Blunders left evil nurse free to kill on NHS ward: Demands for inquiry after Filipino psychopath with forged qualifications poisoned 22 patients

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Stephen Wright In Manila

and
James Tozer for the Daily Mail

Pressure was growing last night for an inquiry into vetting failures that allowed a nurse to kill two patients and poison scores more in an NHS hospital.

Victorino Chua, a 49-year-old father of two, attacked the very people he was supposed to be caring for. At the height of his poisoning spree, police even considered shutting down Stepping Hill Hospital in Stockport.

Police believe the ‘narcissistic psychopath’ from the Philippines used forged qualifications to register as a nurse here. They even suspect that someone might have sat his nursing exam for him in his homeland.

Ahead of Chua’s sentencing today there were calls for a public inquiry and a review of how foreign nurses are recruited.

It can also be revealed that:

Last night, the recently retired prosecutor who helped bring Chua to justice said he believes there could be hundreds of nurses using fake qualifications in UK hospitals.

Nazir Afzal told BBC North West: ‘In all my 24 years as a prosecutor, I have never escalated concerns to another government department except in this case. I do not know whether there were hundreds or thousands or dozens.

‘What I do know is the opportunities were there for them to lie about their qualifications, to obtain them fraudulently, and to cover up their disciplinary matters. It must be, for all patients, extremely worrying and desperately concerning.’

Kath Murray, 57, a civil servant who has suffered years of health problems as a result of being given a drip contaminated with insulin by Chua, described herself as a ‘living victim’ of the poisoner. 

‘How could they let someone like that work in a hospital, as a nurse?’ she demanded yesterday. ‘He was meant to be caring for people, yet he had all that anger inside him.’

Stephen Jones, a clinical negligence specialist at law firm Slater and Gordon which is representing several of those affected, said patients and their families could be entitled to significant damages from Stockport NHS Foundation Trust. Chua injected insulin into saline bags and ampoules while working on two wards at Stepping Hill Hospital in June and July 2011.

These were then unwittingly used by other nurses on the ward – leading to a series of insulin overdoses to mainly elderly victims.

Two patients, Tracey Arden, 44 and Derek Weaver, 83, suffered agonising deaths and a third, Grant Misell, 41, was left brain damaged as the insulin overdoses starved the victims’ brains of oxygen. 

Chua was convicted at Manchester Crown Court yesterday of two murders, 22 counts of attempted grievous bodily harm, one count of grievous bodily harm, seven attempts of administering poison and one count of administering poison.

Det Supt Simon Barraclough, who led the investigation, said: ‘I have no confidence in the qualifications he has provided via the Professional Regulation Commission (which verifies the qualifications of nurses).’

Stepping Hill accepted Chua without exhaustive checks into his background in 2009 – seven years after he arrived in the UK. Publicly available documents held at the Regional Trial Court of Manila show that in 2000 Chua was accused of stealing 1,070 Philippines pesos, equivalent to about £18, from the city’s Metropolitan Hospital, where he worked.

For 18 months, the case hung over Chua before the allegations of ‘qualified theft’ were dismissed on February 7 2002.

Two weeks later, on February 21, Chua flew to London, via Amsterdam, to start a new life in the UK.  

There’s a devil inside me, killer nurse confessed 

Victorino Chua penned what he called a ‘bitter nurse confession’ in which he spelt out ‘how an angel can turn into an evil person’.

In the extraordinary document released yesterday, he wrote: ‘They thought I’m a nice person but there is a devil in me.’

Over 13 rambling pages, the Filipino killer nurse said he might explode at any time, adding: ‘If I will be pushed, they gonna be sorry.’

Dependant on painkillers, sleeping tablets and antidepressants, Chua also wrote he sometimes felt like killing himself, but feared he would ‘go straight to hell no questions asked’.

The document was found in a kitchen drawer at his home in Stockport after he was arrested in January 2012.

Jurors were told how in hard-to-follow, broken English, written in scrawling capital letters, he recounts the story of his life, beginning: ‘My name is Victorino Domingo Chua.’

In the document, the father of two said he was writing ‘in case something happen to me (so) my family can continue my case or can tell somebody to look at it and work out how an angel turn to an evil person’.

