seeing people suffer.”
In Saldivar’s first confession, he spoke vaguely of contributing to deaths at hospitals where he moonlighted by neglecting to offer medical help patients needed, such as by providing “not the greatest CPR.” He said he gave lethal injections only at Glendale Adventist.
Confessed to Killings at Other Hospitals
In the second confession, though, Saldivar volunteered that his killing “wasn’t just at Glendale [Adventist],” and named two other hospitals: Methodist Hospital of Southern California in Arcadia, where he worked part time from 1991 to 1993; and Glendale Memorial, where he moonlighted from 1991 to 1994.
Asked how many patients he killed, Saldivar said, “over at Memorial, maybe 10.”
He said he was less active at the Arcadia hospital, “maybe two or three . . . less than five,” according to the transcript of the confession.
Saldivar said he also obtained vials of Pavulon at Glendale Memorial. “They just kept the packs of 10 over there in the fridge,” he said.
McKillop, who headed the task force, said police alerted both hospitals of Saldivar’s statements, but did not think it was feasible to expand the investigation because the patients’ bodies were “just too long in the ground.”
A spokesman for Methodist Hospital said last year that “there was no evidence that anything had transpired.” Glendale Memorial said in a statement Wednesday that “an exhaustive internal investigation” found no link between Saldivar and “any patient fatalities,” or any breach of security practices for handling drugs.
Glendale Adventist said Wednesday that “the search for the truth in this matter has been difficult for the families and medical center staff. . . . We are relieved that this process is at an end.”
As he did in his first confession, Saldivar also told investigators that he was not the only respiratory therapist to kill at Glendale Adventist. He said two male co-workers followed his lead.
“They knew what I was doing,” Saldivar said. “They wanted to try it. . . . I helped with the first couple by being the lookout. . . . After that, they’re on their own.”
The number of patients killed by the pair “had to be less than six,” he said, and they never discussed the incidents later.
The two men Saldivar named were among four respiratory therapists fired by Glendale Adventist after his 1998 confession, apparently for failing to disclose their suspicious about him. Both were given limited immunity during the investigation of Saldivar, meaning anything they said could not be used against them in a criminal case. But even with immunity, neither admitted killing patients and they provided little testimony that was useful to the task force, according to transcripts of their statements filed in court last year.
During a grand jury appearance last October, another of the four, Ursula Anderson--whom Saldivar did not accuse of killing patients--described finding a vial of one paralyzing drug, succinylcholine chloride, on a windowsill and giving it to him. “He had asked me to get him some,” said Anderson, who often worked the overnight shift with Saldivar.
She also recalled seeing him inject a drug into a patient’s intravenous line, though she didn’t know if the patient died.
“Did you report Mr. Saldivar to anyone at Glendale Adventist Medical Center?” she was asked.
“No, I didn’t,” she said. Asked why she didn’t report the incident, she said, “I don’t know.”
All four of the fired therapists still have their state licenses. The head of the California Respiratory Care Board said recently that the agency had monitored all four in any jobs they have held since they left Glendale Adventist, but did not pursue potential disciplinary cases against them to avoid jeopardizing the prosecution of Saldivar.
With his criminal proceedings completed, “we’re going to be expediting it,” Stephanie Nunez, the board’s executive officer, said Wednesday.
Though Saldivar’s name may now be included on lists of leading serial killers, Judge Ito indicated Wednesday that the hospital worker came close to never having criminal charges filed against him.
Judge Praises Prosecutors’ Tenacity
Ito praised the “tenacity” of the current prosecutors for bringing the case to a conclusion “when others thought it was a lost cause years ago. . . . This case was moribund for a long time.”
Ito told the lawyers in the case last month that their plea bargain had avoided a potentially “difficult” trial.
Had the case gone to trial, public defender Bradford was expected to challenge the legitimacy of Saldivar’s confessions, both given without a lawyer present. In addition, while Saldivar spoke in general terms about killing scores of patients, he offered no patient names or dates, even after he was shown the medical charts and photos of the people he was suspected of murdering.
Under the plea deal, Ito sentenced Saldivar to six life terms without parole for the murder counts and 15 years to life for the attempted murder of Coyle. “This, above all, was a very human tragedy,” the judge said. “I think nothing more needs to be said.”
Times staff writer Jennifer Sinco Kelleher contributed to this report.