Beverley Gail ALLITT
A.K.A.: "Angel of Death"
Classification: Serial killer
Characteristics: Nurse suffering from the mental illness Munchausen's Syndrome by Proxy
Number of victims: 4
Date of murders: February-April 1991
Date of arrest: November 1991
Date of birth: October 4, 1968
Victims profile: Liam Taylor, 7-months-old / Timothy Hardwick, 11-years-old / Becky Phillips, 2-months-old / Claire Peck, 15-months-old
Method of murder: Poisoning (insulin - lignocaine)
Location: Lincolnshire, England, United Kingdom
Status: Sentenced to 13 concurrent terms of life imprisonment on May 28, 1993
Beverley Allitt, a nurse suffering from the mental illness Munchausen's Syndrome by Proxy (a desire to kill or injure to get attention), was given 13 life sentences at Nottingham crown court in 1993 after being convicted of murdering four children and attacking nine others.
Her arrest followed an investigation into several incidents of alleged tampering with patients' ventilators and pumps delivering intravenous medication at various hospitals in Lincolnshire and Nottinghamshire.
Beverley Allitt, dubbed the "Angel of Death", was a nurse who was convicted of killing four children and injuring nine others on the ward she worked at Grantham Hospital, Lincolnshire.
She received 13 life sentences in 1993. She is presently at the top-security Rampton Secure Hospital in Nottinghamshire. The minimum term she was required to serve before becoming eligible for parole was thirty years, though she would only be released at that point if no longer considered a threat to the public.
Allitt's motives have never been fully explained. According to one theory, she suffers from Munchausen Syndrome by Proxy, a controversial personality disorder which supposedly prompts its sufferers to falsify illnesses in others, in order to attract attention.
In 2006 the BBC made a dramatisation of the story, titled 'Angel of Death: The Beverly Allitt Story' and starring Charlie Brooks.
Beverley Gail Allitt (born 4 October 1968) is an English serial killer who was convicted of murdering four children, attempting to murder three other children, and causing grievous bodily harm to a further six children.
The crimes were committed over a period of 59 days between February and April 1991 in the children's ward at Grantham and Kesteven Hospital, Lincolnshire, where Allitt was employed as a State Enrolled Nurse. She administered large doses of insulin to at least two victims and a large air bubble was found in the body of another, but police were unable to establish how all the attacks were carried out.
In May 1993, at Nottingham Crown Court, she received 13 life sentences for the crimes. Mr. Justice Latham, sentencing, told Allitt that she was "a serious danger" to others and was unlikely ever to be considered safe enough to be released. She is detained at Rampton Secure Hospital in Nottinghamshire.
* Liam Taylor (aged seven months old)- was admitted to the ward for a chest infection and was murdered on 21 February 1991.
* Timothy Hardwick (aged eleven years old)- suffered cerebral palsy and was admitted to the ward after having an epileptic seizure. He was murdered on 5 March 1991.
* Kayley Desmond (then aged one year old)- admitted to the ward for a chest infection. Allitt attempted to murder her on 8 March 1991 but the child was resuscitated and transferred to another hospital where she recovered.
* Paul Crampton (then aged five months old)- admitted to the ward for a chest infection on 20 March 1991. Allitt attempted to murder him with an insulin overdose on three occasions that day before he was transferred to another hospital where he recovered.
* Bradley Gibson (then aged five years old)- admitted to the ward for pneumonia. He suffered two cardiac arrests on 21 March 1991, due to Allitt administering insulin overdoses, before he was transferred to another hospital where he recovered.
* Yik Hung Chan (then aged two years old)- admitted to the ward following a fall on 21 March 1991. He suffered an oxygen desaturation attack before he was transferred to another hospital where he recovered.
* Becky Phillips (aged two months old)- admitted to the ward for gastroenteritis on 1 April 1991. She was administered with an insulin overdose by Allitt and died at home two days later.