He added: ‘The bitter nurse confession. Got lots to tell but I just take it to my grave. My family will make history here in England.’

In a later addition to the document, dated December 2010, Chua described how he could control the number of painkillers he took for back and knee pain when he was at home – but at work he ‘can’t help it to take more than the limit’.

He added: ‘I’m just telling them I’m fine and alright just to shut there mouth.

‘Still inside of me I can feel the anger that any time it will explode ... just still hanging on ... can still control it but if I will be pushed they gonna be sorry.’

Earlier he wrote how he was avoiding going drinking with friends, adding: ‘They thought I’m a nice person but there (is) a devil in me.’

Drug addict and fantasist who tricked his way into the UK: Killer nurse haunted by father’s death fled Philippines after answering newspaper advert to work in UK care home 

For Victorino ‘Vic’ Chua a nursing career in England was a ticket out of poverty. He had been earning just £3 a day as a nurse when he answered a newspaper advert to work in a UK care home.

Chua set his sights on working in Britain after learning of Tony Blair’s plan – announced in 2000 – to recruit thousands of overseas nurses.

But it now seems clear that he should never have been working for the NHS. An original transcript of his nursing qualifications suggest that his exam marks may have been tampered with. 

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There are also strong suspicions that another individual may have sat some of his exams in Manila. Police in Manchester think the man who sat the exam, in the name of Chua, did not even look like the killer.

The Mail can also reveal that when Chua applied to work in the NHS, only ‘cursory’ checks were carried out by regulators at the Nursing and Midwifery Council which accepted photocopied documents.

Checks were not carried out on his CV, which contained lies, and there are concerns he forged several references.

Born Victorino Domingo Chua on October 30, 1965, he was one of six children born to Juanita, now 65, and his father, a department store manager of mixed Filipino/Chinese descent – who died suddenly of a heart attack aged 49 in 1985. Despite a difficult upbringing, he did well enough at school to be eligible to take a degree.

At the Chua family’s single-storey home of breeze-blocks and a corrugated iron roof in Caloocan City, north of the capital Manila, his mother gave us a copy of her favourite picture of him posing with a skeleton at nursing college, as well as more recent images of him, his wife Marianne and two young daughters in the UK.

She remembers little about his education, saying: ‘Because I married and had my first child very young – I was just 14 – I didn’t take any interest in my children’s education. We were like peers. My in-laws brought up Vic. 

She went on: ‘My husband was a womaniser. He had six children with me, five with his first mistress, two with his second mistress, and one with his third mistress.’

Chua was tormented by his father’s unexpected death – which may explain his rage against anyone who crossed him. His sister Joanne, 47, said: ‘Vic was very close to his father. They used to sleep on the same sleeping mat as each other.’

In the year that his father died Chua enrolled on a four-year BSc in Nursing degree at Manila’s Metropolitan Hospital School of Nursing. Records show that he struggled with the course and in the crucial third year he was thrown out and moved to the privately run Galang nursing school, one of the worst in Manila, to finish his degree.

He was awarded a BSc in nursing in October 1989 from Galang. After supposedly graduating he worked at the Galang Medical Centre, part of the same complex as the college.

So many people died at the 70-bed facility that it was nicknamed the ‘Galang Memorial Hospital’. Now shut down, it could be where Chua whet his appetite for murder. Records of dead patients have long since been destroyed. 

After a couple of years, he somehow landed a job back at the Metropolitan Hospital. He married Marianne in a civil ceremony in 1996 and lived next to the Chua family home. Joanne was reluctant to talk about why her brother was sacked at the Metropolitan Hospital over a theft allegation in the late 1990s.

He was accused of stealing 1070 pesos, equivalent to about £18. The case hung over Chua before it was quietly dismissed in 2002. This gave Chua the green light to move to Britain. He flew to London on February 21, 2002, via Amsterdam and paid a fixer £2,000 to ensure he had the right visas.

Before he worked at Stepping Hill, Chua worked at a number of private nursing homes, most notably Newlands in Stockport

His family in Manila showed us a reference allegedly from Newlands, dated December 20, 2005, recommending Chua to other prospective employers. But it is feared Chua stole drugs from Newlands, now under new ownership, during his time there – almost certainly for personal use. 

