News, Manchester
Family photoA hospital nurse who accidently gave a critically ill new born baby a large overdose of medication has accepted there were two missed opportunities to check the dose, an inquest has heard.
Polly Lindop, who was born 10 weeks premature, died within 24 hours of being born at Manchester’s St Mary’s Hospital in March 2023.
She was already gravely ill with a serious infection when nurses mistakenly gave her 10 times the correct dose of a muscle relaxant, Manchester Coroners Court heard.
Nurse Fahima Begum earlier told the inquest the nursing team on the neo-natal intensive care unit “should have gone back and checked it, but that wasn’t done”.
Polly suffered a cardiac arrest six minutes after the overdose and died within a few hours.
However, a post-mortem examination found the primary cause of her death was sepsis and prematurity, and that she had suffered severe lung damage.
Ms Begum and her colleague Nurse Akila Pandoor were responsible for preparing the drug, Atracuriam, to be given to Polly.
“When you’re making up an infusion, you should be checking”, Ms Begum said.
“I believe it should have been checked again.”
Ms Pandoor told the inquest she “didn’t physically look at the pump once the infusion started”, even though she accepted it was standard practice to check the data.
Both nurses, who were not directly responsible for Polly’s care, said they did not feel under pressure to get the drug ready quickly.
Family handoutA hospital consultant in charge of Polly’s treatment told the court that due to the severity of Polly’s condition, he believed she “would not have survived”, even without the mistake by the nursing team.
“What happened with Polly has gone around in my head for the past two years,” Dr Gareth Penman told the court.
“Did it [the overdose] cause her cardiac arrest to happen earlier? I’m not sure. But what I do think is that Polly was not going to survive this infection.”
Dr Penman described how Polly’s condition worsened overnight, despite numerous treatments.
“It was an intense situation, things were moving rapidly,” he added.
The hearing was told there was no mention of the overdose when Dr Penman reported Polly’s death to the coroner.
Dr Penman said: “I recognise I should have put it in at that point. I didn’t think it had contributed to her death.”
In the following days and fter speaking with hospital staff and Polly’s family, Dr Penman informed the coroner of the mistake.
“I apologise to Polly’s parents if they thought I was trying to cover this up….that was not my intention,” he added.
Following Polly’s death, Greater Manchester Police started an investigation into possible gross negligence manslaughter.
But the force later said no criminal charges were being brought.
The inquest continues.