* Katie Phillips (then aged two months old)- the twin of Becky, she was admitted the ward as a precaution following the death of her sister. She had to be resuscitated twice after unexplained apneic episodes (which were later found to be due to insulin and potassium overdoses). Following the second time where she stopped breathing, she was transferred to another hospital but, by this time, has suffered permanent brain damage, partial paralysis and partial blindness due to oxygen deprivation. In a twist of fate, her parents had been so grateful to Allitt's care of Becky that they had asked her to be Katie's godmother.
* Claire Peck (aged fifteen months old)- admitted to the ward following an asthma attack on 22 April 1991. After being put on a ventilator, she was left alone in Allitt's care for a short interval during which time she had a cardiac arrest. She was resuscitated but died after a second cardiac arrest, again following a period when she was left alone with Allitt.
Trial and imprisonment
Allitt had attacked thirteen children, four fatally, over a 59 day period before she was brought up on charges for her crimes. It was only following the death of Claire Peck that medical staff became suspicious of the number of cardiac arrests on the children's ward and police were called in. It was found that Allitt was the only nurse on duty for all the attacks on the children and she also had access to the drugs.
Four of Allitt's victims had died. She was charged with attempted murder and grievous bodily harm in November 1991. On Friday 28 May 1993 she was found guilty on each charge and sentenced to 13 concurrent terms of life imprisonment, which she is serving at Rampton Secure Hospital in Nottinghamshire.
Allitt's trial judge recommended she serve a minimum term of 40 years (one of the longest minimum terms ever suggested by a trial judge, High Court judge or politician), which would keep her in prison until at least 2032 and the age of 64, and even then she could only be released if she was no longer considered to be a danger to the public. In August 2006, Allitt launched an appeal on the length of her sentence.
On 6 December 2007, the High Court ruled that Allitt would have to serve at least 30 years in prison, meaning she will now have to wait until at least 2022 and the age of 54 until she can apply for parole.
Allitt's motives have never been fully explained. According to one theory, Allitt showed symptoms of factitious disorder, also known as Münchausen syndrome. Münchausen syndrome by proxy, also known as factitious disorder by proxy may explain her actions. This controversial disorder is described as involving a pattern of abuse in which a perpetrator ascribes to, or physically falsifies illnesses in someone under their care, in order to attract attention.
In 2005, the BBC made a dramatisation of the story, "Angel of Death", in which Charlie Brooks played the role of Allitt.
In 2008, the Beverley Allitt story was told as part of the production company Title Role's recreation documentaries, "Crimes That Shook Great Britain" in its own episode, with a young Lexi Wolfe playing Allitt.
Angel of Death
Beverly Allitt, better known as the "Angel of Death", is one of Britian's most notorious female serial killers. Her murderous spree was all the more shocking because she would befriend the parents of her victims who entrusted their children into her care.
As a child, Beverly would use factitious injuries in order to gain attention. She took to wearing bandages and casts over "wounds" but would not allow them to be examined. As a teenager an overweight Beverly began spending an excessive amount of time in hospitals with numerous physical complaints. At one point she convinced a surgeon to remove a perfectly healthy appendix. When they realized what she was doing she would doctor-shop, moving on from one physician to the next.
She attended Grantham college in Lincolnshire and trained as a nurse. Her bizarre behavior continued throughout her training. While working at a nursing home she was suspected of smearing feces on the walls. Her attendance during her training was poor due to her many illnesses and as a result she failed her nursing examinations. Still she was able to obtain a position at Grantham and Kesteven Hospital in Lincolnshire in 1991 as a State Enrolled Nurse. Beverly was assigned to Children's Ward 4.
On February 21, 1991 seven-week-old Liam Taylor was admitted to the ward for possible pneumonia. After Allitt had reassured his parents that he was in capable hands and would be well cared for they went home for the night. When they returned the next morning they were informed that he had suffered respiratory problems during the night but that he had recovered and appeared to be doing well. The next night Allitt volunteered for extra night duty. At one point during the night she was left alone with little Liam and moments later Allitt summoned the code team. He had stopped breathing. Despite the efforts of the team Liam had suffered severe brain damage and was being maintained on life support. Knowing that he would never recover his parents made the heart rending choice to remove him from life support. His death was listed as heart failure. Even though her fellow nurses were confused about the failure of the apnea monitors to alarm when Liam stopped breathing Allitt was never questioned.
