Cullen’s dismissal from Somerset Medical Center came after investigators examining a crime uncovered his history and advised the hospital to fire him. The book presents the termination not only as the end of his employment, but also as a decision shaped by the hospital’s exposure to lawsuits: the source of the instruction mattered almost as much as the fact that Cullen was gone.

Background

The investigators’ advice followed their inquiry into Cullen and the discovery of his history. Somerset Medical Center was in a difficult position: it needed a reason to dismiss him, but a reason grounded in its own suspicion that he had murdered patients could also be treated as evidence that the hospital had recognized a danger. The account therefore distinguishes the investigators’ conclusions from the hospital’s stated basis for acting.

The Dismissal

Cullen was gone after the detectives advised Somerset Medical Center to fire him. The hospital could characterize the action as a reasonable response to the Somerset County Prosecutor’s Office, which was investigating a crime, rather than as an independent judgment that Cullen was responsible for particular deaths. That distinction did not change the practical outcome for Cullen, but it shaped how the institution could explain its decision.

Liability and Significance

The book describes following the prosecutor’s direction as the best possible situation for Somerset Medical Center from the standpoint of minimizing liability. Compliance with outside authorities’ suspicions was not, in itself, an admission that the hospital had shared those suspicions. The distinction was especially consequential because, if Cullen could not be definitively linked to specific patient deaths, the hospital could argue against civil liability for those deaths. The dismissal thus marks both an employment consequence of the investigation and an institutional effort to separate removal of Cullen from an admission of prior knowledge.