Accused serial killer Elizabeth Wettlaufer was fired from a Woodstock nursing home for a “medication error” that put the life of a resident at risk, according to documents obtained by the Star.

The documents also reveal that her firing from the Caressant Care home on March 31, 2014, was reported to the College of Nurses of Ontario, which regulates the profession.

Yet Wettlaufer, 49, continued to work as a registered nurse until October 2016, when she was charged with eight counts of first-degree murder of people in her care. Four counts of attempted murder and two counts of aggravated assault were added later.

All registered nurses fired from their jobs must be reported to the college. But when the Star revealed that Wettlaufer was fired from Caressant, where seven of the alleged murders occurred, home officials and the college refused to say whether notification had occurred.

A letter to the college makes clear that it did, and reveals for the first time the reason for Wettlaufer’s dismissal.

“We are reporting the termination of the above named individual (Elizabeth Wettlaufer) to the College of Nurses,” says the Caressant Care letter, dated April 17, 2014. “She was terminated due to a medication error which resulted in putting a resident at risk.”

The college acknowledged receipt of the termination notice in a letter to Caressant Care dated July 17, 2014.

“The College is considering the information you have brought forward to determine what further action should be taken,” says the college’s letter, also obtained by the Star.

The college asked Caressant to keep all documents relevant to Wettlaufer’s firing for up to two years “pending investigation.” It adds, however, that the matter will be treated as confidential, and Caressant will not be informed of any investigation into Wettlaufer the college might conduct.

The college then thanks Caressant for the notification and adds: “It is through actions of this kind that the College is able to fulfil its responsibility for governing the profession and protecting the public interest.”

Wettlaufer is accused of killing 75-year-old Arpad Horvath at a London nursing home five months after she was fired from Caressant. Police allege she then tried to kill a nursing home resident in Paris, Ont., in September 2015, and tried to kill again while providing in-home care in August 2016.

Her dismissal from Caressant raises questions about whether her three alleged victims after leaving the nursing home could have been spared.

Jane Meadus, staff lawyer at Toronto’s Advocacy Centre for the Elderly legal clinic, called on the college to reveal whether it investigated Wettlaufer once it was notified of her dismissal.

“Who are they protecting?” Meadus said of the college. “Are they protecting the public or are they protecting their members? Their job is to protect the public, and we need to know that they have done their job.”

Medication errors in nursing homes are unfortunately common, Meadus said, and nurses who commit them are rarely fired. That suggests Wettlaufer’s error must have been extremely serious or it came on the heels of a series of medication errors during her seven years at Caressant, Meadus added.

“What did the college do?” Meadus asked. “Did they get this (termination notice) and go, ‘Oh, medication error, we’ll just file that away.’ ”

What’s clear is that there was no record of disciplinary action on Wettlaufer’s public status with the college until she “resigned” as a registered nurse shortly before being charged last October, Meadus notes.

The college has said it is investigating Wettlaufer’s “professional conduct,” but refuses to say whether it investigated her at the time of the dismissal notice. Told about Caressant’s notification letter, the college refused to say what actions it took, if any.

“The College understands the public’s desire for more information given the extremely serious nature of this case,” the college’s director of communications, Deborah Jones, said in a statement to the Star.

However, the ongoing criminal investigation, the college’s own investigation and confidentiality requirements limit what the college can say, the statement added.

Jones said the college investigates all termination reports it receives and “takes appropriate action based on the level of risk to the public.”

Friends of Wettlaufer’s have said she told them she got hooked on drugs from the medication cart she controlled at Caressant Care, and got fired when she gave a resident the wrong medicine while high.

Meadus also wonders how much information about Wettlaufer’s dismissal Caressant gave to the college, and whether the family of the resident subjected to the medication error was informed.

Contacted by the Star, a Caressant spokesperson, Lee Griffi, refused to comment on the letter to the college.

After Wettlaufer was charged, inspectors with the Ministry of Health and Long-Term Care found 41 “medication incidents” at Caressant Care between early August and late December 2016.

They include five cases where medication was “given to the wrong residents,” three cases where meds were given at the wrong time, six where the wrong dosage was given, 22 where prescribed meds were not given, and one where a medication was given with no prescription from a physician.

On Jan. 25, the ministry suspended new admissions at Caressant because of safety concerns. The for-profit home has 193 beds.

Wettlaufer appears via video link Wednesday in a Woodstock court.