“There are three explosive devices in building one. You have two hours,” the caller said.
James Perrault received the first of several threatening phone calls around 5:30 p.m. on September 26, 1996, according to court records. Perrault, a hospital police officer, was on duty at the security desk at the Veterans Affairs Medical Center in Northampton, Massachusetts.
“This is my last call. In 25 minutes, I’ll see you in hell,” the distorted voice said in a later message.
In response to the bomb threat, fifty acutely ill patients were moved to another building several hundred yards away. No explosive devices were found.
On September 27, Perrault received two more calls at the security desk from someone using the same distorted voice. After reviewing the calls from both days, he believed they had been made by Kristen Gilbert.
Perrault had befriended Gilbert, then a 28-year-old married nurse assigned to Ward C at the hospital, in the summer of 1995. They worked similar schedules and Perrault’s job included responding to medical emergencies in Gilbert’s ward. Within months, the two were engaging in an extramarital affair, court records show.
Gilbert, who was a mother of two, filed for divorce from her husband, Glenn Gilbert, in November 1995, according to court records.
At the time of the September 1996 bomb threats, James Perrault and Kristen Gilbert’s relationship had fallen apart and Gilbert was under investigation for the murder or attempted murder of several of her patients.
Kristen Gilbert started working at the VAMC in 1989. A proficiency report obtained by the Boston Globe described her as “highly skillful,” calm and compassionate. She organized charity drives and collections for the needy, one of her defense attorneys said, and she once organized a memorial service for a colleague who died of cancer.
However, Gilbert did have a tendency to be nearby when patients died. Co-workers sometimes referred to her as the “angel of death,” the Boston Globe reported.
Federal prosecutor Bill Welch said that death rates seemed to increase significantly during the shifts Gilbert was assigned to, according to the Globe. Eventually, her fellow nurses grew suspicious.
In particular, Gilbert’s co-workers started to raise concerns about an increase in medical emergencies (“codes”) and deaths in Ward C between August 1995 and February 1996, court records show. A criminal investigation was launched in February, and Gilbert left her job soon after learning she was the target of it.
According to a search warrant affidavit, a statistical analysis of codes and deaths in Ward C between January 1, 1995 and February 19, 1996 showed that Gilbert was present or on duty for 37 of them. Authorities determined the likelihood that her frequent presence during these emergencies was merely coincidental was less than .1%.
Fellow nurses suspected that Gilbert was injecting epinephrine—a form of adrenaline—into patients to induce accelerated heart rates, the affidavit stated. In one incident, a nurse discovered used epinephrine ampoules in a disposal box after a patient stabilized. In another, epinephrine was found to be missing soon after a patient coded.
Prosecutors alleged that Gilbert took epinephrine from the ward’s medical cabinet, entered patients’ rooms when they were alone and injected the drug under the pretense of flushing their IV lines with saline, according to court records. The drug would then cause cardiac emergencies that appeared to be natural to personnel that responded, including Perrault.
Two motives were suggested by authorities to explain why Gilbert would cause the codes: they enabled her to spend time with Perrault; and they gave her “the attention and excitement that she craved,” court records stated.
As a result of the investigation, Gilbert was indicted for the murders of four patients and the attempted murders of three others.
Massachusetts does not have the death penalty, but because the alleged crimes were committed on federal government property, the case would be tried in federal court. If convicted, Gilbert could have faced a death sentence, administered by lethal injection.
“Ow, ow, you’re killing me,” Stanley Jagodowski yelled from his room on Ward C on August 21, 1995, according to federal prosecutors.
Kristen Gilbert was seen entering Jagodowski’s room with a syringe before that, prosecutors said. The 66-year-old Army veteran had not been ordered to take any intravenous medication.
Soon afterward, Jagodowski went into cardiac arrest. He died the following day.
On December 8, 1995, Henry Hudon, a 35-year-old schizophrenic Air Force veteran, was admitted to Ward C for treatment of the flu. Hudon’s condition was stable until Gilbert’s shift started later that day. He suffered four cardiac arrests while she was on duty and died. An autopsy and toxicology tests determined that his cause of death was epinephrine poisoning, according to prosecutors.
Gilbert was assigned to the care of Thomas Callahan, 60, in the ICU on January 22, 1996. At 7:45 p.m., he screamed that he felt like he was going to die. His heart rate rose to 240 beats per minute and his blood pressure was extremely elevated for 15 minutes before he stabilized.
