{"id":135287,"date":"2025-04-27T13:36:01","date_gmt":"2025-04-27T13:36:01","guid":{"rendered":"https:\/\/quixnet.net\/wpinstance\/with-insulin-killings-the-murder-weapon-is-often-hiding-in-plain-sight-nbc-news\/"},"modified":"2025-04-27T13:36:01","modified_gmt":"2025-04-27T13:36:01","slug":"with-insulin-killings-the-murder-weapon-is-often-hiding-in-plain-sight-nbc-news","status":"publish","type":"post","link":"https:\/\/quixnet.net\/wpinstance\/with-insulin-killings-the-murder-weapon-is-often-hiding-in-plain-sight-nbc-news\/","title":{"rendered":"With insulin killings, the murder weapon is often hiding in plain sight – NBC News"},"content":{"rendered":"

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When a lifesaving drug \u2014 insulin \u2014 is used as a murder weapon, medical professionals are likely unprepared to consider that the difficult-to-detect medication was used to commit a crime, according to a forensic pathologist who worked on the recent case of a West Virginia pharmacist convicted of fatally dosing her husband<\/a>.
Dr. Paul Uribe, a former military medical examiner who consults as a pathologist across the United States and helped solve a string of insulin murders at a West Virginia veterans hospital<\/a>, told NBC News that there appear to be few protocols showing pathologists and emergency room doctors how to best handle the cases.
\u201cYou\u2019re not going to stumble across an insulin homicide,\u201d Uribe said. \u201cYou have to have a suspect and you have to look for it, because if you\u2019re not looking for it, you\u2019re not going to find it.\u201d
While such crimes are rare, Uribe said, some recent cases in the U.S. have had a staggering number of victims. In Pennsylvania, a nurse confessed to trying to kill 19 people with insulin<\/a> at five facilities between 2020 and 2023. Seventeen of her patients died. At the West Virginia veterans hospital, a nurse admitted in 2021 to killing seven elderly patients with insulin.
Uribe said he knows of no protocols promoted by\u00a0organizations for ER\u00a0doctors or medical examiners and knows of only one state \u2014 West Virginia \u2014 where lawmakers have sought to reckon with this apparent lack of awareness. A bill introduced this year<\/a> in the state Legislature seeks to require emergency rooms to test patients for insulin when they\u2019re admitted with possible symptoms of insulin poisoning.
Jonathan Jones, the former president of the American Academy of Emergency Medicine, said that while the organization is concerned about insulin overdoses, it does not believe in \u201clegislating medical care.\u201d
\u201cThe best medical care is provided by properly educated, trained and board-certified physicians and not by legislators,\u201d he said in an email to NBC News. \u201cWe believe in continuing medical education around this issue and all others applicable to the physician\u2019s specialty but oppose treatment mandates and repercussions.\u201d
He did not respond to a request for comment about whether ERs need stronger guidelines.
Asked if forensic pathologists need better protocols, Reade Quinton, president of the National Association of Medical Examiners, said: \u201cI am not sure that is the right question. What medical examiners need is unobstructed access to scene information, witness statements and medical records so we can perform a complete and independent death investigation.\u201d
The lead sponsor of the West Virginia bill did not respond to requests for comment. But the parents of Michael Cochran \u2014 who was killed by his pharmacist wife and for whom the bill is named \u2014 believe the legislation could serve as a model for the country. And it could help others avoid the gut-wrenching search for answers that they endured for years.
\u201cThey won\u2019t have to wait for a result like we had to wait,\u201d Cochran\u2019s mother, Donna Bolt, told \u201cDateline.\u201d \u201cSix years.\u201d
Uribe\u2019s first insulin homicide case was at the veterans hospital in Clarksburg, West Virginia. Then a pathologist with the Armed Forces Medical Examiner System, Uribe\u00a0said he was asked in late 2018 to examine a series of mysterious deaths among elderly patients, all of whom were found to have had severe hypoglycemia, or low blood sugar.
The condition can be caused by excessively high doses of insulin, which acts as a lifesaving regulator of blood sugar for people with diabetes.
Some of the veterans were diabetic, Uribe recalled, but others were not. He said he was asked to find a \u201csmoking gun\u201d that could prove insulin was the murder weapon.
For emergency room physicians and pathologists, he said, this can be a difficult task because of how quickly the body metabolizes insulin. The test cited in the West Virginia legislation \u2014 known as a \u201cc-peptide\u201d test \u2014 can measure insulin, Uribe said, but timing is key: It has to be conducted before doctors provide treatment for low blood sugar, he said.
\u201cBecause once you give that person glucose, that triggers the body\u2019s natural release of insulin, and it\u2019ll throw off the insulin c-peptide measure,\u201d he said.
Many smaller hospitals often do not have the tests available, he added.
Uribe cited two possible methods for pathologists to document insulin. One of the most common ways of administering the medication is through an injection, and it can briefly linger in the body\u2019s tissue at an injection site, he said. Researchers have also documented insulin in postmortem vitreous fluid, a substance found in the eyeball, he said.
