SOMERVILLE, N.J. -- A nurse who killed at least 29 patients was sent to prison for the rest of his life yesterday, after his victims' relatives and friends branded him ''vermin," ''garbage," and a ''monster" who had ruined lives and who had shattered their faith in the medical profession.
The convict, Charles Cullen, avoided the death penalty after making a plea agreement with prosecutors to tell them which patients he had killed with injections of drugs whose presence in the body was difficult to detect.
He received 11 consecutive life terms at a tense and sometimes turbulent hearing in which he came face to face with his victims' families for the first time.
Wearing a bulletproof vest under his sweater, Cullen sat quietly, his eyes often closed, as relatives wept and yelled at him from behind a lectern about 15 feet from where he sat.
''You betrayed the ancient foundations of the healing professions," Superior Court Judge Paul Armstrong said as Cullen stood motionless, his eyes closed.
Cullen, 46, pleaded guilty to murdering 22 people in New Jersey and trying to kill three others.
He will be sentenced later for seven murders and three attempted murders in Pennsylvania.
Cullen has claimed to have killed as many as 40 people during a career that spanned 16 years and 10 nursing homes and hospitals.
He was fired from five nursing jobs, and he resigned from two others. But he always managed to find another job, in part because hospitals did not share their suspicions for fear of being sued. New Jersey lawmakers have passed legislation protecting nursing homes and hospitals from lawsuits when reporting disciplinary actions against employees.
About 60 relatives of the victims attended the sentencing, calling him ''trash," ''one pathetic little man," and ''an agent from the deepest depths of hell."
As the family members spoke, he kept his eyes closed, frustrating some of them.
''In case he forgot what my mother looked like, look into my eyes now," said Richard J. Stoecker, whose mother, Eleanor, was murdered in 2003.
Some family members said they wished Cullen could die as his victims did, by lethal injection.
''I want you to die tomorrow so that you can meet God tomorrow, because guess what? There ain't no door out of hell," said Debra Yetter Medina, the granddaughter of victim Mary Natoli.
Cullen declined to make a statement, telling the judge he had ''nothing to say" and disappointing relatives who had hoped to hear him explain why he had committed the crimes.
John Shanagher, whose father, John, was murdered, said his family ''will never feel safe in a hospital again. We will never feel we can trust the medical profession again."