Two weeks later, 11-year- old Timothy Hardwick, who suffered from cerebral palsy, was admitted after suffering an epileptic seizure. Allitt volunteered to care for him. Within a few moments of being left alone in her care, his heart stopped. And again, despite the efforts of the code team they were unable to revive him. His death was attributed to his epilepsy even though no obvious cause of death was found.
On March 3, 1991, one-year-old Kayley Desmond was admitted to Ward 4 for a chest infection. Allitt was assigned as her nurse. She was well on the road to recovery when 5 days later she inexplicably went into cardiac arrest. She was successfully resusitated and transferred to another hospital in Nottingham. While she was being examined the physicians noticed a peculiar puncture mark under her armpit and an air bubble. It appeared to be an accidental injection and was never investigated.
On March 20, 1991, five-month-old was admitted for Bronchitis. Shortly before he was to be discharged he was taken care of by Allitt. He was nearly comatose and when his blood was checked he was found to have a high level of insulin. He would suffer from the same symptoms three more times before he was transferred to another hospital in Nottingham. When he arrived at the hospital his blood was checked and he was again found to have a high level of insulin. The nurse that was sent with him in the ambulance was none other than Beverly Allitt. Miraculously he survived.
March 21, 1991, five-year-old Bradley Gibson was admitted for Pneumonia. Later that evening he went into cardiac arrest but was successfully resuscitated. When his blood was tested he was found to have a high level of insulin. He was cared for again by Allitt and his heart stopped again. After he was resuscitated he was transferred to another hospital in Nottingham.
Sadly no one was suspicious enough to connect the dots back to Allitt. She was free to continue wreaking havoc on poor defenseless babies.
March 21, 1991, two-year-old Yik Hung Chan was admitted to Ward 4 after falling from a window and suffering a skull fracture. While he was being cared for by Allitt, his oxygen levels dropped dangerously low twice. He was transferred to a larger hospital in Nottingham. His symptoms were attributed to his head injury.
On April 1, 1991, two-month-old Becky Phillips was admitted for a stomach virus. While being cared for by Allitt she began exhibiting symptoms of hypoglycemia. She was examined and finding nothing wrong Becky was sent home with her mother. During the night she went into convulsions and when her parents contact a physician they were told that she probably had colic. She died later that night.
As a precaution her twin sister, Katie Phillips was admitted to Ward 4. Not long after being cared for by Allitt she stopped breathing and had to be resuscitated. Two days later she stopped breathing again but this time she suffered permanent brain damage due to prolonged lack of oxygen. When she was transferred to another hospital it was later found that her apneic spells had been the result of her receiving large doses of insulin and potassium. Katie's mother Sue Phillips was so grateful to Allitt for saving her baby's life that she asked Allitt to be her child's godmother. Beverly Allitt graciously accepted.
Four more helpless victims fell prey to Allitt's vicious attacks but it would be the death of 15-month-old Claire Peck that would bring her murderous spree to an end.
On April 22, 1991 baby Claire was admitted to Ward 4 following a serious ashtma attack that required her to be placed on a ventilator. After being left alone with Allitt she suffered a cardiac arrest and had to be resuscitated. She was stabilized and then again left alone with Allitt. Shortly thereafter she suffered another heart attack and this time the doctors were not successful. When an autopsy was performed it was discovered that she had traces of Lignocaine in her tissues, a drug that is given during cardiac arrest but never to a baby.
When the police were finally notified they examined the records of 25 suspicious cases. In most instances the victims, four of whom were dead, either had high levels of insulin or potassium or both in their systems. The only common factor linking all the cases together was Beverly Allitt.
