A woman charged with killing two nursing home patients in Butler County by overdosing them with insulin faces new allegations that she caused a third such death at a Lower Burrell health care facility where she was a supervisor.

The claims are part of a wrongful death lawsuit filed Tuesday against Belair Healthcare and Rehabilitation Center that accuses Heather Pressdee of killing Marianne Bower, a 68-year-old grandmother of seven with multiple sclerosis, by administering a lethal dose of insulin — and then sending a sympathy card and gift to the family.

Bower, who died Sept. 28, 2021, was a resident of Belair.

The lawsuit in Allegheny County Common Pleas Court marked the first indication since Pressdee was arrested in May by the state Attorney General’s Office that there might be additional victims among the 11 nursing homes where she has worked since 2018.

As of now, the new allegations are only civil, not criminal.

Pressdee has not been charged in connection with Bower’s death.

Brett Hambright, a spokesman for the attorney general, refused Tuesday to address details in the lawsuit other than to call the agency’s ongoing investigation “very active.”

The complaint goes beyond alleging ghoulish behavior by Pressdee, 41, of Harrison, who remains in jail in Butler County and is not named as a defendant.

It targets Belair, claiming the facility’s administrators failed to properly vet Pressdee for problems before hiring her as an assistant director of nursing — and then not only brushed off concerns among staff about the woman, whom some colleagues called “the killer nurse,” but disciplined co-workers who spoke about how Pressdee cared for residents.

Phil DiLucente, one of Pressdee’s criminal lawyers, declined to comment.

But Belair’s parent company, Guardian Healthcare, issued a statement that said management and staff at Belair “are devastated and disheartened that someone entrusted to care for our patients could do something like this. Our deepest sympathies go out to the families that have been impacted by Heather Pressdee’s actions and behavior, especially Ms. Bower’s family.”

Pittsburgh lawyer Robert Peirce III represents plaintiff Scott Hess of Buffalo Township, one of Bower’s two sons. Peirce said the family learned last month from an agent with the state Attorney General’s Office that Pressdee had confessed to giving a lethal amount of insulin to Bower, who was not diabetic and was not prescribed the hormone, which helps regulate blood sugar.

During a Tuesday morning news conference, Peirce said the attorney general’s information proved critical. Had the agent not contacted the family, Bower’s survivors would have gone on thinking that she died from respiratory failure. More practically, it allowed Peirce to launch litigation just under the statute of limitations deadline.

Hambright refused to corroborate Peirce’s account of a confession. But in court papers filed at the time of Pressdee’s arrest in May in connection with the deaths of two male residents of Quality Life Services-Chicora in Butler County, the attorney general’s office said she admitted to both of those homicides.

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In one case, investigators said Pressdee told them she “felt bad” for the victim, a 55-year-old man identified only as J.B., because his quality of life was not good, so she injected him with insulin.

As for the other homicide victim, investigators said Pressdee admitted to killing an 83-year-old man identified as J.C. for the same reason, giving him insulin in his stomach.

A third alleged victim who survived, identified as E.A., a 73-year-old man, was in covid isolation and having a “very difficult time,” according to the affidavit supporting criminal charges against Pressdee. She told investigators he asked her to kill him.

The lawsuit paints a troubling picture of a “predatory” nurse who appeared compassionate and caring on the surface but allegedly concealed murderous intent. And it slammed Belair and a web of related corporate entities, including Guardian Elder Care, for what one of Peirce’s law partners called a “shocking failure” to look into Pressdee’s itinerant background.

“We do not believe the proper checks were performed,” Peirce said. “There were major steps missed by Belair. Had simple steps been taken to look into why nurse Pressdee was let go from these facilities, it is the family’s belief their mom would still be here today.”

Citing litigation and privacy laws, Guardian said it could not extensively discuss Bower’s time at the nursing home.

But it defended its hiring practices. It said it has “policies and procedures in place that are designed to vet the qualifications and background of potential employees. Management at Belair or any Guardian site take seriously their responsibility not to employ an individual who has the potential to intentionally harm one of our residents.”

By the time she was hired by Belair, Pressdee had been fired or forced to resign from a half-dozen other nursing homes in Western Pennsylvania — all after she was disciplined for abusive behavior toward residents and staff, investigators have said.

It did not take long after Pressdee was hired at Belair for fellow staffers to get suspicious, the lawsuit said.

Pressdee spent “significant” time with certain residents, and those patients would “unexpectedly deteriorate,” according to the complaint.

But, the lawsuit said, Belair and Guardian should have been able to figure out Pressdee was a danger.

Several co-workers coined the “killer nurse” moniker in response to the effect they thought Pressdee was having on patients.

Yet, despite knowing about the rumors surrounding their employee, Belair and Guardian failed to investigate her, the lawsuit claimed.

Instead, they disciplined the nurses who talked about Pressdee’s interactions with patients and threatened to fire them if the rumors persisted, according to the lawsuit.

In August 2021, four months after Pressdee was hired at Belair, the state Department of Health launched an inspection of the nursing home upon discovering a pattern of residents suffering from high blood sugar levels and diabetic ketoacidosis, a potentially deadly complication of diabetes when the body can’t produce enough insulin, the lawsuit said.

Inspectors even interviewed Pressdee, who admitted she didn’t call Belair’s doctor for a patient with high blood sugar, according to the lawsuit.

When the health department completed its inspection, it issued an alarming report, finding a pattern of serious harm.

Belair, inspectors determined, failed to notify doctors of patients’ high blood glucose levels and did not assess residents for high blood glucose. Residents, the report said, were in “immediate jeopardy.”

Belair and Guardian still didn’t investigate Pressdee, the lawsuit said, even as she “targeted” residents who were terminal. Pressdee spent “excessive” time caring for certain patients — including Bower.

When Bower died, Pressdee bought wind chimes engraved with Bower’s initials and gave them to her son. She sent a condolence card to the family.

And, in a post on Bower’s online obituary five days after she died, Pressdee wrote, “My thoughts are with you at this difficult time. She was a wonderful woman,” the lawsuit said.

The following February, Belair fired Pressdee, according to the complaint. She moved on to four other nursing homes before being arrested in May. The state has suspended her nursing license.

The complaint contained no details about Bower’s death or what exactly Pressdee is alleged to have done. Peirce said the ongoing criminal investigation of Pressdee limited the information provided to the Bower’s family.

Peirce described Bower’s family as being sickened upon learning of the allegation against Pressdee.

“Out of the blue they get a phone call from the attorney general’s office letting them know that an employee at Belair confessed to giving insulin and purposely giving it to their mother, leading her to pass away,” Peirce said. “They literally describe collapsing to the floor when they got this information.”

The lawsuit seeks compensatory and punitive damages and a jury trial.

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