Edson Isidoro Guimaraes

Case record: Edson Isidoro Guimaraes

Background

Edson Isidoro Guimarães was a Brazilian nursing assistant and nurse’s aide at Salgado Filho Hospital in the Méier district of Rio de Janeiro, Brazil.

He was born in 1957.

The offence

Guimarães was a convicted serial killer.

He confessed to five murders and was convicted of four murders.

He was suspected of committing up to 131 murders in total.

Prosecutors said his victims were mostly unconscious or comatose patients. Guimarães killed patients by lethal injection and by removing oxygen masks.

Guimarães claimed that he chose patients whose conditions were irreversible, and who were in pain and suffering. He said he carried out the killings to ease the anxiety of families who were “agonising because a patient was suffering a lot.” He also said he was in peace because patients were in a coma and had no way of recovering.

Guimarães was thought to have killed up to 131 patients between January 1 and May 4 1999. Between 1 January and 4 May, 131 of 225 deaths in the hospital’s emergency ward occurred while Guimarães was on duty.

He was said to have confessed to five murders of seriously ill patients.

Investigation

Investigators were alerted after a higher than average death rate on his ward raised suspicions.

A cleaning lady reported that in late April she first spotted Guimarães drawing a syringe of deadly potassium chloride from the supply room, slipping it into his pocket, and then strolling into the intensive care unit. While Guimarães made his rounds, the cleaning lady said he pressed the needle into the IV drip bag of one of the unit’s half-dozen patients and hit the plunger. Moments later, the patient was dead.

Guimarães had been caught after a hospital porter saw him fill a syringe with potassium chloride and inject a comatose patient who immediately died.

Prosecutors and police described the evidence that Guimarães had been causing deaths on his shifts, including changes in death rates when he was moved away from the unit.

A possible motive involved undertaker referrals. It was said he was paid about $60 dollars a time to inform local funeral homes of a patient’s death so that they could contact the deceased’s relatives. According to Josias Quintal, Rio’s secretary for public security, “He may have begun doing it to earn money and then just lost control”.

A motive described by Flavio Silveira, the administrator of Salgado Filho, was that Guimarães said he wanted to abbreviate suffering and also make some money on the side, because “everybody gets some money on the side.”

During the investigation, it was also noted that death by potassium chloride was referred to as a “white death” in Brazil, leaving no identifying anatomical or chemical signature during routine autopsy. It was stated that autopsies on the last two patients showed red stains on their hearts and lungs characteristic of asphyxia, but such marks could occur after the failure of an oxygen mask, for instance.

Arrest

Guimarães was detained on suspicion of murdering patients.

He was caught in 1999 when a hospital porter saw him fill a syringe with potassium chloride and inject a comatose patient who immediately died.

On his arrest, he confessed to five murders.

When alerted by the cleaning lady, administrators transferred Guimarães to an outpatient unit on his next shift. The death rate in intensive care fell to zero. When he returned three days later, on May 4, four patients died, even as police waited in a nearby office to make an arrest.

Following Guimarães’ arrest, a check of hospital records revealed that the unit’s death rate more than doubled during Guimarães’ 12-hour shifts, from an average of just under two deaths to four or more.

Trial

Guimarães appeared on television on Globo with a video-taped statement in which he confessed to killing five seriously ill patients, saying his aim was “to ease the anxiety of families which were agonising because a patient was suffering a lot”.

Guimarães told reporters prior to his trial: “I don't regret what I did”, adding “I did it to those in irreversible comas and whose families were suffering.”

After his confession, Guimarães’ lawyer initially appeared to be preparing an insanity defense. In a recent court deposition, Guimarães, who had hired a new lawyer, changed his story.

In response to reporters at a press conference about whether he had poisoned patients, Guimarães said: “Some patients, yes.”

Asked if he had taken away patients’ oxygen masks, he said: “The oxygen mask was taken away, yes. There were five patients that this happened to... I chose the patients I saw suffering, generally patients with AIDS, patients who were almost terminal. I am calm because the patients were in a coma and had no way of recovering.”

He also said: “I do feel a bit sorry, OK, because I should not have taken anyone's life.”

Guimarães said that he confessed only because he was threatened by police.

He told reporters: “I am not sorry because I am at peace, because the patient was in coma and there was no prospect of recovery.”

He also insisted that while he had directed relatives of dead patients to the funeral home of a friend, he had never received any payment for it.

Following these statements, Marcelo Monteiro, a member of the prosecution team, said that Guimarães had been charged with only four murders. Monteiro said: “I'm completely convinced he's a murderer. The proof will demonstrate he's responsible for what happened.”

Monteiro also said: “I'm convinced the only truths he told today were his name, date of birth and address.”

Sentencing

Guimarães was convicted on February 21, 2000, of the murders of four patients.

He was sentenced to 76 years in prison on February 21, 2000.

Outcome

Guimarães remained convicted for the four murders he was charged with and sentenced for.

He was suspected of additional murders beyond those for which he was convicted.

Aftermath

Local newspapers investigated reports that Guimarães may have been paid a commission by undertakers to recommend their services to patients’ relatives.

Guimarães was dubbed an “angel of death”.

He had previously been described as a nurse’s aide at Salgado Filho Hospital.

He had initially confessed to five murders and later retracted aspects of his confession, insisting that he did not kill anyone and that he only confessed because police threatened to beat him.

He was thought to have killed up to 131 patients between January 1 and May 4, 1999.