Some had waited years, and defendant Charles Cullen had filed court papers trying to avoid the confrontation.
One by one, for nearly four hours, two dozen relatives of the dead told a New Jersey judge what Cullen had taken from them. (Watch the victims' kin confront a serial killer -- 4:30)
Some called Cullen names -- "Satan's son" or "monster" -- and told him to "burn in hell." Others simply remembered their lost loved ones.
Judge Paul W. Armstrong then handed down 11 consecutive life sentences. Parole is out of the question, since Cullen, 46, will not be eligible until he has served 397 years.
Cullen has pleaded guilty to committing 22 murders in New Jersey and seven in Pennsylvania. He also admitted attempting to murder six people.
Deaths not mercy killings
Cullen administered lethal doses of medication to patients under his care in nursing homes and medical facilities. He claimed at one point that he was an angel of mercy trying to end his patients' suffering.
But the judge rejected that notion. He said the court "would not countenance the characterization of these crimes as acts of human compassion."
Cullen said nothing during the hearing, sitting beside his attorney with his hands in his lap and his eyes lowered. His lack of visible emotion seemed to enrage some relatives of his victims.
They had plenty to say.
Dolores Stasienko called Cullen a monster for killing her father, Jack Toto, whom she described as a hard-working farmer, mechanic and war veteran.
"Burn in hell, Mr. Cullen, for all eternity," she said.
"Am I boring you?" asked Deborah Yetter-Medina, whose grandmother was killed. "Look at me," she demanded.
"Yes, I was the woman who coined the phrase 'Satan's son,'" she said. "You are Satan's son." Later, she told Cullen: "There ain't no doors out of hell, babe."
Richard Stoecker, whose mother, Eleanor, also was a victim, told Cullen: "Maybe you thought you could play God that day by injecting her, but she planned on living, she was a fighter."
As many as 40 victims
As part of his plea agreement, Cullen has been working with law enforcement officials to identify additional victims. He originally told authorities he killed up to 40 patients during the course of his 16-year nursing career.
Last month, when a deal to allow Cullen to donate a kidney to a friend fell through, he filed court papers seeking to waive his appearance at sentencing.
The move outraged victim family members, some of whom have said addressing Cullen is an important part of their grieving process.
"He has to hear that we're human beings and that our father, son, mother, whoever, were human beings," said John Shanagher, whose father, Jack, was killed by Cullen. "Hopefully it will give us some sense of justice that it's, after all this time, finally done."
The judge ruled Cullen had to be present for victim impact statments and sentencing. Cullen will be allowed to donate his kidney now that he has been sentenced.
Just thought I'd share it with you guys..not sure why...it was interesting to me..he should have recieved the DEATH PENALTY
