Stepping Hill murders: how Victorino Chua's poisonings were uncovered
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Version 0 of 1. Usually it is immediately obvious when there has been a murder. But for some time after Victorino Chua embarked on his killing spree at Stepping Hill hospital during the summer of 2011, no one really noticed. His victims were mostly, but not exclusively, elderly. All were unwell. Each was already in hospital when he secretly loaded their drips with insulin in order to put them into hypoglycaemic shock, causing their blood sugar levels to plunge to dangerously – and sometimes fatally – low levels. Two patients were dead by the time the police were called on 12 July 2011. Attempts had been made to grievously harm several others. Chua had poisoned them with insulin, but foul play was not suspected straight away. His victims were seemingly chosen at random. They simply had the misfortune of being connected to drips fed by saline bags, which, for reasons that have never become clear, Chua had previously tampered with in the privacy of the hospital’s treatment rooms. By this method he murdered Tracey Arden, 44, on 7 July and Alfred Weaver, 83, later that month. Related: Stepping Hill nurse Victorino Chua guilty of murdering patients It was the unusual events of the weekend of 11-12 July 2011 that prompted Greater Manchester police to begin their biggest and most complex investigation in 10 years – bigger, in the early stages, than that which pieced together the crimes of Harold Shipman, the GP from Hyde convicted in 2000 of murdering 15 patients. Five patients on the male ward (A1) at Stepping Hill suffered unexpected hypoglycaemic attacks. Just one, 67-year-old Philip Jones, was diabetic. He was the only one of the five who could have been expected to suffer insulin regulation problems, though he controlled his illness by diet rather than insulin injections. All five had suffered classic symptoms of insulin overdose. They appeared pale and sweaty; some had convulsions and fits. One man, 41-year-old Grant Misell, who had been rushed to hospital after taking an overdose, fell into a coma and suffered irreversible brain injury as a result of the maladministration of insulin. Weaver became so unwell that he died 10 days later. Related: Nurse cleared of Stepping Hill poisoning sues police Staff were confused. Why were so many patients suffering these attacks? The following day, a nurse discovered a number of saline bags – known as ampoules – that were leaking, having clearly been tampered with. Chua was working that night and was party to the discussions about what might have gone on. At that stage no one suspected there was a poisoner in their midst. But after the ampoules were tested and insulin discovered in the solutions, the police were contacted. The investigation came too late for some of the women on the A3 ward. Chua had tampered with their drips, injecting bags containing saline solution with insulin. He chose to use two kinds of pharmaceutically manufactured insulin, taken from the unlocked fridges in Stepping Hill’s treatment rooms, human (ie human-derived or naturally harvested insulin) and synthetic. The use of the human insulin muddied the water. During Chua’s trial, both prosecution and defence accepted that six of the 21 victims had suffered attacks caused by the administration of synthetic insulin. But the defence argued that 15 patients had underlying health conditions that could explain why they might have suffered the episodes of critically low blood sugar. Daphne Harlow, 86, was the first woman to suffer the ill-effects of Chua’s tampering that night. Admitted after a fall, she had no history of diabetes, yet 24 hours after her admission she could not be roused and looked like she was having a fit. It was a severe hypoglycaemic episode. Twenty-four-year-old Zubia Aslam was next. On examination, it emerged that her saline drip contained high amounts of human insulin. When the bag was examined by a forensic scientist, it was noticed that there was a small v-shaped cut to the rubber septum of the resealable bung and two puncture holes to the inner membrane of the bung consistent with a hypodermic needle. Panic set in. Police were again called and products were removed. On testing it emerged that a glucose bag, saline bag and antibiotic bag had needle puncture holes consistent with the insertion of a hypodermic needle. Another saline bag had been contaminated with Lidocaine, a local anaesthetic. So began Operation Roxburg, Greater Manchester police’s 18-month investigation into the poisonings. They began by advising sweeping changes to the hospital’s security policies, restricting access to treatment and drug storage rooms and installing CCTV to entrances and exits to wards. Detectives carried out a review of all hypoglycaemic incidents at Stepping Hill, examining medical records and preserved blood samples to see which patients had suffered unexpected drops in blood sugar levels. They cross-referenced