SEATTLE POST-INTELLIGENCER
http://seattlepi.nwsource.com/local/290455_nurserape30.html

Nursing aide in rape case fired 3 times
State system 'failed' paralyzed stroke victim

Monday, October 30, 2006

By VANESSA HO
P-I REPORTER

The young woman had suffered a devastating stroke that paralyzed most of
her body and erased her ability to speak. But her mind was still sharp,
and she knew she was going to a long-term care facility recommended by
another hospital.

But a month into her stay at Kindred Hospital in Seattle, a nursing
assistant raped her twice, according to charging documents.

In one of the alleged attacks, he placed a towel over her face. The woman
knew exactly what was happening to her, but couldn't scream or fight back.
All she could do was shake her head "no."


  Darboe
It wasn't the first time the man, 39-year-old Lamin Darboe, was suspected
of being sexually aggressive. Twice he had been arrested for investigation
of rape and cleared. He had been fired for sexually harassing a female
patient, convicted of a domestic-violence assault and ordered to stay away
from another woman he allegedly threatened.

Yet Darboe was able to remain a certified nursing assistant, licensed by
the state Health Department for 13 years. And despite having been fired
from two other hospitals, he managed to get a job at Kindred, an 80-bed
facility in Northgate that specializes in treating critically ill
patients.

"I don't see how they could not have a sense that he was questionable,"
said Louise Ryan, the state's assistant long-term care ombudsman, of both
the Health Department and Kindred.

"Where there's smoke, there's fire," she said. "It sounds like there's
enough red flags to make a provider think very carefully before hiring
someone like that."

The case, which prosecutors filed in August, illuminates glaring
deficiencies in Washington's health care system -- such as a fear of
lawsuits and bungled communication -- that allowed Darboe to skip from
hospital to hospital. As he did so, his suspected criminal behavior grew
bolder.

That pattern was not obvious on background checks, because Darboe's one
conviction -- in the assault case -- was dismissed after he completed
probation.

Darboe also filled out questionnaires designed to winnow out unsuitable
candidates. But in 2002, when he applied for a second license -- to be a
health care assistant -- he lied, saying he had never been guilty of a
crime. No one caught it, and he got the license, which allowed him to do
more specialized work.

There are other tools to gauge a prospective employee's behavior, from job
references to simple court searches. But those tools are up against the
crowded, growing world of certified nursing assistants, who number 62,000
statewide.

The pay is low and the turnover high. Longtime workers sometimes wager how
soon a newbie will quit -- after exhausting shifts of cleaning up bodily
fluids and lifting heavy patients.

Nursing assistants also generate more complaints than any other category
of health worker. A 2004 state report found that nursing assistant
applicants had the highest percentage of criminal convictions, of which
only 40 percent were disclosed before a background check.

By the time Darboe saw the 31-year-old stroke patient in Room 213 at the
far end of the hall, he had faced a jury just months before, on charges
that he kidnapped and raped a woman he picked up at a bus stop.




Safety net failed

A presidential bodyguard in his native Gambia, Darboe came to Snohomish
County in the early 1990s. He followed the path of many Gambians and
became a certified nursing assistant. All he needed was about 100 hours of
training.

"The nephew I know is not capable of doing such a thing. We don't do this
kind of rubbish. We are Muslim and believe in the Almighty God. We believe
in protecting the weak," said Darboe's uncle, Kalilou Fofana. Darboe has
professed his innocence to detectives.

Fofana, who is a nurse, said sexual allegations are common against male
employees who provide intimate care, especially if they are black. Other
Gambian men said they feel uncomfortable bathing female patients and
usually ask a female co-worker to trade assignments, or assist in the
room. Some of Darboe's co-workers at Kindred said he tried to follow that
practice.

Darboe, who is facing extradition from Philadelphia to Seattle, could not
be reached for comment. But his record speaks volumes.

After working in a series of rehabilitation centers, he found a job at
Swedish Medical Center in 1999. He soon began getting into trouble. A
girlfriend told police he slapped and punched her. Another woman said
Darboe threatened her, after they dated once and she rebuffed him.

In 2001, Marysville police arrested Darboe on suspicion of third-degree
rape. A woman said Darboe forced her to have sex during a date, police
records show. Darboe told police the sex was consensual, and prosecutors
declined to charge him.

Melissa Tizon, a spokeswoman for Swedish, said the hospital was unaware of
the assault conviction, protection order and rape-investigation arrest.

But in 2002, Swedish learned of allegations that Darboe had sexually
harassed two female patients. While giving a sponge bath to one, he asked
if she could "keep a secret," told her she was beautiful and penetrated
her digitally, according to court records.

