By Tony Gardner
A JUNIOR doctor who gave a patient a massive overdose of insulin had worked more than 100 hours in the week leading up to her mistake.
Dr Helen Pike told police that fatigue from working the gruelling hours at Leeds General Infirmary was behind the error which contributed to the death of 58-year-old Tony Wright.
Mr Wright, from Holbeck, suffered a devastating heart attack moments after Dr Pike injected him with around ten times the recommended dosage.
He died in intensive care 10 days later, after his family made the agonising decision to switch off his life-support machine.
Mr Wright's widow Freda, 71, yesterday consoled the doctor as she gave evidence at Leeds Coroner's Court.
Mrs Wright told her: "I would just like to say that we do not attach any blame to you. You did your best."
Punishing
And the detective who carried out the investigation into the death told the court how he sympathised with the doctor over her punishing work schedule.
In the week leading up to the incident on December 19 2003 she was supposed to work six 13-hour shifts. But in reality she had worked in excess of 100 hours by the time the lethal dose of insulin was administered as a result of working extra hours and swapping shifts with colleagues.
Much of the sleep she managed to get was in a staff room at the hospital and was often interrupted by calls for her to return to the wards.
In a statement to police after Mr Wright's death, Dr Pike described how, in the days before the incident, she had become concerned as Mr Wright's condition deteriorated following an artery bypass operation and she had tried to get him admitted to a High Dependency Unit.
He developed potentially fatal levels or potassium in his blood and doctors decided to give him insulin to bring them back to safe limits.
But instead of the usual 5ml or 10ml of the drug, the senior house officer injected 50ml into his foot and he went into cardiac arrest 10 minutes later.
When questioned Dr Pike said the error may have been down to her writing down the higher figure because it was a standard dosage given to insulin-dependent diabetics.
A police inquiry found no evidence to support bringing criminal charges against the doctor.
James Hopkins, a former West Yorkshire Police detective who was in charge of the investigation, said: "We discussed the number of hours she worked that week and, to be honest, I empathise with her. I know what it's like to average about four hours sleep and work four days."
He added: "At no time was there any attempt to cover up the fact that the doctor had prescribed the medicine and at no time did she try to place the blame on any member of staff.
"It was a full and frank admission with the mitigation of the hours that she had worked."
Mr Wright was suffering from respiratory problems, the beginnings of kidney disease and furred arteries.
But Prof Alexander Forrest, a consultant in clinical chemistry at the Royal Hallamshire Hospital in Sheffield, said the insulin injection had an impact on his condition.
He added: "The injection could have been the tipping of the balance and I believe it made a more than minimal contribution (to Mr Wright's death)."
Condolences
Assistant Deputy Coroner Mary Burke recorded a narrative verdict in which she gave the cause of death as brain damage due to a cardiac arrest caused by complications of surgery, an insulin overdose and chronic obstructive airways disease.
After the hearing Mrs Wright, who has been paid £11,000 compensation in an out-of-court settlement by hospital bosses, said: "It was a fair hearing. They have admitted that a mistake had been made and I accept that."
A spokesman for the Leeds Teaching Hospitals NHS Trust said that European Working Time Directives had come into force since the incident and were being adhered to.
He added: "We would once again like to express our sincere condolences to Mr Wright's family.
"Although we carried out a full internal investigation following Mr Wright's death, we note today's verdict and will study the coroner's findings thoroughly to see if any further action is required."
tony.gardner@ypn.co.uk