Beverly Allitt was eventually arrested and charged with 4 counts of murder, 11 counts of attempted murder and 11 counts of causing grievous bodily harm. While in prison awaiting trial she was examined by several healthcare professionals and found to be exhibiting symptoms of both Munchausen’s syndrome, and Munchausen’s syndrome by Proxy.
On May 23, 1993, Allitt was convicted and given 13 life sentences for murder and attempted murder. She is presently serving her sentence at Rampton Secure Hospital.
Beverley Allitt, or the 'Angel of Death' as she became known, has become one of Britain’s most notorious female serial killers. This is made more shocking by the fact that whilst she went on a killing spree that claimed four young lives and attempted the murder of nine other victims, she befriended the parents of her victims with her caring and solicitous manner.
Allitt exhibited some worrying tendencies early on, whilst growing up as one of four children, including the wearing of dressings and casts over wounds that she would use to draw attention to herself, without actually allowing these injuries to be examined. Becoming overweight as an adolescent, she became increasingly attention-seeking, often showing aggression towards others. She spent considerable time in hospitals seeking medical attention for a string of physical ailments, which culminated in the removal of her perfectly healthy appendix. This was slow to heal, as she insisted on interfering with the surgical scar. She was also known to self-harm, and had to resort to 'doctor-hopping', as medical practitioners became familiar with her attention-seeking behaviours, she would move to the next doctor.
She went on to train as a nurse and was suspected of odd behaviour, such as smearing faeces on walls in a nursing home where she trained. Her absentee level was also exceptionally high, the result of a string of illnesses. Her boyfriend at that time said later that she was aggressive, manipulative and deceptive, claiming false pregnancy as well as rape, before the end of the relationship.
Despite her history of poor attendance and successive failure of her nursing examinations, she was taken on a temporary six-month contract at the chronically understaffed Grantham and Kesteven Hospital in Lincolnshire in 1991, where she began work in Children’s Ward 4. When she started, there were only two trained nurses on the dayshift and one for nights, which might explain how her violent attention-seeking behaviour went undetected for as long as it did.
On 21 February 1991, her first victim, seven-month-old Liam Taylor, was admitted to Ward 4 with a chest infection. Allitt went out of her way to reassure his parents that he was in capable hands and persuaded them to go home to get some rest. When they returned, Allitt advised that Liam had endured a respiratory emergency but that he had recovered. She volunteered for extra night duty, so she could watch over the boy, and his parents chose to spend the night at the hospital as well.
Liam had another respiratory crisis just before midnight but it was felt that he had come through it satisfactorily. Allitt was left alone with the boy and his condition worsened dramatically; becoming deathly pale before red blotches appeared on his face, at which point Allitt summoned an emergency resuscitation team.
At the time, Allitt’s nursing colleagues were confused by the absence of alarm monitors which had failed to sound when he stopped breathing. Liam suffered cardiac arrest and, despite the best efforts of the attending team, he suffered severe brain damage and remained alive only due to the use of life-support machines. On medical advice, his parents made the agonising decision to remove their baby from life support. His cause of death was recorded as heart failure. Allitt was never questioned about her role in baby Liam’s death.
Only two weeks after the death of Liam Taylor, her next victim was Timothy Hardwick, an 11-year-old with cerebral palsy, who was admitted to Ward 4 following an epileptic fit on 5 March 1991. Allitt took over his care and, again following a period when she was alone with the boy, she summoned the emergency resuscitation team, who found him without a pulse and turning blue. Despite their best efforts, the team, which included a paediatric specialist, were unable to revive him. An autopsy later failed to provide an obvious cause of death, although Liam's epilepsy was officially blamed.
