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Nurse Wettlaufer lied on applications but regulator didn't follow up, inquiry hears

The lawyer for a Woodstock, Ont., long-term care home that fired Elizabeth Wettlaufer in 2014 for making a medication error says the nurse's regulatory body didn't consider public safety enough when handling the serial killer's file. The College of Nurses of Ontario was in a unique position to assess Wettlaufer's ability to continue nursing because only the college knew her history of stealing narcotics from her employer, overdosing and having a problem with drugs and alcohol.

Leaving out history of lying and alcoholism 'a very significant omission,' care home lawyer says

Anne Coghlan, executive director and CEO of the College of Nurses of Ontario, testifies at the long-term care inquiry. (CBC)

The lawyer for a Woodstock, Ont., long-term care home that fired Elizabeth Wettlaufer in 2014 for making a medication error says the nurse's regulatory body didn't consider public safety enough when handling the serial killer's file. 

The College of Nurses of Ontario was in a unique position to assess Wettlaufer's ability to continue nursing because only the college knew her history of stealing narcotics from her employer, overdosing and having a problem with drugs and alcohol. 

That happened in 1995, when she was working her first job as a nurse at Geraldton General Hospital. 

 But Wettlaufer lied about those incidents and about her health history, which included diagnosed mental illness, in subsequent dealings with the college. 

"The college was aware that Elizabeth Wettlaufer had a history of lying and that she had a history of lying to the college," lawyer David Golden said to Anne Coghlan, head of the college, who is testifying at the long-term care inquiry being held at the Elgin County courthouse in St. Thomas, Ont. 

Wettlaufer lied about how many drugs she stole and took, and she lied about being an alcoholic. 

"You were well aware that she was an alcoholic," Golden told Coghlan. 

History of lying

Still, Wettlaufer's history of lying and alcoholism wasn't included in a summary note sent to Coghlan by a college investigator who recommended Wettlaufer not be censured but rather sent a letter to remind her to brush up on her professional obligations. 

"I suggest to you that the memo is meant to summarize risk assessment, and to leave out that she was an alcoholic was a very significant omissiion," Golden said. 

Caressant Care had fired Wettlaufer for making a medication error and listed several, but not all, of the problems it had with the nurse since she began working at the Woodstock, Ont., home in 2007. 

Coghlan has said she didn't get enough information about Wettlaufer's problems at Caressant Care to establish a pattern of abuse, neglect or professional misconduct.

But Golden said it's the college that didn't follow up on the information it had about Wettlaufer, plus the information sent to it by Caressant Care.  

"Does it not factor into your risk assessment that you are dealing with someone who is repeatedly lying to the college? I'm going to suggest to you that the fact that you know she is lying to the college, that is something you should take into account." 

The guide for what facilities should include in termination reports to the college lists only "reason for termination," which Caressant Care provided, Golden said, along with additional information. 

Coghlan said she wants to see more information that would help in a risk assessment about the nurse. 

Caressant Care didn't tell the college it considered Wettlaufer "a danger to resident safety" when it fired her. 

The college didn't follow up with Wettlaufer about whether she actually looked over her professional obligation. Wettlaufer got a new job at Meadow Park long-term care in London, Ont., and killed again. 

Backlog of cases

It takes up to a year to investigate some nurses who have been reported to their regulatory body by their employers or patients, the inquiry has heard. 

"We attend to matters within six months, but there are some that are outliers," Coghlan testified Wednesday. "Earlier this year, there were some that were a year old, and that would be unacceptable." 

The college oversees the province's 175,000 registered nurses and registered practical nurses. 

The inquiry is examining what problems in the long-term care system allowed Wettlaufer to commit her crimes — killing several residents in her care over a decade — and aims to prevent similar tragedies. She was sentenced in June 2017 to eight concurrent life terms in prison. 

Several of Wettlaufer's employers, from 2007 to 2016, when she quit and confessed her murder spree to a psychiatrist, have come under fire for not reporting problems with her performance, including inappropriate sexual comments and other interactions with staff and residents, neglectful or abusive treatment of residents in her care, and medication errors that could have led to serious harm. 

The spotlight on the case has led to a doubling of reports about nurses to the college, Coghlan has said. The college now deals with about 40 reports a week. 

As a result of the increased load, the regulatory body has increased its budget for 2018 by $10 million. It is also raising fees for members in 2019 so it can hire more investigators. 

Reports are triaged based on urgency, Coghlan told the inquiry on Wednesday. Cases of sexual abuse or neglect are dealt with more quickly, she said. 

"You've indicated that in some circumstances, the first initial review by an intake investigator might take as long as six months. Do you think that members of the public would be disappointed in that timeframe?" Coghlan was asked by Alex Van Kralingen, a lawyer who represents the loved ones of several of Wettlaufer's victims. 

"I appreciate that they may be disappointed. What I want the public to appreciate is that the college is looking at the things that pose the most serious risk of harm. Our triaging and continual prioritizing of matters is designed to make sure that action is taken, that those matters that pose the most serious risk of harm are addressed on an urgent basis." 

Coghlan's testimony is expected to continue Thursday. The inquiry will also hear from an intake investigator who received a report about Wettlaufer's termination from Caressant Care in 2014.

​The inquiry began in June and is expected to last until September.