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Elizabeth Wettlaufer is escorted by police from the courthouse in Woodstock, Ontario, in June 2017. Photo: The Canadian Press via AP

Canadian serial killer nurse Elizabeth Wettlaufer wouldn’t have been caught if she hadn’t confessed, inquiry reveals

  • Wettlaufer, 52, is in jail for life for injecting eight seniors in her care with fatal overdoses of insulin
  • Changes needed in health care system to avoid similar tragedies in future, government-appointed commissioner says
Crime

Elizabeth Wettlaufer arrived for her first day of work as a nurse at the Meadow Park nursing home in 2014 with glowing references. She was well liked, they said, a “good worker” who “loved to mentor and teach”.

None revealed that Wettlaufer had been disciplined several times for incompetence, maltreatment of residents and colleagues, and medical errors. Her supervisors did not indicate that she had been fired for administering insulin to the wrong patient.

But even if her behaviour had raised suspicions, no one imagined the dark truth about the nurse.

Wettlaufer, 52, has admitted to intentionally injecting eight seniors in her care with fatal overdoses of insulin as she worked at multiple nursing homes and long-term care facilities in Ontario from 2007 to 2016. The murders shook public confidence in Ontario’s long-term care system and caused employees to feel guilt and shame for failing to prevent them.

The fact that Wettlaufer is behind bars does not mean that we are safe from health care serial killers. It means only that we are safe from her
Eileen Gillese, inquiry commissioner

On Wednesday, the government-appointed commissioner charged with investigating how Wettlaufer’s killing spree went undetected for so long released her chilling conclusion: no one would have discovered that Wettlaufer was Canada’s first health care serial killer had she not confessed to her crimes.

“The evidence in this inquiry shows that nothing would have triggered an investigation into Wettlaufer or the incidents underlying the offences,” Commissioner Eileen Gillese told family members, officials and reporters here, not far from the Caressant Care nursing home where seven of Wettlaufer’s victims were slain.

Injecting insulin into a person who does not need it can cause that person’s blood sugar to drop below the normal range. Even if the deaths of Wettlaufer’s victims had been fully investigated, Gillese wrote, it is unlikely they would have produced evidence indicating that she had intentionally injected them with too much insulin.

“This finding is significant because it tells us that, to prevent similar tragedies in the future, we cannot continue to do the same things in the same ways in the long-term care system,” Gillese wrote.

Ontario killer nurse admits murdering eight elderly patients

The commissioner had the authority to make findings of individual misconduct, but declined, instead blaming “systemic vulnerabilities in the long-term care system” for which there is “no simple fix”.

Though Ontario’s system of caring for the elderly is strained, she wrote, it is not broken.

The 91 non-binding recommendations in Gillese’s four-volume report include calls to strengthen the management of medications such as insulin at long-term care homes, bolster background and reference checks for prospective employees, increase funding for additional nursing staff when necessary and create a dedicated unit within the provincial health ministry to help long-term care facilities comply with regulations.

The Caressant Care home, where Elizabeth Wettlaufer killed several elderly patients, in Woodstock, Ontario, in October 2016. Photo: Reuters

Wettlaufer was sentenced to life in prison in 2017 after pleading guilty to first-degree murder in the deaths of the eight seniors, four counts of attempted murder and two counts of aggravated assault.

“The fact that Wettlaufer is behind bars does not mean that we are safe from health care serial killers,” Gillese wrote. “It means only that we are safe from her.”

Wettlaufer checked herself into a mental health hospital in Toronto in 2016 and began to talk about the killings with her psychiatrist. She wrote a four-page confession that prompted the hospital to contact police.

Wettlaufer detailed how she killed each of her victims in a videotaped confession that year. After her marriage fell apart in 2007, she said, she was “just angry in general … at my job … at my life”. When she felt what she called “the red surge” come over her, she would kill.

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After the first murder, she said, she felt as if “a pressure lifted from my emotions”.

The Ontario government launched its public inquiry after Wettlaufer’s sentencing hearing in 2017. Over a two-year period, the inquiry took testimony from some 50 witnesses and reviewed more than 42,000 documents.

The inquiry heard that Wettlaufer’s colleagues began sounding alarms about her from 1995 – the year she began her nursing career – and continued until 2016, when she confessed to her crimes.

But the red flags were not enough to stop her from getting work, Gillese wrote. The age of her victims, which ranged from 75 to 96, made them easy prey; few suspected that their deaths were anything but natural.

Elizabeth Wettlaufer appeared before a judge in the courthouse in Woodstock, Ontario, in October 2016. Photo: Reuters

“When Wettlaufer committed the offences, the victims were still enjoying their lives and their loved ones were still enjoying time with them,” the commissioner said. “It was not mercy to harm or kill them.”

Wettlaufer was fired from her first job, at an Ontario hospital, after working while high on anti-anxiety medication that she admitted to stealing during an overnight shift.

She killer first victim in 2007, after starting work at the Caressant Care facility in Woodstock, some 128km (80 miles) southwest of Toronto. By the time she was fired in 2014 for administering insulin to the wrong patient – not a victim – she had killed seven patients there and injured four others, often as the sole nurse working during the night.

When the nursing home terminated Wettlaufer, former administrator Barbara Van Quaetham told the inquiry, she could not fit all of her misconduct onto the form she submitted to Ontario’s nursing regulator.

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But to avoid fighting a grievance filed by the provincial nurses’ union, the nursing home sent Wettlaufer on her way with C$2,000 (US$1,520) and a recommendation letter stating that she had left for personal reasons.

Wettlaufer would go on to work at Meadows Park in London, Ontario – where she killed another patient – and other facilities.

While in prison for her crimes, Wettlaufer told prison staff that she had harmed two other residents in long-term homes. Police investigated, but did not file additional charges.

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