Allitt's third victim, one-year-old Kayley Desmond, was admitted to Ward 4 on 3 March 1991 with a chest infection, from which she seemed to be recovering well. Five days later, with Allitt in attendance, baby Kayley went into cardiac arrest in the same bed where Liam Taylor had died a fortnight before. The resuscitation team were able to revive her and she was transferred to another hospital in Nottingham. Attending physicians discovered, during a thorough examination, an odd puncture hole under her armpit. They also discovered an air bubble near the puncture mark, which they attributed to an accidental injection but no investigation was initiated.
Five-month-old Paul Crampton became Allitt’s next victim, placed in Ward 4 on 20 March 1991, as a result of a non-serious bronchial infection. Just prior to his discharge, Allitt, who was again attending a patient by herself, summoned help as Paul appeared to be suffering from insulin shock, going into a near-coma on three separate occasions. Each time, the doctors revived him but were unable to explain the fluctuation in his insulin levels. When he was taken by ambulance to another hospital in Nottingham, Allitt rode with him and he was again found to have too much insulin. Baby Paul was extremely fortunate to have survived the ministrations of the Angel of Death.
The next day, five-year-old Bradley Gibson, a pneumonia sufferer, went into unexpected cardiac arrest but was saved by the resuscitation team. Subsequent blood tests showed that his insulin was high, which made no sense to the attending physicians. A visit from Allitt later that night resulted in another heart attack and Bradley was transported to Nottingham, where he recovered.
Despite this alarming increase in the incidence of unexplained health events, all in the presence of Allitt, no suspicions were aroused at this time and she continued unchecked in her spree of violence.
On 22 March 1991, two-year-old victim Yik Hung Chan turned blue and appeared in considerable distress when Allitt raised the alarm but he responded well to oxygen. Another attack resulted in his transferral to the larger hospital in Nottingham, where he recovered. His symptoms were attributed to a fractured skull, the result of a fall.
Allitt next turned her attention to twins, Katie and Becky Phillips, just two months old, who were kept in for observation as a result of their premature delivery. A bout of gastro-enteritis brought Becky into Ward 4 on 1 April 1991, when Allitt took over her care. Two days later, Allitt raised the alarm, claiming that Becky appeared hypoglycaemic and cold to the touch but no ailment was found. Baby Becky was sent home with her mother.
During the night, Becky went into convulsions and cried out in apparent pain but the doctor who was summoned suggested she had colic. Her parents kept her in their bed for observation but she died during the night. Despite an autopsy, pathologists could find no clear cause of death.
Becky’s surviving twin, Katie, was admitted to Grantham as a precaution. Unfortunately Allitt was again in attendance. It wasn't long before she was again summoning a resuscitation team to revive baby Katie, who had stopped breathing.
Efforts to revive Katie were successful but two days later she suffered a similar attack, which resulted in the collapse of her lungs. Following another revival effort, Katie was transferred to Nottingham, where it was found that five of her ribs were broken, in addition to having suffered serious brain damage as a result of her oxygen deprivation.
In a supreme twist of irony, Katie's mother, Sue Phillips, was so grateful to Allitt for saving her baby's life that she asked her to be Katie's godmother. Allitt accepted willingly, despite having inflicted partial paralysis, cerebral palsy, and sight and hearing damage on the infant.
Four more victims followed but the high incidence of unexplained attacks in otherwise healthy patients, along with Allitt’s attendance during these attacks, finally caused suspicions to be raised at the hospital. On 22 April 1991 Allitt’s violent spree was brought to an end with the death of 15-month-old Claire Peck, an asthmatic who required a breathing tube. Whilst in Allitt’s care for only a few minutes, the infant suffered a heart attack but the resuscitation team revived her successfully. Once more alone in Allitt’s presence, baby Claire suffered a second attack from which she could not be revived.
Although an autopsy indicated that Claire had died from natural causes, Dr Nelson Porter, a consultant at the hospital, initiated an inquiry. The high number of cardiac arrests over the previous two months on Ward 4 alarmed him. An airborne virus was initially suspected but nothing was found. A test that revealed a high level of potassium in baby Claire’s blood resulted in the police being summoned 18 days later. Her exhumation resulted in the discovery of traces of Lignocaine in her system, a drug used during cardiac arrest but never given to a baby.