In West Virginia, the bodies of seven veterans were exhumed and Uribe tested injection site tissue samples, he said. The tests revealed trace amounts of insulin in some of the victims, including those who were not diabetic and had never been prescribed the medication, he said.
\u201cThat was the definitive proof they had been injected with insulin,\u201d he said.
Reta Mays, a nursing assistant at the hospital, was eventually identified as a suspect in the killings. She admitted to administering the lethal doses, pleading guilty to seven counts of second-degree murder and one count of assault with intent to commit murder in connection with the death of an eighth man. Mays was sentenced to seven life sentences.
In Uribe\u2019s second case, pharmacist Natalie Cochran was convicted in January of giving her husband a fatal dose of the drug in a plot that prosecutors said was aimed at covering up a multimillion-dollar fraud that she perpetrated on friends and family.
But it took years for the case to be resolved.
In February\u00a02019, Michael Cochran was hospitalized in an unresponsive state before he was removed from a ventilator and placed in hospice. He was 38. His death certificate listed his manner of death as \u201cnatural.\u201d
Michael Cochran\u2019s emergency room records showed that when he was admitted to the hospital, his blood sugar had plummeted, even though he had no history of diabetes, Uribe said.\u00a0No insulin test was done at the time, he said.
But Tim Bledsoe, <\/strong>then an investigator with the West Virginia State Police, came to suspect that Natalie Cochran may have played a role in her husband\u2019s death, and during a search of her home, he discovered a vial of insulin in her fridge.
Knowing that no one in the home was diabetic, he asked Natalie Cochran about the vial, Bledsoe told \u201cDateline.\u201d\u00a0She told the detective she kept it there for a neighbor\u2019s diabetic son, Bledsoe said. But the neighbor, Jennifer Davis, denied this and told \u201cDateline\u201d that Natalie Cochran said she\u2019d asked for the insulin for herself, claiming that she was using it to recover from a cancer diagnosis that prosecutors later said she faked.
She asked for the insulin the morning Michael Cochran first became sick, Davis said.
Two years after Michael Cochran\u2019s death, his wife was indicted on a murder charge. An autopsy had been performed seven months after his death, but by then his body was in an advanced state of decomposition and the medical examiner ruled his cause of death undetermined, Bledsoe said.
It isn\u2019t clear why an autopsy was not done immediately after his death, nor is it clear if any steps were taken in the examination to try and document postmortem insulin. The West Virginia Department of Health and Human Resources, which oversees the state medical examiner, did not respond to a request for comment.
Uribe said it\u2019s unlikely any postmortem evidence of insulin could have been found given how much time passed between when Michael Cochran would have been given the drug and when he died.
The undetermined finding, combined with a lack of physical evidence, led the Raleigh County district attorney to drop the case, according to the county\u2019s current top prosecutor, Tom Truman.
\u201cIf you don\u2019t have the medical examiner saying homicide, you\u2019ve got a big problem,\u201d he told \u201cDateline.\u201d
But two years later, the charge was refiled after Uribe was asked to examine the case. During a second exhumation and autopsy, Uribe said that he searched for possible injection sites but that Michael Cochran\u2019s remains were skeletal by that point and the examination yielded nothing.
Still, Uribe said no other reason that could explain Michael Cochran\u2019s plummeting blood sugar \u2014 such as sepsis or a rampant infection \u2014 had been documented in his medical records. Combined with other circumstances surrounding Michael Cochran\u2019s death, Uribe ruled the death an insulin homicide.
At trial, an endocrinologist who testified for the prosecution agreed that no other explanation could account for Michael Cochran\u2019s hypoglycemia.
Natalie Cochran\u2019s lawyers acknowledged that she defrauded friends and relatives \u2014 she\u2019d pleaded guilty in a separate federal fraud and money laundering case \u2014 but they said she had nothing to do with\u00a0her husband\u2019s\u00a0death, which they attributed to a lethal mix of workout supplements, steroids and possibly his own use of insulin.
On Jan. 29, after two hours of deliberation, a jury convicted Natalie Cochran of first-degree murder. She was sentenced to life without the possibility of parole.
To Uribe, this case and the killings at the veteran\u2019s hospital underscore the need for better insulin overdose guidelines.
For physicians, he said, those protocols could include watching out for red flags like severely low, unexplained blood sugar in a nondiabetic person, or unexplained low potassium, known as hypokalemia, which can also be fatal and caused by excessive insulin.
And they need to ensure that they administer a c-peptide test before treatment, he said.
Pathologists should search for possible injection sites, he said, and they should try testing vitreous fluid, he said.
\u201cIf you\u2019re able to detect that in the vitreous fluid of someone who\u2019s not a diabetic, who\u2019s never been prescribed this medication and has no history of them being injected, that could legitimately tell you something,\u201d he said.
Tim Stelloh is a breaking news reporter for NBC News Digital.
© 2025 NBCUniversal Media, LLC<\/p>\n

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