the dates of these incidents with the shift patterns of the hospital’s 4,000-plus staff and – unfortunately for one woman – jumped to the wrong conclusion. On 20 July 2011, police arrested a nurse called Rebecca Leighton, who worked on A3. Early forensic tests indicated that she had handled a number of suspected contaminated IV products. She was charged with criminal damage with intent to endanger life and spent six weeks on remand in prison before the senior investigating officer, DS Simon Barraclough, realised she was not responsible. He approached the Crown Prosecution Service and got it to drop the charges. Leighton, dubbed the “angel of death” by some media outlets, was entirely innocent, Barraclough says now. “The evidence proved not to be the evidence that we expected it to be. The fact is Rebecca Leighton didn’t do this.” In 2013, she began proceedings to sue Greater Manchester police for up to £100,000 after officers allegedly leaked her name to the media and made public her private Facebook account. Meanwhile, Chua continued to work at Stepping Hill. But with the hospital on virtual lockdown and new control measures in place, he had to take a different tack, Manchester crown court heard. He waited five months before continuing. On the night shift of 1-2 January 2012, Chua was once again working on A3. That night he was involved in a number of curious incidents. First he had an argument with the daughter of Maria Pawlyszyn, an elderly patient who had been admitted that night. The daughter left in tears and the next morning it was discovered that her mother’s prescription chart had been altered. The following morning after the handover, when Chua had gone home, other nurses realised something was amiss with the prescribed dosages of drugs on some patient prescription charts. They noticed “crude alterations” had been made to the charts of Pawlyszyn and five other women aged 79 to 92. But by then the wrong dosage had been administered to another victim, Theresa Bailey, who fortunately suffered no significant ill effects. Chua was arrested at home in Stockport on 5 January 2012. Police had produced a Venn diagram plotting the suspicious hypoglycaemic episodes against the staff working the shifts when and where the episodes occurred. Only one name found its way into the intersection as the common denominator: Victorino Chua, who came to the UK from his native Philippines in February 2002 on a temporary two-year work permit. Born on 30 October 1965, he qualified with a degree in nursing and during the 1990s practised as a nurse in Manila. In 2003, he was registered in the UK as a nurse and in 2008 was naturalised as a UK citizen and settled with his wife and two children in Stockport. In 2009, he was appointed to the post of staff nurse at the Stockport NHS foundation trust and on 1 June 2009 he started working at Stepping Hill. During the three-month trial no motive ever really emerged for why Chua decided to kill his patients. In the vast majority of cases, his victims were chosen by fate, after he contaminated products or altered prescription charts at random. As prosecutor Peter Wright QC put it when he opened the case in January: “It was, to a degree, a lottery as to who was treated with a contaminated product and who was not.” Yet on occasion he was solely responsible for the care of his victims when they suffered an unexpected hypoglycaemic attack, and chose to do nothing about it, other than to conceal it on the medical notes of observations. Wright said to the jury: “You can draw your own conclusions as to why someone seized with the responsibility of caring for a patient should elect to do that. We say only he knows the real reason for his conduct. It is his responsibility for it that we seek to establish, not what caused him to do it and to turn from a man who had dedicated his life to caring for others, to harming them.” The only clue as to Chua’s state of mind came in a letter he had written but never sent, discovered by police during a search of his home following his arrest. In the letter, dismissed as “the bitter nurse confession” by Chua, the nurse said he was “an angel turned into an evil person” and “there’s a devil in me”, who had things he would “take to the grave”. The crown accepted Chua had written the document at the suggestion of a counsellor during a therapy session in June 2010 – a year before he went on his poisoning campaign. But Wright told the jury: “We say this letter, in the form of autobiography, was a living and unfinished document. There was unfinished business. It is a narrative of his life, of his feelings, of his pent-up frustrations. It was a portent of things to come and of what he had done. “It is an insight into his thought process during a period of considerable anger and disharmony both at home and at work which coincided with these events. The evidence points sadly to a man who, for reasons truly known only to himself, decided to take out his frustrations on his and other’s patients.” |