Stuart Clifton, the police superintendent assigned to the investigation, suspected foul play. He examined the other suspicious cases that had occurred in the previous two months, finding inordinately high doses of insulin in most. Further evidence revealed that Allitt had reported the key missing to the insulin refrigerator. All records were checked, parents of the victims were interviewed and a security camera was installed in Ward 4.
When record checks revealed missing daily nursing logs, which corresponded to the time period when Paul Crampton had been in Ward 4, suspicions were raised. When 25 separate suspicious episodes with 13 victims were identified, four of whom were dead, the only common factor was the presence of Beverley Allitt at every episode.
By 26 July 1991, police felt that they had sufficient evidence to charge Allitt with murder but it wasn’t until November 1991 that she was formally charged.
Allitt showed calm and restraint under interrogation, denying any part in the attacks, insisting she had merely been caring for the victims. A search of her home revealed parts of the missing nursing log. Further extensive background checks by the police indicated a pattern of behaviour that pointed to a very serious personality disorder. Allitt exhibited symptoms of both Munchausen’s syndrome, and Munchausen’s syndrome by Proxy, which are characterised by gaining attention through illness. With Munchausen’s syndrome, physical or psychological symptoms are either self-induced or feigned in oneself to gain attention. Munchausen’s by Proxy involves inflicting injury on others to gain attention for oneself. It is fairly unusual for an individual to present with both conditions.
Allitt’s behaviour in adolescence appeared to be typical of Munchausen’s syndrome and, when this behaviour failed to elicit the desired reactions in others, she began to harm her young patients in order to satisfy her desire to be noticed.
Despite visits and assessments by a number of healthcare professionals whilst in prison, Allitt refused to confess what she had done. After a series of hearings, Allitt was charged with four counts of murder, 11 counts of attempted murder, and 11 counts of causing grievous bodily harm. As she awaited her trial, she rapidly lost weight and developed anorexia nervosa, a further indication of her psychological problems.
After numerous delays due to her "illnesses," (as a result of which she had lost 5 stone in weight) she went to trial at Nottingham Crown Court on 15 February 1993, where prosecutors demonstrated to the jury how she had been present at each suspicious episode, and the lack of episodes when she was taken off the ward. Evidence about high readings of insulin and potassium in each of the victims, as well as drug injection and puncture marks, were also linked to Allitt. She was further accused of cutting off her victim’s oxygen, either by smothering, or by tampering with machines.
Her unusual behaviour in childhood was brought to light and the paediatrics expert, Professor Roy Meadow, explained Munchausen’s syndrome and Munchausen’s by Proxy syndrome to the jury, pointing out how Allitt demonstrated symptoms of both, as well as introducing evidence of her typical post-arrest behaviour, and high incidence of illness, which had delayed the start of her trial. It was Professor Meadows’ opinion that Beverley Allitt would never be cured, making her a clear danger to anyone with whom she might come in contact.
After a trial that lasted nearly two months (and at which Allitt attended only 16 days due to continued illness), Allitt was convicted on 23 May 1993, and given 13 life sentences for murder and attempted murder. It was the harshest sentence ever delivered to a female but, according to Mr Justice Latham, it was commensurate with the horrific suffering of the victims, their families, and the ignominy she had brought upon nursing as a profession. Indeed, the impact on the Grantham & Kesteven Hospital was so severe that the Maternity Unit was closed down altogether.
Rather than going to prison, Allitt was incarcerated at Rampton Secure Hospital in Nottingham, a high-security facility mainly housing individuals detained under the Mental Health Act. As an inmate at Rampton, she began her attention seeking behaviour again, ingesting ground glass and pouring boiling water on her hand. Allitt subsequently admitted to three of the murders for which she was charged, as well as six of the assaults. The appalling nature of her crimes placed her on the Home Office list of criminals who will never be eligible for parole.