Bathing her made him "wet," he told the woman, giving her his phone number.

Another female patient had similar complaints. Swedish fired Darboe on
July 8, 2002.

It was the first time Darboe had been accused of being sexually aggressive
toward patients, and the first known opportunity to prevent further abuse.

But the safety net that should have caught him failed to work.


'Unknown' assistant

When Swedish reported Darboe to the Health Department as required, there
was no mention of sexual contact, because the patient hadn't complained of
any. It wasn't until a detective on the Kindred case interviewed the
patient -- four years later -- that she disclosed how Darboe touched her.

In its report, Swedish provided a brief description of Darboe's behavior,
calling it "inappropriate," but made no mention that it occurred while
bathing a patient.

Terry West, the Health Department's deputy executive director, said the
account was so vague it didn't trigger an investigation. "Inappropriate
comments, that doesn't tell us enough. It didn't say someone was harmed,"
she said. "We don't have the resources to investigate every single
complaint."

Swedish contends the department should have investigated its report, which
described Darboe giving personal contact information to patients. "(That)
should have been a major red flag to them," said Pam Inch, Swedish's
director of work force planning.

Another glitch kept the complaint off Darboe's record -- until recently.

Lamin Darboe is a common Gambian name, shared by three other nursing
assistants in Washington at the time. The state didn't know to which man
Swedish was referring. And it never asked.

Doing so would have constituted an investigation, West said.

So Swedish's report ended up in a file labeled "Unknown Nursing
Assistant." Anyone checking Darboe's license had no way of knowing what
happened.

Job references are supposed to be another way to illuminate employee
behavior. But experts say fear of lawsuits from former employees makes
many hospitals reluctant to say much, particularly about bad employees.
Some hospitals won't even reveal that someone was fired, unless a release
form was signed.

That helped Darboe stay employed. He also benefited from a questionable
reference.

A month after Swedish fired him, he applied for work at Cascade Valley
Hospital in Arlington, records show.

On a reference check form, Darboe listed his former supervisor as Wally
Njie. On the same form, later returned to Cascade, every box for Darboe's
attendance, appearance and relationships with patients and staff was
checked as "excellent."

"Respect patients privacy," someone wrote. "Happy always smiling." "Good
worker." The reason for leaving Swedish was noted as "voluntary
resignation."

Njie, who said he works at Swedish, told the Seattle P-I that he didn't
recall filling out the form and that he never supervised Darboe, whom he
called a colleague.

Inch said Njie has never been a supervisor. She said the Cascade form,
which was never signed, did not go through Swedish's human resources
office.

Darboe got the job at Cascade in September 2002. A human resources
coordinator did not return calls for comment on the form.

Two years later, when a job reference did go through Swedish's official
channels, it was less than telling. Darboe had applied for work at Stevens
Hospital in Edmonds in 2004, and the only thing Swedish told Stevens were
his dates of service.

"Please note we have answered all the questions our current policy
allows," Swedish's rubber-stamped message said. "The omission of requested
information is in no way a reflection of this individual."

Again, Darboe got the job.


'Very positive reference'

The night of Jan. 29, 2003, Darboe picked up a woman from a bus stop in
Everett and drove her to a remote area, according to court documents.

He demanded her cash, punched her in the head and ribs, held her by her
throat and raped her in his car, she told police.

"All this time, he's telling me to 'Shut up or I'll kill you,' " the woman
said in a sworn statement before trial.

After he drove her home in Marysville, she called 911. He was arrested
that night.

While he sat in jail, someone called Cascade, where he was working, to say
he needed time off to tend to a sick relative, Cascade officials said. The
hospital fired him upon learning his true whereabouts, ending a five-month
stint.

Two years later, in 2005, prosecutors charged Darboe with forcible rape
and kidnapping. By that time, he was working at Stevens, which fired him
after learning about the case from a local newspaper report. He had been
there eight months.

Cheryl Payseno, the chief executive officer at Kindred, declined to say
when Darboe worked for her. Between 2003 and July 2006, it appears he left
Kindred and returned, but is unclear when and for how long.

Kindred apparently hired him the same month Cascade fired him. Kindred
also gave Darboe "a very positive reference" in 2004 when he applied for
work at Stevens, Stevens spokeswoman Beth Engel said.

Payseno said Kindred followed "normal" hiring procedures in checking
Darboe's criminal history and references. She said she didn't know he had
been a first-degree rape suspect or that he had been fired three times.

"Patient safety is our utmost priority," she said.