The Nursing and Midwifery Council was responsible for him becoming a registered nurse in the UK in 2003 but it did not carry out any proper checks to verify his qualifications. Officials accepted him as a registered nurse after Chua presented photocopies of his nursing qualifications, as well as proof of education, training and identity.

Jackie Smith, chief executive of the NMC, said: ‘That was the process at the time 12 years ago. It is the responsibility of employers to do the appropriate employment reference checks.’ Newlands recommended him to the NMC after helping him through a period of ‘supervised practice’ for foreign qualified nurses. Chua left Newlands in 2007, becoming an NHS ‘bank nurse’ – or temp – until securing a staff post at Stepping Hill in 2009.

Stepping Hill accepted him without exhaustive checks. Once there, it was not long before he became a deeply unpopular member of staff. But repeated warnings about his conduct and behaviour were ignored.

One concerned an elderly woman with breathing problems. She received inappropriate treatment from Chua, who rubbed cream into her buttocks while treating her late at night. She complained to the hospital authorities, but it was not dealt with properly. 

There was also evidence of Chua falsifying signatures and forging statements. Stepping Hill said concerns about Chua from staff were about ‘his interpersonal skills only latterly’ and were dealt with ‘in accordance with Trust Policy and procedures’. When he was arrested, police found he was addicted to pain killers. In his body were ‘industrial quantities’ of codeine. He also took large amounts of other drugs.

Police suspect he stole them from Stepping Hill. They also think he stole valuables from patients. His spiralling drug dependency and deteriorating mental state coincided with him needing counselling from therapists.

By now a British citizen, he was allowed to continue working at Stepping Hill even when suffering from Hepatitis B. In the months leading up to the murders, he was receiving emotional support from the occupational health team at Stepping Hill. Although he confided he was suffering from severe depression, the Stepping Hill occupational health team did not alert managers to any concerns about him.

They advised him to write down his frustrations, which Chua did in a rambling 13 page letter he called the ‘Bitter Nurse Confession’. In it, he described himself as a ‘Robin Hood guy’, who, while in the Philippines, would help the poor to get cheap medical care.

His wife and children now line in the south of England and did not attend the murder trial. 

For just £43, I bought the bogus papers that ‘qualified’ me as a nurse: Reporter uncovers rampant trade in counterfeit certificates as questions are raised over killer nurse's credentials  

From Stephen Wright and Jamie Wiseman in Manila for The Daily Mail

Nursing diplomas can be bought for as little as £43 in the Philippines, I can reveal today.

Doubts about Victorino Chua’s qualifications emerged after this newspaper alerted police to suspicions over his credentials back in 2012.

And I have found there is a rampant trade in bogus exam certificates in Manila – with fixers and forgers always on hand to fabricate any document.

Scroll down for video 

The Mail’s revelations are a major embarrassment to ministers, hospital chiefs and officials at the Nursing and Midwifery Council, which regulates nursing.

In March 2013, the council imposed a temporary recruitment freeze on foreign nurses amid fears that workers could have faked documents to get jobs here. Yet hundreds of nurses are still being recruited from the Philippines by NHS trusts, because of a massive shortfall of staff.

The ‘passport’ to a nursing job in the UK is provided by organised crime networks who employ some of the world’s best forgers.

On Recto Avenue in downtown Manila are stalls openly offering fake nursing degrees, education records, diploma pictures, police clearance to work overseas, passports, driving licences and birth and marriage certificates. Police turn a blind eye in return for bribes.

When I visited Recto Avenue, dubbed ‘Xerox Alley’, a fixer for the forgers went through a list of documents I would require to become qualified, including a degree certificate, police clearance to work overseas and employment certificates and references.

All these were supplied for a total of £43. The fixer even helpfully suggested which date I should graduate from Manila’s respected nursing college at Our Lady of Fatima University.

Of course, the vast majority of Filipino nurses are qualified and have the correct credentials to work in the UK.

But many in this impoverished nation struggle to find the money to finish their degree courses and are tempted to buy their qualifications they need to obtain work in the UK where salaries are vastly higher.

In the run-up to yesterday’s court verdicts, NMC chief executive Jackie Smith told the Mail its vetting system was now ‘robust’ and that her staff insisted on seeing original education documents from prospective foreign nurses.

