Nursing aide in rape case fired 3 times

(Editor's Note: This story has been altered. A charitable fund established to help a hospital rape victim is not non-profit. It was incorrectly described in the original version of this story.)

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.