She then pointed the finger at other hospitals. "I just wish the
facilities would be more diligent about properly reporting," she said. She
added that the reluctance of some hospitals to disclose much information
should also be scrutinized.

Darboe was acquitted of the Snohomish County charges in February.
Recently, his accuser -- an alcoholic who had fallen off the wagon and was
drinking heavily the night she met Darboe -- said she was saddened to hear
of another alleged rape victim.

But not surprised.

"I feel so sorry for her," she said. "I told them it was going to happen
again, that he's not going to stop. How they let him work here -- and
especially in a health care position -- it's just beyond me."


'Vile predator'

In July, it finally took a quadriplegic who couldn't speak to get Darboe's
license revoked.

Before the woman suffered her stroke in May, she had been vibrant and
healthy, working a full-time sales job while raising four school-age
children. The stroke left her with few ways to communicate. She could
shake her head or nod. She could cry.

A month after she was admitted to Kindred, her friend came to visit and
asked if she was uncomfortable with Darboe. He had just bathed her. The
woman nodded her head vigorously and cried.

Through the help of a spelling board, the woman told police Darboe had not
only raped her, but also had repeatedly penetrated her digitally and
licked her genitals, according to charging papers filed in King County
Superior Court. He told her not to tell anyone.

The woman's husband said she used to be unfazed working in a
male-dominated place. "She pretty much stepped on all the guys," he said.
But at the hospital, she was afraid to report Darboe.

Darboe left for Gambia during the police investigation, saying his
grandfather was dying. Prosecutors later charged him with second-degree
rape and indecent liberties.

In September, he was arrested in the Philadelphia airport upon returning
to the country and is now facing extradition to Washington.

Soon after his arrest, the Health Department revoked Darboe's license for
20 years, leveling one of its harshest penalties.

But it came too late for state Rep. Tom Campbell, R-Roy, the vice chairman
of the House Health Care Committee. Campbell said health officials need
more access to arrest data, to weed out abusive providers.

"If someone is arrested for abuse of a child, or battery on a woman, it
needs to be there," Campbell said. "I'd rather err on the patient not
being raped, than be worried about someone not having a job."

He said he will introduce a bill to expand the Health Department's scope
on background checks. He also said hospitals should disclose more
information about fired employees.

The woman's friend is also lobbying for change. She wants a law that would
require a second person in a room during intimate care for a patient.

"If such a law were in place during my friend's stay at Kindred Hospital,
she would have been protected from this vile predator," she said.

The woman's husband has hired a lawyer. He is struggling with insurance
papers and medical bills, and the couple's friend has started a fund for
donations.

He visits his wife nearly every day at a new rehabilitation home. She's
begun to show movement in one of her legs. Often, he brings the kids.

His wife's ordeal is "beyond imaginable," he said. He blames Kindred and
the state.

"The only thing I can say," he said, "is that they both failed considerably."

A CHECKERED PAST
Nursing assistant Lamin Darboe stayed employed despite being repeatedly
suspected of sexually aggressive conduct. His license was renewed shortly
before he allegedly raped a female stroke patient in Seattle.

DARBOE'S EMPLOYMENT AND CRIMINAL HISTORY
Criminal incidents italicized and highlighted.

1993

Nov.: Gets state nursing-assistant license.
1994

Nov.: Starts work at Washington Center for Comprehensive Rehabilitation.
1999

June: After several other short-term jobs, hired by Swedish Medical Center
in Seattle.
July: Arrested for domestic-violence assault in Lynnwood; later pleads
guilty.
2000

July: Protection order bars Darboe from contacting another Snohomish
County woman who says he threatened her.
2001

Nov.: Arrested on suspicion of rape in Marysville; prosecutor later rules
out charges.
2002

July: Fired by Swedish for sexually harassing female patients.
Aug.: Swedish reports Darboe to state Department of Health; no
investigation is done.
Sept.: Starts work at Cascade Valley Hospital in Arlington.
Nov.: Gets health care assistant license.
2003

Jan.: Arrested on suspicion of rape in Marysville.
Feb.: Fired by Cascade; apparently hired by Kindred Hospital in Seattle.
2004

May: Hired by Stevens Hospital in Edmonds.
2005

Jan. 10: Charged with rape and kidnapping in Snohomish County.
2006

Jan. 18: Fired by Stevens.
Feb. 22: Acquitted of all charges.
March 13: Health care credential renewed.
Aug. 10: After three-week investigation, charged with raping a female
stroke patient at Kindred; later leaves country for native Gambia.
Sept. 4: Returns to U.S. and is arrested in Philadelphia; currently being
extradited to Washington.
Sept. 14: State revokes license for 20 years.
P-I reporting

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