Two nurses found three used epinephrine ampoules in a needle disposal bucket in the ICU after the cardiac emergency. Experts later testified that the change in Callahan’s condition could only be explained by an epinephrine overdose, prosecutors said.
Kenneth Cutting, a 41-year-old multiple sclerosis patient who had lost his eyesight and use of his limbs, was being treated in the ICU for sepsis on February 2, 1996. According to prosecutors, Gilbert asked a co-worker if she would be able to go home early if Cutting were to die. She had a date with Perrault later that night.
About 40 minutes after that conversation, Cutting suffered a cardiac arrest, allegedly while he was alone with Gilbert. He died at 7:15 p.m.. In 1997, Cutting’s body was exhumed and experts concluded that his death was likely caused by epinephrine poisoning.
Two days after Cutting died, on February 4, Gilbert was working as the medication nurse for Angelo Vella, a 65-year-old former Marine. Gilbert was supposed to flush his IV site with saline, prosecutors said, but Vella screamed that whatever she injected him with “burned.” His heart rate increased to 300 beats per minute and he went into cardiac arrest.
After he was stabilized, Vella allegedly told nurses that Gilbert had injected something in his IV.
On February 15, 1996, Edward Skwira, 69, was admitted to the ICU in stable condition about an hour before Gilbert’s 4 p.m. shift began. At 5:07 p.m., Gilbert reported that Skwira had gone into cardiac arrest. He died three days later from related complications.
Another nurse told authorities that there were three ampoules of epinephrine in the ICU medicine cabinet at 4:00, but there were none at 5:07. The nurse then found three used ampoules in the unit’s needle disposal bucket. Gilbert was alone with Skwira at the time of the cardiac arrest, according to prosecutors.
Prosecutors also alleged that Gilbert injected another patient, Francis Marier, with epinephrine and insulin on December 20, 1995, but Marier survived.
As the investigation of the deaths on Ward C began, Kristen Gilbert left her position at the hospital. According to the Boston Globe, she started collecting worker's compensation for a workplace shoulder injury.
Gilbert initially relied on Perrault to keep her informed about the progress of the investigation, court records said. She discussed the case with him and complained about former co-workers who she believed were cooperating with authorities and pointing fingers at her.
Their relationship grew strained and Perrault tried to end it in June 1996, but Gilbert begged him not to. He made another attempt to distance himself from her that August.
In September 1996, Perrault told Gilbert he was set to be interviewed by federal prosecutors. She allegedly urged him not to go.
After he rejected her, on the day of the interview, Gilbert blocked Perrault's car in his driveway with her own, according to court records. He still insisted on proceeding with the interview.
Gilbert left, but later that day, Perrault returned to his car in a Springfield parking lot to discover that the air had been let out of one of his tires.
In the days that followed, somebody threw eggs at Perrault's vehicle, painted its windshield, scratched the surface with keys and damaged the front license plate. According to court records, Perrault spotted a car similar to Gilbert's nearby after one incident.
Perrault started receiving phone calls from someone who would only breathe heavily or just hang up when he answered. Seven of those calls were traced back to Gilbert’s phone number, court records stated.
Then came the bomb threats.
According to investigators, Kristen Gilbert walked into a Toys-R-Us on September 26, 1996 and purchased a "Talkgirl Jr" voice-changing device. She also purchased several packages of batteries compatible with the device at a drug store about an hour later.
A neighbor saw Gilbert leave her apartment around 5 p.m., the same time Perrault was taking over a two-hour shift at the VAMC security desk.
At 5:11 p.m., Perrault answered the phone at the desk and heard a brief recorded message from a voice he later described as “staticky” and “mechanical” that made a reference to Persian Gulf veterans.
11 minutes later, the first call about the explosive devices came in, the voice sounding the same as in the previous call. Over the next 90 minutes, the security desk received more than ten taunting messages warning them to evacuate.
On September 27, when Perrault was again stationed at the security desk, he got two more anonymous calls. His next night on duty, September 30, another call came in, this one saying, “Officer Perrault, I’ve been watching you, boy.”
About 20 minutes before that call was made, according to court records, Gilbert purchased a “Talkboy Jr”—a similar voice-changing device to the Talkgirl Jr—and batteries at a Toys-R-Us.
Perrault described the voice that called on September 30 as similar to the previous ones but with a southern drawl. Several other departments at the hospital received anonymous calls that night, including the nurses’ station on Ward C.
