Suffering from
tertiary syphilis during his later years, his health continued to deteriorate until he was judged mentally incompetent and finally committed to a sanitarium in 1912. According to the Incompetency hearings, Sullivan elicited paranoid delusions, believed he was being spied upon and his food was being poisoned. On January 12, 1913, the
New York Sun reported in a prominent page two article that he was mourned after being committed, "beyond cure" (without naming illness), suffering from "religious mania". After nearly a year, he managed to escape from his brother's house after eluding nurses on the early morning of August 31 (although other accounts claim he had escaped from orderlies after an all-night card game). Within a few hours, his body was found on the tracks in the Eastchester area of the Bronx, New York. Sullivan's family did not report him missing for more than 10 days, and his body was brought to and held at the local Fordham morgue. Finally, after a fortnight, Sullivan was classified as a vagrant and scheduled for burial in
Potter's Field despite his tailored clothing and "TDS" diamond monogrammed cufflinks. Just before removal, his body was finally recognized by Police Officer Peter Purfield, who was assigned to the morgue detail.
The New York Times later speculated that Sullivan might have been killed and placed on the tracks. In fact, the engineer of the train that struck Sullivan stated that he thought the body was already deceased. And, adding to the speculation of foul play, Thomas Reigelmann, the Bronx coroner and Tammany political appointee who signed the death certificate, failed to recognize the body of his longtime friend despite the lack of trauma to the decedent's face. Sullivan's wake was held at his clubhouse, located at 207 Bowery, and over 25,000 people turned out for his funeral at St. Patrick's Old Cathedral, New York, on Mott Street. He was interred in
Calvary Cemetery, Queens, New York. For the next seven or eight years, there was a protracted battle over Sullivan's estate, which by some estimates ranged as high as $2.5 million. After creditors were satisfied, the bulk of the assets went to Sullivan's full siblings, Patrick H. and Mary Anne, and half-brother Lawrence Mulligan. For several years after Big Tim's death, Patrick H. Sullivan attempted to maintain his late brother's political and criminal clout. However, he proved to be an ineffectual leader and withdrew from politics to pursue real estate ventures. Sullivan had one child with his wife, Helen, a daughter who died in infancy. He did, however, father at least six illegitimate children, many with actresses affiliated with his theatrical ventures, two of whom were
Christie MacDonald and
Elsie Janis. ==In popular culture==