The killing of Pasquale Napolitano is identified retrospectively as one of Charles Cullen’s murders: Cullen killed him on July 13, without knowing his name at the time. That detail gives the event a starkly impersonal edge. The record establishes the victim, the date, and the killer, but does not specify how Napolitano was killed or describe the immediate scene.

Identification and chronology

The identification appears as a concise note in the book’s later chronology. It makes clear that Napolitano’s name was not known to Cullen when he killed him; the connection between victim and killer belongs to the subsequent account, not to Cullen’s recognition of the person in his care. The date is given as July 13, without a year in the note identifying the killing.

The hospital setting and Cullen’s methods

Other episodes in the book show how Cullen’s access to patients and ordinary clinical routines could conceal deliberate harm. At Saint Luke’s, he injected digoxin into an elderly patient’s intravenous line through a port normally used for routine line care, then returned to the nursing station and took part in the response when the patient’s condition deteriorated. In a separate episode, he used access to medication supplies and intravenous bags to carry out a less direct poisoning method. These accounts establish patterns in Cullen’s conduct; they do not specify the method used against Napolitano.

The wider history also includes a different kind of warning sign at Saint Barnabas Hospital, where testing found insulin in an intravenous bag and laboratory results showed unusually high levels of insulin administered to patients. That investigation illustrates how suspicious harm could first appear as unexplained clinical crises rather than as an identifiable attack. It is background to the book’s account of Cullen’s repeated access to patients and medication, not evidence about Napolitano’s individual case.

What the event establishes

The account firmly attributes Napolitano’s death to Cullen and supplies the date, but offers no patient-specific description of the killing, its drug or other means, or the investigation that identified Napolitano. Other nurses’ recollections of unexpected deaths and Cullen’s proximity to patients belong to separate Saint Luke’s cases; they help establish the broader pattern of suspicion around his work, but cannot fill in the missing particulars of this event.

Napolitano’s killing is therefore presented as a confirmed fact within a larger sequence, not as a fully narrated scene. The contrast between Cullen’s ignorance of the patient’s name at the time and the later naming of the victim captures the distance between the act as it occurred and its eventual reconstruction.