Accused killer prohibited from possessing insulin
Court order was issued shortly before former nurse was charged with murders
Insulin, a drug that can be lethal and hard to detect, is the sole substance that a court order specifically prohibited Elizabeth Wettlaufer from possessing, shortly before the former nurse was charged with the murders of eight nursing-home residents.
The OPP alleges Wettlaufer gave drugs to seven residents at Caressant Care Woodstock and one resident at Meadow Park long-term-care home in London, Ont.
Police have not revealed which drug Wettlaufer is alleged to have administered. However, a peace bond issued to Wettlaufer, 49, on Oct. 6, nearly three weeks before her arrest, banned her from possessing insulin, as well as “medications or any drug as defined by the Controlled Drugs and Substances Act unless prescribed for you by a physician, or over the counter medication for your own personal care.” Insulin, commonly used to treat diabetes, is the only drug specifically mentioned.
OPP spokesperson Sgt. Dave Rektor would not comment on the possible use of insulin in the case of the eight deaths, saying that police had “nothing further to say or confirm in regards to the investigation underway right now.” No details of the investigation had been shared with families of the victims, he added.
A media outlet reported Wednesday that certain victims’ family members, whose names were not mentioned in the report, claimed police had told them insulin was used in their loved ones’ deaths.
Vincent Marks, a chemical pathologist and clinical biochemist who has been an expert in many high-profile insulin cases, said the only way to medically prove insulin poisoning is to show a high level of insulin in a person’s blood. Insulin, which regulates the concentration of glucose in the blood, is produced naturally by the pancreas at a rate of about 30 to 70 units a day.
Marks said that, if a healthy person is given a high dose of insulin — 100 units for instance — then the person would likely fall unconscious in about an hour and probably stay unconscious for three to four hours. As insulin levels go down, the person would recover.
“If you were unfortunate enough to have a heart that wasn’t very good, you might die from heart failure because one of the things the body does to respond to insulin overdosage is to produce a lot of adrenalin,” Marks said.
A big dose of adrenalin can upset the heart, where the heart goes into a funny rhythm, a distorted rhythm, and doesn’t work properly causing the person’s death.
“Fortunately heart attacks as a result of low blood sugar are very, very rare, but they do occur,” Marks said.
If a person is injected with a big dose of insulin, he said, and that person goes unconscious and stays unconscious without being discovered, then the person dies.
“I say ‘nobody discovers,’ because, if somebody discovers they are unconscious, somebody will measure their sugar level and, if they find it’s low, they’ll give them some glucose and they’re no longer hypoglycemic and they, therefore, won’t die,” he said. “So it’s the glucose that’s the problem, not the insulin.”
A high dose of insulin can reduce glucose in the blood to the point where the brain can’t function, Marks said. “The brain must have glucose in order for it to work properly. And insulin controls the con- centration of glucose in the blood.”
To prove that someone died of an insulin overdose one would have to measure insulin and another substance called c-peptide, which is always produced in the body along with insulin, Marks said. If c-peptide is low and insulin is high, then that is almost certainly due to insulin, he said. Simply measuring glucose level is no good, because glucose levels drop in the body after death anyway, he explained. Subtle changes also occur in the brain after an insulin overdose, but it takes a few days for those changes to appear and the person has to remain alive, he said.
Marks said low blood-sugar levels in a person are not always associated with insulin. “Sick, ill people can have low blood sugar, not due to insulin, but due to illness.”
So proving a person died of an insulin overdose, when the person has been dead for years, amounts to supposition, he said.