State gets tougher on sexual misconduct
Seattle Times staff reporter
A year ago, Lamin Darboe might have kept his nursing-assistant license despite being charged with rape.
The victim, a 31-year-old Seattle woman in his care, had been paralyzed by a stroke and couldn't speak. She could only nod or blink when investigators pointed to an alphabet board.
Letter by letter, she relayed to investigators that Darboe, 39, had sexually assaulted her this past summer at a Seattle hospital, according to King County court records.
But no witnesses were found, no evidence recovered, just a victim's voiceless account.
A year ago, that evidence simply wouldn't have been enough for the state Department of Health to take action. Over the past decade, it dropped more than a dozen cases involving sexual assault when the evidence hinged on an incapacitated patient.
A yearlong Seattle Times investigation, published in April, revealed that the state allowed hundreds of doctors, counselors and others to keep practicing despite their sexual misconduct. The Health Department, which regulates health-care practitioners, repeatedly failed to adequately investigate and punish offenders, allowing many to victimize again, the Times found.
The investigation also revealed that the department dismissed — without doing any investigation — nearly one-third of the nearly 1,500 sexual-misconduct complaints it received since 1995.
Among those dismissed was a 2002 complaint against Darboe from Swedish Medical Center. It accused the nursing assistant of inappropriate conduct with female patients.
In response to the Times series, state Health Department Secretary Mary Selecky said the department has spearheaded widespread reforms. So far this year, the department has quadrupled the number of emergency license suspensions it filed, stripping away licenses from 21 practitioners deemed an imminent public risk, state records show.
The department has brought or settled more charges of sexual misconduct than in any year before — 71 cases. Those cases range from a Bellingham doctor disciplined for raping a pregnant patient to a chemical-dependency counselor accused of molesting a court-referred client.
This time, rather than drop the Darboe complaint, the Health Department quickly investigated and revoked his nursing-assistant license.
"We're changing the culture," Selecky said. "I've put everyone on notice that we have to do better."
Among the changes:
• Sexual-misconduct complaints are looked into right away. Previously, health investigators evaluated all complaints in the order received. The department, which receives about 14,000 complaints a year, sometimes took weeks or longer to even look into a complaint of sexual misconduct.
• The state's 300,000 licensed health-care practitioners will be screened four times a year for in-state criminal convictions. The state previously checked their criminal backgrounds only once, when they first applied for a license.
• The state's 17,000 registered counselors — who aren't required to have a high-school degree — may soon be required to have community-college credits or face automatic license suspension. Registered counselors had more sexual-misconduct sanctions than any other health-care profession.
Washington is the only state in the country that grants credentials to so many counselors under such meager standards.
Also for the first time, regulators adopted uniform definitions of sexual misconduct for the 57 health-care professions they regulate.
"It seems so simple. You need to define the problem before you can fix it," Selecky said.
Clustered in a rented three-story building in Tumwater, Thurston County, Health Department programmers joke that the average teenager owns a more powerful and versatile computer system.
It's close to the truth. One of the department's main computers was designed in the 1980s for real-estate licensing.
The department also is handicapped by antiquated policies. The state so far refuses to use the FBI's national criminal-conviction and fingerprint databases for screening practitioners. For now, Washington patients remain vulnerable to criminals who hopscotch across state lines and find work in the health fields.
Selecky said such checks are too time-consuming and costly.
But nearly half of the states screen fingerprints of health-care applicants through the FBI database, one of the nation's most comprehensive criminal-justice tools. Most states, such as Oregon, pass on the $30 to $40 fees to applicants, without cost to taxpayers.
"It's ridiculous that we don't do this," says state Rep. Tom Campbell, R-Roy, vice chairman of the House Health Care Committee. He said lawmakers will introduce a bill in the next legislative session that will require national background checks.
Until then, regulators are taking smaller steps.
For the first time, they are matching the names of all health-care practitioners against the Washington State Patrol's criminal-case database. Using computer matching, investigators so far have uncovered 32 undisclosed felony cases, nine of them involving sex offenses.
Six months ago, regulators for the first time began screening applicants through the National Practitioner Data Bank, a federal licensing database that tracks disciplinary actions reported in all states. This taxpayer-funded databank does not contain criminal convictions.
1st complaint dismissed
Darboe first came to the attention of the Health Department four years ago.
In August 2002, Swedish Medical Center officials notified the agency's complaint division that they had fired the nursing assistant for inappropriate behavior with female patients.
Swedish officials expected that regulators would investigate Darboe. Instead Swedish's complaint letter was tagged as inconsequential and dismissed without investigation, state health officials now acknowledge.
The letter might have remained unnoticed if Darboe had not been charged this year with raping a paralyzed woman at Kindred Hospital, an 80-bed, long-term-care facility in Northgate.
The investigation was launched by a friend of the victim. During a visit July 15 this year, she noticed the victim's discomfort when Darboe entered the room to give a sponge bath. Afterward, the friend asked if the 31-year-old woman was comfortable around Darboe.
The victim "vigorously shook her head to indicate no," according to court records.
When asked if Darboe had inappropriately touched her, the victim "indicated yes in a vigorous way and began to cry."
Kindred Hospital officials immediately called Seattle police as well as the state Health Department. Seattle detectives invited a health investigator to participate in the case.
Statewide, police agencies rarely invite health regulators to take a front seat on criminal investigations, The Times found. Also, they often fail to report charges or convictions of practitioners to the Health Department.
The victim recounted to investigators that several times she had awakened to find Darboe on top of her. Once, he covered her head with a towel so she could not watch and other times he warned her not to say anything, according to court records.
Seattle police also uncovered Darboe's criminal history: Court records show that he was arrested in 2001 on suspicion of rape but charges were dropped; in 2005, he was charged in Snohomish County with the rape and kidnapping of a Marysville woman. He later was acquitted.
Darboe told a Seattle detective that he was being framed by Kindred Hospital employees who "had it in" for him, the detective wrote in a statement filed with King County court.
In August, two days before charges of second-degree rape and indecent liberties were filed against him, Darboe fled to his native homeland, Gambia. He was arrested a month later on a warrant when returning through Philadelphia. He remains in the King County Jail pending trial.
Darboe's rapid suspension is a success story, Selecky said. This time it took only 24 days.
Michael J. Berens: 206-464-2288 or firstname.lastname@example.org
Copyright © 2006 The Seattle Times Company