This episode profiles three homicides that occurred within a 15-month time span at Clifton T. Perkins, Maryland's maximum security forensic psychiatric hospital. On July 25, 2010, 51-year-old patient El Soundani El Wahhabi, also known as Saladin Taylor, strangled 45 -year -old patient Susan Sachs in her bed. On October 11, 2011, 24-year-old patient Vitali Davidov beat his roommate, 22-year-old patient David Rico Noyola, to death. Six days later, 40-year-old patient Regilio Mondragon was beaten by patient, 46 year old Andre Mayo.

This episode also profiles the unsolved shooting death of 14-year-old Sterling Emmanuel Settle, who was shot near Covington Road, in Brandywine, on October 9, 1995.