Thursday 14 November 2019

Nurse 'gave baby fatal overdose after posting this picture on Facebook'

picture was posted on Facebook between the 22nd and 23rd of June 2009 to be removed twelve hours later
picture was posted on Facebook between the 22nd and 23rd of June 2009 to be removed twelve hours later

A nurse made a "catastrophic" error by giving a four-month-old baby a fatal overdose of salt just days after posting a picture of herself asleep next to him on Facebook, a hearing has been told.

Nurse Louisa Swinburn faces being struck off after accidentally gave baby Samuel McIntosh ten times the prescribed dose of an infusion, the Nursing and Midwifery Council heard.

Days before making the error, Swinburn posted a picture of herself asleep next to the four-month-old on Facebook, without the knowledge or consent of his parents.

Swinburn, who worked for the Nottingham University Hospitals NHS Trust, has admitted posting the photograph and administering the dose of sodium chloride.

She denies falling asleep at work, or that her fitness to practise is impaired by reason of misconduct.

If found guilty of misconduct following the four-day hearing, she could be expelled from the profession.

The hearing was told Swinburn had made a “catastrophic drug administration error” while treating Samuel, who was known as Baby A throughout the hearing.

The baby was born prematurely on March 1, 2009, at City Hospital, Nottingham, weighing just 1lb 4oz and was given a 25 per cent chance of survival.

He was transferred to the Queen's Medical Centre to receive intensive care, making enough progress for medics to consider letting his parents take him home.

Swinburn, who cared for him overnight from June 22 to 23, took a photograph of herself appearing to be asleep next to Samuel’s hospital cot and posted it on Facebook.

The picture shows the nurse with her eyes shut and arms crossed, slumped in a chair while Samuel is next to her.

The hospital trust were not made aware of the photograph.

Less than two weeks later, on July 4, Samuel became unwell again with low sodium chloride levels, and was put on a court of fluid infusion.

He was initially prescribed three milimoles of the fluid infusion per kilogram per day, and was later treated with a separate salt solution.

Swinburn, who was responsible for administering the solution, instead gave him an infusion with around ten times the level of salt required.

By 3.40am he had lost 340grams of weight, 12.5 per cent of his body weight, and was suffering swelling to his brain.

Hannah Stephenson, for the Nursing and Midwifery Council, told the hearing the baby remained “significantly unwell” over the next 24 hours.

“He remained ventilated and he received fluids to correct his sodium level,” she said.

“Neurologically Baby A had a decreased consciousness level and persistent seizures.

“His sodium level gradually improved, however, there was no improvement in the neurological status.”

Two days later Samuel's heart stopped and he had to be resuscitated.

By then, doctors had determined the damage caused to this brain was “non-survivable”, the hearing was told.

Samuel's parents were informed and a joint decision was taken to stop his intensive care treatment. He died at 11am on July 7, 2009.

The hospital trust launched an investigation, with senior members of staff finding the used to administer the fatal salt dose contained 5000 milimoles of sodium chloride; ten times that which prescribed.

At the inquest into Samuel's death, Paul Balen, the solicitor acting for Samuel's parents Robert and Sarah McIntosh, urged the Nottingham Coroner, Dr Nigel Chapman, to consider a verdict of unlawful killing.

Dr Chapman recorded a narrative verdict after ruling that Samuel died after a "drug error" on the high dependency unit at the QMC.

There was no doubt that a dreadful mistake had taken place, he ruled, but said that it did not fall into the category of a gross failure.

Swinburn, who did not attend the central London hearing in person, admitted administering the fatal salt dose and posting a picture of herself with Samuel on Facebook, but denies falling asleep on duty.

If found guilty of misconduct she could be compelled to leave the profession.

The hearing continues.

By Hannah Furness

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