Severe violent crime—such as murder, abuse, or sexual violence—causes significant trauma and harm. When such crimes are discovered in organizations, investigations often show that they occurred over an extended period of time. While research on organizational misconduct explains how white-collar crime is perpetuated, organizational scholarship offers little insight into how violent crime can persist in organizations. In this paper, we develop theory about how severe violent crime can remain concealed within an organization for extended periods of time and how it is eventually discovered. We distill two potential explanations from the literature—cover-ups and whistleblowing—but these explanations are inherently limited by the assumption that the crime is known and visible inside the organization. Given this limitation, we conduct an inductive qualitative study of the case of Niels Högel, a nurse who killed at least 85 hospital patients between 1999 and 2005. We leverage this revelatory case to develop a model of cycles of suspicion, which reveals how violent crime is concealed in organizations. Our model theorizes that the diffuse, uncertain nature of suspicion prevents confrontation of a suspected perpetrator, while suspicion also accumulates through ongoing nurturing. These cycles of avoidance and accumulating suspicion can remain stable for long periods, enabling the perpetrator to commit more crimes. The findings from our case study and the implications of our model contribute to the literature on organizational misconduct by providing an explanation of how severe violent crime can persist in organizations.