But a source close to the Stepping Hill case said: ‘Vetting of nurses in the Philippines is very, very poor. A lot is done on the word of the Philippines regulatory authorities.

‘They rely on stamped documents as proof of proper qualifications. This is why police can’t be certain that Chua’s qualifications are genuine.’

Another said: ‘We can’t be certain that the Philippines’ Professional Regulation Commission has exercised due diligence with regard to the NHS. Once you have a PRC stamp, you are more or less guaranteed a job in the UK.’

It was eerie. He'd silently appear at my bedside like something from a horror movie: How victim suffering from common holiday bug was subjected to poisoning ordeal by killer nurse  

She was only in hospital to recover from a common holiday bug. But civil servant Kath Murray found herself at the mercy of a serial killer who prowled the ward by night and subjected her to a terrifying poisoning ordeal.

The mother-of-three remains haunted by the memory of the rogue nurse’s ice cold manner and lack of basic humanity.

‘All the other nurses would chat to you and show a caring side – it made being in hospital that little bit easier,’ she said. 

‘But Chua never said a word to me the whole time. His face was a mask – he might as well have been a robot. There was a sense of emptiness about him.

‘It was really eerie the way he would silently appear at my bedside. It’s chilling now to think what was going through his head.

‘The only thing I’m grateful for is that I didn’t give him any grief – if I’d caused a fuss at all, would I still be here today?’

Even worse have been the mental problems that have haunted the devoted grandmother and devout Roman Catholic and left her contemplating suicide.

‘I would wake up the night hallucinating that there was a nurse in an old-fashioned outfit holding an enormous syringe pointed at my neck standing at the end of our bed – like something out of a horror film.

‘I don’t know how my husband put up with it – we had a terrible time. Someone had tried to kill me – that’s a big thing to take in. I couldn’t even say it without crying – why would someone want to kill me?’

Now 57, Mrs Murray was on a package holiday to Greece with her husband Mike in June 2011 when she fell ill with labyrinthitis, an ear infection.

On her return, she was admitted to ward A3 of Stepping Hill Hospital, put on a saline drip to rehydrate her and given intravenous antibiotics. 

But on the night of July 7 she suffered two terrifying hypoglycemic episodes – when her blood sugar fell dangerously.

Although he was not covering the ward that night, during a shift two days earlier Chua had contaminated its saline stores with minuscule amounts of insulin.

Now the drip that was meant to be restoring Mrs Murray to health was instead slowly poisoning her as she slept.

‘I woke up soaking wet through and shaking violently, moving all over the bed,’ she told the Daily Mail. ‘I was terrified. I didn’t know what a hypo was at that stage, I’m not diabetic. I just started shouting “Nurse, nurse, what’s happening to me?”.’

A female nurse came over, checked her blood sugar, said it was dangerously low and brought her a cup of glucose solution.

‘It was horrible, she practically had to force it down me,’ Mrs Murray said. ‘I also had a Mars bar by my bed and she virtually rammed that into my mouth.

‘For a long time I marvelled at what that nurse did, I thought she’d saved my life by instinct. I only found out much later that it was because so many patients had been going down with low blood sugar.’

Indeed, only the night before, 44-year-old Tracey Arden had died on A3 after a sudden deterioration caused by an insulin overdose.

Mrs Murray dozed off, but awoke again a few hours later in exactly the same state.

‘I was scared by now, I wanted Mike to come and take me home,’ she said. ‘Of course I didn’t know then what was happening, but I thought I was dying.’ 

With his wife lying in bed and barely able to move, Mr Murray took a photograph which clearly shows the drip connected to her arm which would prove a key piece of evidence.

During the following day, the mysterious drops in blood sugar were not repeated – but the following night, Chua’s shift saw him covering her bay himself.

That evening she had a third suspected attack – although Chua recorded it as a ‘hot flush’ and it didn’t form part of the prosecution case.

However, it would be nearly a week before the continuing spate of hypos – followed by the discovery that an ampoule of saline had been contaminated with insulin – would trigger the police inquiry.

Chua would not become a suspect for a further six months, but Mrs Murray said: ‘It was obvious to me then he had no compassion – he was simply going through the motions.

‘But now I see it was so much worse than that – he had just tried to kill me, just as he had tried to kill so many other patients.’

