Caressant Care and Ontario College of Nurses at odds over serial killer Wettlaufer's firing

Caressant Care Woodstock, the nursing home where Elizabeth Wettlaufer murdered seven residents, and the College of Nurses of Ontario are telling two different versions of events about how her firing was handled.

The long-term care home in southwestern Ontario issued a statement Wednesday that conflicts with information provided by the college on Tuesday at a disciplinary hearing that revoked Wettlaufer's nursing licence.

The college revealed previously unknown details at the hearing about the action it took when it was notified by Caressant Care that she was fired on March 31, 2014. Wettlaufer, who is currently serving a life sentence, was "terminated due to a medication error that resulted in putting a resident at risk."

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The error, according to the college, involved giving insulin to one resident that was meant for another. The resident was supposed to take insulin, but Wettlaufer gave the wrong kind.

Insulin was Wettlaufer's murder weapon. She used the drug to intentionally overdose patients in order to kill them.

She was never caught, but her crimes came to light when she checked herself into Toronto's Centre for Addiction and Mental Health in September and confessed to doctors and then police. She pleaded guilty in June to eight counts of murder, four counts of attempted murder and two counts of aggravated assault.

Report outlined concerns

Wettlaufer killed her eighth victim at a nursing home in London, Ont., that hired her shortly after she was fired from Caressant Care. 

When long-term care homes fire a nurse they are required to tell the regulatory body. The college says that when it received Caressant Care's notification about the firing of Wettlaufer, a staff member called the home's director of nursing. According to the college's version of events, the director "indicated there was no underlying issue or concern" with Wettlaufer, that she owned up to her mistakes and there was "no sustained harm to the residents."

But Caressant Care is pushing back on that description of the phone call. "Caressant Care has no records indicating that its leadership or staff believed or said this in response to any inquiry following the termination," its statement said.

The home also says it sent the college a 20-page chronological report "outlining our concerns" on April 17, 2016. Wettlaufer had made 10 workplace violations over 2½ years and had been suspended multiple times because of them.

The college acknowledged that Caressant Care "set out other practice issues" related to Wettlaufer, but said they were not all related to medication errors. Some were related to less serious offences such as documentation mistakes, a lawyer for the college, Mark Sandler, said.

The details about the interaction between the home and the college are important because the college's legal team said Tuesday it made the decision not to look deeper into Wettlaufer's skills and conduct as a nurse because of what Caressant Care's nursing director said in that phone call.

"It was on that basis that it was determined that no further formal investigation had to take place in the matter," Sandler told reporters.

Instead, the college advised Wettlaufer to ensure she was meeting standards of practice. Her firing, the reason, and the college's inquiry into it, were not part of her record, which appeared clean to her next employers. Wettlaufer was honest with Meadow Park, the London home that hired her, about her dismissal from Caressant Care. According to court documents, the person who interviewed her said she believed in giving second chances.

College stands by statements

Wettlaufer went on to kill Arpad Horvath at Meadow Park, and she attempted two more murders after that at different locations before ending her own killing spree.

Horvath's son has filed a lawsuit against against Wettlaufer, Caressant Care, Meadow Park and the company that runs it, Jarlette Health Services. Among other claims, it alleges Caressant Care was negligent in its management and oversight. Its failure to "monitor and detect Wettlaufer's series of murders" meant she had the opportunity to murder Horvath, it says.

The college, not named in the lawsuit, defended its decision not to take further action after Wettlaufer left Caressant Care.

"I'm satisfied, looking at the information that was available to the college at the time, that they absolutely came to a fair conclusion, that this wasn't an appropriate case to refer to discipline," another of its lawyers, Linda Rothstein, said.

The college gets about 1,300 termination notices a year, the lawyers said, and it does a risk assessment and evaluates the level of seriousness "based on the information that is provided to it."

The college emphasized that at the time there was no indication Wettlaufer's errors had any malice behind them.

"Obviously one looks at everything in this case with the benefit of hindsight, but if you look at it at the time having regard to what the errors were that were identified, and how [Caressant Care] characterized what Ms. Wettlaufer's reaction was to it, a decision was made that it didn't warrant formal investigation," Sandler said.

Despite their differing accounts of how Wettlaufer's firing was handled, the college and Caressant Care are on the same page on another matter: the upcoming public inquiry. Both say they will fully participate.

A spokesperson for the college, Deborah Jones, said in response to Caressant Care's statement that it stands by what it said at the hearing about the information it got from the home.

"The documentation which supports the college's statements about what it was told by the director will be provided to the public inquiry, which we expect will fully investigate these issues," Jones wrote in an email. 

The province hasn't announced yet when the inquiry will get underway or who will lead it.

Caressant Care declined to answer questions about its statement Wednesday, including whether it feels the college is shifting blame to the home. It also declined to provide a copy of the 20-page report it says it gave to the college.