An expert on serial murderers in the health carefield told the Elizabeth Wettlaufer public inquiry that more education on what a “normal death” looks like in long-term care could help medical professionals and family detect suspicious deaths.
Beatrice Yorker, a professor at California State University who authored a 2006 study on serial murders in health care, spoke Wednesday at the public inquiry probing the actions of the former Woodstock nurse, who killed eight elderly patients in her care.
“In hindsight, Elizabeth’s Wettlaufer’s victims did not have a good death,” she said, adding that a conversation should occur about what a typical death looks like for a person with diseases common among patients in long-term care.
“The more than we educate nurses and families about how to prepare for dying, the more an atypical death would show up and be suspicious.”
Last year, Wettlaufer pleaded guilty to eight counts of first-degree murder, four counts of attempted murder, and two counts of aggravated assault after using insulin to overdose 14 elderly patients in her care.
Wettlaufer’s offences, which took place between 2007 and 2016, came to light after she confessed to her crimes while receiving treatment at the Centre for Addiction and Mental Health in Toronto in 2016.
The incidents occurred in a private home and three Ontario long-term care facilities where she was employed, including the Caressant Care home in Woodstock, the Meadow Park facility in London, and Telfer Place retirement home in Paris.
She was sentenced to life in prison without the chance of parole for 25 years in June 2017 and the public inquiry was established on Aug. 1, 2017.
Yorker said her 2006 study, which analyzed 90 cases of serial murder among health-care professionals dating back to the 1970s, found that 86 per cent of the killings were carried out by nurses and nursing staff and only 12 per cent were carried out by physicians.
The primary method of murder was injection and most occurred in hospitals.
While the majority of the cases in the study occurred in the United States, Yorker said new data suggests that the number of serial murders in health care in the country is declining.
“I think what really struck us as we looked at the new data is that there are far fewer (cases) in the United States compared to the 1980s,” she said.
The advent of new technology, including electronic medical records, and new safeguards related to medication tracking could be partly responsible for this decrease, she said.
Since the 2006 study, Yorker said more and more serial murders are occurring in long-term care facilities and homes.
“With the aging population, a lot of care is moving out of hospitals,” she said, adding that there is often less supervision in these types of facilities.
Given that people are admitted into long-term care when their heath is failing, she said it raises fewer alarm bells when they pass away.
“It is less likely that there would be an investigation or that it would be considered unusual,” she noted.
Another change she noted since her study was published was an increase in serial murders involving insulin.
She suggested an increase in people diagnosed with diabetes and the drug’s availability could have contributed to the spike.
“I just think it is access. There is just so much of it out there. So many patients are on it,” she said.
She added that she hopes the data she has collected on the subject helps people notice red flags.
She noted that some cases of serial murder among health-care workers can be very challenging to detect.
“In Wettlaufer’s case, there wasn’t a cluster, there wasn’t an epidemic,” she said. “It is very difficult.”
Other people expected to testify this week at the inquiry, which is being held in Toronto, include Julie Greenall, an expert on medication management, and Michael Hillmer, an expert on data analytics.