Mrs Murray was safely discharged the next day. Now both she and her 56-year-old husband – who restores stained glass windows – are furious that warnings signs about Chua’s erratic behaviour and dubious qualifications were not picked up in time to save her and the other victims.

Initially, doctors suggested she may have a rare pancreatic tumour called an insulinoma which can cause similar symptoms in non-diabetic patients. Five months later that Mrs Murray was finally told this alarming diagnosis had been a red herring and that Chua had been responsible.

But after being bedridden and off work for several weeks at their home in the Heaton Chapel area of Stockport, she developed shingles and facial paralysis diagnosed as Bell’s palsy.

In a cruel twist, she was even placed on ward A3 again after going in with an eye complaint. Then in January 2013, Mrs Murray received another bombshell – she had breast cancer. Mrs Murray was later informed by an oncologist that the tumours could have been detected as far back as 2011.

‘I was feeling so terrible anyway as a result of being poisoned that I didn’t notice the signs,’ she said. ‘If I hadn’t been given insulin, or if I’d been given a full medicaI after being poisoned, they might have caught the cancer sooner.’ She has yet to be given the all-clear.

Mrs Murray remains furious that Stepping Hill failed to act on concerns about Chua’s mental state and the qualifications he claimed to have secured.

‘How could they let someone like that work in a hospital, as a nurse? There were tell-tale signs that something was wrong from how he was behaving.

‘I’m a living victim and I’ve still only partially recovered. I hope to God that lessons have been learned.’

Seeing Chua give evidence in court, she felt shocked at his cold, emotionless manner. ‘To think that someone could make me feel that weak, then seeing him in court showing no remorse – it was horrible.’

The last victim of Chua’s poisoning spree was admitted after the hunt for the saboteur began, but was still given insulin because hospital bosses failed to realise how much medication he had tampered with. Zubia Aslam, now 27 and by far the youngest of Chua’s victims, was admitted to ward A3 with a severe stomach bug on July 13, 2011 – the day after police were called in.

However, while all stocks of ampoules – small, sealed containers – of saline had immediately been removed from the wards where Chua worked in response to the spate of hypoglaecemic attacks, saline bags remained in circulation.Yesterday she told of the trauma of being poisoned with sufficient insulin to have left her brain damaged if nurses hadn’t been on the look-out for the signs of low blood sugar after the spate of ‘hypos’. Miss Aslam recalled how she woke up ‘sweating, really, really wet, my whole body was wet’.

‘I didn’t think I was going to make it,’ Miss Aslam told BBC 5 Live. ‘When I came around …I had lots of people around me, I didn’t know what was going on, next minute I know my family are there.’

The nurse who connected Miss Aslam to a saline drip to rehydrate her checked the bag for signs of tampering but failed to spot the tiny V-shaped cut where Chua had injected saline, his trial heard. It was so small it could only be detected in a laboratory.

After she was taken ill, the treatment room where medication was kept was belatedly sealed of. Tests on the saline bag given to Miss Aslam found it contained two syringes full of insulin – if it had run its course, she would have suffered irreversible brain damage. Miss Aslam, a former bank clerk from Glasgow and now a mother-of-one who continues to suffer health problems, is taking legal action against the trust which runs Stepping Hill. ‘I’d say I’ve lost faith in the NHS,’ she added. ‘When you’re in hospital you think you are safe.’

Tracey Arden was a working mother-of-two who, at 32, was diagnosed with severe multiple sclerosis which left her blind and unable to speak. She had to move into a care home in Stockport and became a regular patient at Stepping Hill as a result of complications from her illness, where staff remembered she was ‘always smiling’.

Her stay in 2011 was meant to be a routine after she developed pneumonia, and she seemed to be recovering well when her parents, Keith and June, visited her on the afternoon of July 7. But after they got home, ward staff rang to say she was ‘in a bad way’, and despite living just half-an-hour away she had died by the time they got there.

Derek Weaver, 83, was a self-taught electrician who in his youth worked as a projectionist at local cinemas and had later had a successful alarm business.

He and his wife Yvonne had no children. A widower he moved into a care home shortly before being admitted to Stepping Hill with breathlessness. He was poisoned on July 11, 2011, dying ten days later.

 

 

 

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