www.lisashore.com A favourite family picture from 1994 shows Lisa Shore dressed as a hula dancer. She died suddenly in hospital three years ago, aged 10.

TORONTO - Two nurses at the most famous children's hospital in the country will be formally charged with criminal negligence causing the death of a patient.

Ruth Doerksen and Anagaile Soriano, the main nurses who cared for Lisa Shore when the 10-year-old died unexpectedly at the Hospital for Sick Children almost exactly three years ago, are expected to surrender themselves to a downtown Toronto Police station as early as tomorrow.

There they will be booked, fingerprinted and photographed, joining only a handful of other Canadian health professionals who have faced such grave criminal charges and an even smaller sub-group charged not in allegedly deliberate "mercy killings," but rather in connection with the quality of care they allegedly gave a patient.

The nurses' looming arrests come on the heels of a Toronto homicide squad probe that began in February of last year, shortly after the jury at a lengthy coroner's inquest into Lisa's death returned with a verdict of homicide.

In the coroner's system, such a finding is not akin to a criminal verdict of homicide, but means simply the killing of one person by another.

But the verdict nonetheless sparked a complex investigation that saw homicide detectives extensively consult senior officials at the Ontario Attorney-General's office and, last Friday, seek search warrants from Ontario Court Judge William Horkins.

On Monday, having taken the weekend to review the bankers' boxes of material before him, Judge Horkins issued the warrants, and later that day, police quietly seized documents and files from the chief coroner's office.

Yesterday, officers executed another warrant at the hospital.

The move to criminal charges, coming in the anniversary week of Lisa's death, also marks what Winston Churchill famously called "the end of the beginning" for the girl's mother, Sharon.

Mrs. Shore had gone to sleep on a couch shortly after Lisa was admitted to hospital and transferred from the emergency department to room 47 on ward 5-A, one of two wards that specialize in the treatment of children needing pain management.

It was about five hours later that the easy chatter of the orthopedic team doctors out in the hall woke up the mother of three. Mrs. Shore had just finished getting dressed when the team came into the room on their morning rounds, found the pretty girl not breathing and called a "code blue."

If it was a monstrous cruelty for a loving parent to have slept just feet away from the child who was, unknown to her, slipping away -- Lisa's breathing slowing even as her heart rate sometimes soared wildly -- Mrs. Shore's presence in the room later proved a serious blow for the two nurses.

The whole night, she told the inquest jurors, she never saw or heard any of the monitors that were supposed to have been attached to Lisa, one of which, Ms. Doerksen swore in her testimony, had been sounding so many false alarms she had turned part of it off.

Mrs. Shore was as compelling and straightforward a witness at the inquest as she was a fierce advocate for her dead child.

Her view was always that Lisa died needlessly. And ultimately, battling a hospital bureaucracy that so persistently obfuscated the circumstances of Lisa's death that one inquest juror accused the institution of a coverup, Mrs. Shore convinced officials on what's called the pediatric review committee and within the coroner's office there were serious and legitimate questions surrounding the death.

Certainly, but for the chronic -- and entirely undangerous -- pain condition caused by nerve damage sustained when she broke her right leg earlier that year in a playground accident at school, Lisa was a perfectly healthy, normal and happy child when her parents took her to Sick Kids on the night of Oct. 21, 1998.

Her pain, called reflex sympathetic dystrophy, had flared up such that her prescribed medication wasn't touching it, she could not stand even the weight of simple cloth upon her leg, and had to be carried by her parents to the car for the trip to the downtown hospital from the family's suburban Thornhill home.

At Sick Children's emergency room, she was given morphine, an effective painkiller that also depresses respiration, and was admitted under doctor's orders that she be watched carefully -- attached to monitors to measure her breathing and heart rate and her vital signs taken hourly.

But the inquest jurors heard evidence aplenty, including from Ms. Doerksen and Ms. Soriano themselves, that neither nurse ever called up those orders on the hospital's computer system -- called Kidcom -- that their monitoring was sporadic and that the medical significance of what there was of it was apparently misunderstood.

The inquest itself, which began in the fall of 1999, was a fiery and combative one. At one point, presiding coroner Dr. Jim Cairns warned a hospital employee sitting in the courtroom that the jury had alerted him it appeared Ms. Doerksen was being "coached" in her testimony.

A heated clash came when lawyers for the hospital offered, then retracted, a new theory that the monitor in Lisa's room was not reliable. Eventually, the various players all agreed that if there had been a monitor attached to the little girl, it was not on when she died.

The first stage of the criminal case, a preliminary hearing, is unlikely to begin until the spring.

Ironically, it was at this same stage of proceedings, about 20 years ago, that murder charges were thrown out against another former Sick Children's nurse, Susan Nelles. She had been accused of murder in a series of baby deaths at the hospital, was later cleared of wrongdoing and finally won a $60,000 Ontario government settlement for the anguish she suffered, as well as her legal costs.

The case against Ms. Doerksen and Ms. Soriano -- the former an experienced nurse who was in charge of the ward the night Lisa died and a member of the hospital's "peer review committee," and the latter a rookie just months out of nursing school -- may be challenging for prosecutors.

Perhaps the most comparable recent case involved social worker Angie Martin -- who, along with Renee Heikamp, was charged with criminal negligence in the starvation death of baby Jordan Heikamp. Ms. Martin was vigorously supported by the Catholic Children's Aid Society of Toronto, which defended her work, and by many of her colleagues.

Eventually, a judge discharged both women, and in a reversal of how the Lisa Shore matter unfolded, the case then proceeded to inquest, where the jury deemed the baby's death a homicide.

The unspoken lesson for prosecutors from the Heikamp case was that they were not taking on only an individual staffer, but rather a well-financed institution with substantial legal resources. Similarly, at that inquest, did the hospital tenaciously defend its employees and the quality of their work.

The Criminal Code of Canada defines criminal negligence as the offence of doing anything, or failing to do anything, that it is one's duty to do, and that shows wanton or reckless disregard for another's safety. It carries a maximum penalty of life in prison.