Stan Winston's special effects went beyond creating gore for the film. The figure in the full body cast lying in George LeMoyne's hospital bed was a mechanical dummy built by Winston. The life-like detail and elaborate movements the dummy was rigged to make gives the appearance that its a real person and makes the infamous needle-eye stab all the more startling.
Director Gary Sherman originally intended this movie to be a dark comedy.
Writer/producer Ronald Shusett described the impact of the reconstruction scene, "We see a woman's face being reconstructed by the mad doctor. We see an empty eye socket, and then we see him put in an eyeball. In a moment she sits up, blinks, and turns around; it's obvious, she is not a dummy, nor did she have a glass eye. The effect is startling because of the way it's been filmed, it's impossible to tell how it was done. Actually, Stan made a very elaborate dummy of the girl from a new, very fleshy material. In fact, we were often fooled when we came in the room as to whether it was a dummy under those sheets. Anyway, we used that dummy and without a dissolve, we made a switch to the real girl. For the briefest moment, the doctor lifts his elbow to get something and it covers the audience's view of the girl on the table. But they are so interested in what he is doing they don't even notice for a few seconds, they are not able to see the girl. In that period of time, we moved the dummy just out of camera range and substituted the real person. If you think this sort of thing is easy to do, I can tell you it's not: we shot that scene 17 times to get it right!"
This was Jack Albertson's final theatrical film (although he filmed another made-for-television movie the same year he died). In poor health, and suffering from cancer all through filming, Albertson passed away a few months after this movie's release. He nonetheless lived long enough to see it at its world premiere in Hollywood, in which he attended in a wheelchair with an oxygen tank and mask.
During filming, Director Gary Sherman purposely avoided letting the color red be visible in any scene, so the sight of blood during the murder sequences would be all the more shocking. Sherman even went as far as to have the taillights of vehicles replaced with purple lights, instead of the normal red.