The next day, investigators set up surveillance at several pay phones in the area around Gilbert’s apartment during Perrault’s shift. Perrault received at least four calls that night, including one moments after a state trooper observed Gilbert entering a phone booth outside an ice cream stand.
A government expert later tested the Talkboy device and altered the sound from one of the recorded calls to remove the distortion. Gilbert’s friend and her ex-husband both identified the voice in the undistorted recording as hers.
At her trial for the bomb threat charges, prosecutors argued that Gilbert made the calls for two reasons: to get back at Perrault for dumping her and to obstruct the investigation of the Ward C deaths.
In January 1998, Gilbert was convicted of making telephone bomb threats and sentenced to 15 months in prison.
The investigation of the deaths at the hospital continued.
In November of 1998, a federal grand jury indicted Kristen Gilbert on three counts of murder, two counts of attempted murder and several other charges. The indictment included charges related to the deaths of Henry Hudon, Kenneth Cutting and Edward Skwira and the alleged attempted murder of Thomas Callahan and Angelo Vella.
A superseding indictment filed in May 1999 added a fourth murder charge for the death of Stanley Jagodowski and another attempted murder charge for the incident involving Francis Marier. At that time, federal prosecutors also announced they would be seeking the death penalty.
Judge Michael Ponsor, who presided over Gilbert’s four-month trial beginning in November 2000, later described it in a column published in the Daily Hampshire Gazette as “a classic battle of experts.”
Ponsor wrote that the defense presented “well-respected clinicians with excellent credentials” who testified that all of the victims could have died from natural and explainable causes. Prosecutors presented four doctors who concluded that the deaths were consistent with epinephrine poisoning, but they could not state it was definitely the cause, according to the Boston Globe.
There was other evidence, including an alleged admission to the crime by Gilbert herself during an argument with Perrault. Still, Ponsor wrote that much of the government’s case was circumstantial.
The jury deliberated for 12 days before reaching a verdict.
In March 2001, Gilbert was convicted of the first-degree murder of Hudon, Cutting and Skwira, the second-degree murder of Jagodowski, assault with intent to kill of Callahan, Cutting, Vella and Skwira, and assault resulting in serious bodily injury of Jagodowski. She was acquitted of attempting to kill Francis Marier.
After hearing evidence and impact statements from relatives of the victims and the defendant, the jury had to consider Gilbert’s punishment. They ultimately deadlocked on whether to sentence her to death for the first-degree murder convictions.
As a result, Ponsor sentenced Gilbert to four consecutive life terms in prison.
“The defense theory in the case was essentially that the deaths were natural or caused by inadequate medical care,” Harry Miles, one of Gilbert’s court-appointed defense attorneys, told HLN.
Unlike some death penalty cases where the focus is largely on whether the crime is deserving of execution, Gilbert’s case was “tried hard on guilt and innocence,” Miles said, with the defense arguing that there may not have been any crime committed at all.
According to Judge Ponsor, between attorneys’ fees, experts and other expenses, Gilbert’s defense cost the public more than $1.6 million.
Miles described the case as “enormously stressful” to work on because the attorneys put so much time and effort into preparing and trying the guilt phase and then quickly needed to shift to the penalty phase.
Defense attorney David Hoose, who declined to comment for this article, complained in a 2001 speech about the way he felt the prosecutor dehumanized Gilbert in court, particularly during the penalty phase when she was referred to as “an empty chasm of darkness.”
“All to justify what he was doing—asking his fellow citizens to help him expunge a life,” Hoose said, according to a transcript. “It’s the power of conviction. Once they had convinced themselves, there was nothing that could be done—no room to see the slightest possibility of error.”
Miles told HLN he believed it was possible Gilbert could have gotten her conviction overturned on appeal, but she did not want to risk facing the death penalty again.
Gilbert maintained her innocence, but she dropped her appeal effort after a 2003 U.S. Supreme Court decision finding that it was constitutional for a defendant to be sentenced to death if convicted at a retrial after the jury deadlocked in the penalty phase of their original trial.
“That was a significant factor in not appealing the case,” Miles said.
Charles Rankin, the attorney who handled Gilbert’s appeal, did not return a call seeking comment on the case, but the Boston Globe reported that Gilbert wrote in an affidavit withdrawing the appeal, “I do not wish to face the death penalty again, and I do not wish to subject my family to the ordeal of a death penalty trial again.”
“Basically, signing that affidavit means she’s spending the rest of her life in prison,” Rankin told the paper.
Gilbert, now 45, remains in custody at the Carswell Federal Medical Center in Fort Worth, Texas.