There have been accusations, most notably by Chris Taylor, father of baby Liam, Allitt’s first victim, that Rampton Secure Hospital is more like a Butlin’s holiday camp than a prison. The facility, which has some 1400 staff to deal with around 400 inmates, costs taxpayers around £2000 per week, per inmate, to administer. In 2001 there were reports that Allitt was to marry fellow inmate, Mark Heggie, although she is currently still single.
Allitt was the subject of a 'Mirror' newspaper enquiry in May 2005, when it was revealed that she had received over £25,000 in State benefits since her incarceration in 1993. In August 2006, Allitt applied for a review of her sentence which led the Probation Service to contact victims' families about the process. The review remains pending.
Serial killer nurse Allitt must serve 30 years
By David Batty - Guardian.co.uk
December 6, 2007
The serial killer nurse Beverly Allitt must serve a minimum of 30 years in jail for the murder and abuse of children in her care, the high court ruled today.
A high court judge ruled that Allitt, dubbed the "Angel of Death", should serve a minimum sentence of 28 years and 175 days, taking into account the one year and 190 days she spent in custody before being sentenced.
Allitt was given 13 life sentences in 1993 for murdering four children, attempting to murder another three, and causing grievous bodily harm with intent to a further six at Grantham and Kesteven hospital in Lincolnshire.
Mr Justice Stanley Burnton, sitting in London, confirmed the minimum sentence of 30 years, which is the same term previously recommended by the trial judge and the then Lord Chief Justice. Allitt will be 54 before she will be considered for parole.
The former nurse was diagnosed as suffering from Munchausen syndrome by proxy (MSbP) when she carried out the attacks between 1991 and 1993.
The 39-year-old is now being held at the Rampton high-security hospital in Nottingham.
Allitt murdered the four children by injecting them with high doses of insulin.
MSbP is a condition identified by the paediatrician Sir Roy Meadow in 1977, and described as a form of child abuse in which carers deliberately induce or falsely report illnesses in children to focus attention on themselves.
The judge said: "I have to say that I regard the determination of the minimum period in a case such as the present - and fortunately cases as extreme as this are rare - as a very difficult task.
"Once it is accepted that the offender was suffering from mental disorder, difficult ethical and indeed philosophical questions arise as to the degree to which responsibility for the offences in question should be regarded as diminished.
"I have found that there is an element of sadism in Ms Allitt's conduct and her offending. But that sadism is itself, if not the result, certainly a manifestation of her mental disorder, and it would be unduly simplistic to treat it in the same way as one would if the offender were mentally well.
"By her actions, what should have been a place of safety for its patients became not just a place of danger, but if not a killing field something close to it."
The four children murdered by Allitt were seven-week-old Liam Taylor, 11-year-old Timothy Hardwick, two-month-old Becky Phillips and 15-month-old Claire Peck.
They all died between February and April 1991 while Allitt was a nurse at the Lincolnshire hospital.
Nine other children survived her murder attempts.
Allitt was subsequently found to have been the only nurse on duty at the time of all the poisonings.
The judge said: "These were multiple murders and attempted murders of young children whose lives were snuffed out almost before they had begun."
Having considered all the medical evidence, he was satisfied that she was suffering from "an abnormality of mind" when she committed the offences.
Joanne Taylor, the mother of Allitt's first victim, Liam Taylor, said she was pleased with the judge's verdict and his reference to Allitt's sadism.
Taylor, who was in court with her husband, said: "That's what we all felt at the time. There's a fine line between evil and illness, and I'll never forget him saying that word today."
David Peck, of Newark, Nottinghamshire, the father of 15-month-old Claire who died in March 1991, said: "I'm absolutely delighted with the outcome - and pleased for the other families as well.
"We can now put this behind us after 15 years. I couldn't ask for anything better."
Claire, who suffered from asthma, was admitted to hospital and collapsed when Allitt was alone with her.
Allitt was convicted of her murder after the jury heard evidence that the toddler had been injected with potassium and lignocaine.