Hospital blunder was lethal

A Cannock woman died after a lethal blunder by doctors at Stafford Hospital, an inquest heard.

Joan Nicholls died after the wrong drugs were accidentally pumped into her body through an intravenous drip.

The substance in the drip should have been a fluid called gelfusin. Instead, it was double the lethal dose of local anaesthetic lignocaine, which caused a seizure and stopped her heart.

A catalogue of errors led up to Mrs Nicholls' death. The two doctors involved, Dr James Reid and Dr Bharat Kandicanda, told the hearing yesterday that Dr Kandicanda picked up the bag of lignocaine from one of the hospital's resuscitation trolleys, thinking it was gelfusin. And the situation was made worse when Dr Kandicanda botched the setting up of the drip, spilling liquid pm the floor and over his 77-year-old patient.

Tragically, nurse Nikki Bacon saw that the bag contained lignocaine but thought the doctors had meant to give it to Mrs Nicholls. She spoke of the "shocked silence" when she and her colleagues realised the mistake.

The inquest heard how Mrs Nicholls was admitted to Stafford Hospital in the afternoon of September 6 2006 but her condition worsened the same night.

Recording a narrative verdict, South Staffordshire coroner Andrew Haigh attributed the primary cause of death as lignocaine toxicology. He also pledged to write to the National Patients' Safety Agency in the hope that lessons could be learned.