When eight older patients died at a Veterans Affairs (VA) medical center in Clarksburg, West Virginia, their deaths could have easily been mistaken for natural causes. But something didn’t seem right.

Despite their age, the patients—all men in their 80s and 90s—were stable and awaiting release. They died from a dangerous drop in blood sugar called hypoglycemia, though many had no history of diabetes or related illnesses. The mysterious deaths happened between July 2017 and June 2018.

“Just the sheer number of people who were experiencing hypoglycemia was concerning. It wasn’t a very common occurrence on this ward,” said Special Agent Ashley Archibald, who investigated the case out of the FBI’s Pittsburgh Field Office. “This was a ward where patients were awaiting to be released home or transferred to a nursing home.”

The VA Office of Inspector General (OIG) brought in the FBI’s Pittsburgh Field Office to assist with the investigation.

Investigators learned one staff member—nursing assistant Reta Mays—had been working the day of each of the men’s deaths. While she did things like change sheets and help patients bathe, she also simply kept them company, so she was often alone with the patients.

Within days of opening the investigation, VA removed Mays from patient interaction, potentially saving many more lives.

Mays initially denied any involvement, but the investigative team worked with medical experts and the FBI’s Laboratory and behavioral analysis teams to piece together what had happened.

To further the investigation, the bodies had to be autopsied. This required respectfully accessing their remains and re-burying them with military honors.

“Asking these families to let us disinter their loved ones and let us autopsy them, I think it was the hardest part of this investigation, both for the investigators and the families,” Archibald said. “They had to weigh wanting to know what happened with disturbing their loved ones. But we did it in the most respectful way possible.”

Both scientific and circumstantial evidence, including input from outside medical experts, showed Mays’ injection of insulin led to the patients’ deaths.

“The forensic pathologist not only looked at the insulin injection and the remnants of insulin to help determine the cause of death but it was also just as important for us to rule out other causes for the low sugar readings, especially for the non-diabetic patients,” said VA OIG Special Agent Keith Vereb. “We did this to determine that these veterans were, in fact, murdered by Reta Mays.”

When Mays was alone with patients, she took insulin from the hospital’s medication area and injected it into the men for no medical reason. Even if there had been a reason, nursing assistants are not authorized to give medication. Their blood sugar dropped quickly, leading to their deaths.

Mays pleaded guilty to murder charges in July 2020, and in May 2021, she was sentenced to life in prison.

“It was a really old-school investigation—a lot of interviews, a lot of digging through records, a lot of following up on leads, and help from a group of medical experts and sources,” Archibald explained.

Investigators never learned a clear motive for such a depraved crime.

“It’s unfathomable to me, but it seemed like control. She wanted to have control over these really vulnerable people,” Archibald said.

Archibald said the investigative team hopes the sentence, along with the safeguards the VA has added to prevent similar tragedies, will offer some comfort to the patients’ families.

“I hope they will be able to heal and focus on the good memories they have with these veterans,” she said. “This was a big case and a difficult one. I don’t know if I’ll ever have another case in my career that means so much.”