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Nurse's insulin overdose 'horror' | Nurse's insulin overdose 'horror' |
(about 2 hours later) | |
A newly-qualified community nurse gave an elderly diabetic patient 10 times too much insulin and she died about six hours later, an inquest has heard. | A newly-qualified community nurse gave an elderly diabetic patient 10 times too much insulin and she died about six hours later, an inquest has heard. |
Joanne Evans told the Cardiff hearing of her horror when she realised her mistake in bed later the same night. | Joanne Evans told the Cardiff hearing of her horror when she realised her mistake in bed later the same night. |
A diabetes specialist and a pathologist said it was likely the overdose had led to the death of Margaret Thomas, 85, of Pontnewynydd, Pontypool, south Wales. | A diabetes specialist and a pathologist said it was likely the overdose had led to the death of Margaret Thomas, 85, of Pontnewynydd, Pontypool, south Wales. |
The inquest at Cardiff Coroner's Court is expected to last three days. | The inquest at Cardiff Coroner's Court is expected to last three days. |
Giving evidence, Ms Evans said she was "in a tizz" when it struck her in bed that night that she had given Mrs Thomas too much insulin. | Giving evidence, Ms Evans said she was "in a tizz" when it struck her in bed that night that she had given Mrs Thomas too much insulin. |
She said she immediately reported her mistake to a doctor but by that time Mrs Thomas had already died. | She said she immediately reported her mistake to a doctor but by that time Mrs Thomas had already died. |
It was very extreme circumstances and there was an error on my part and I'm really sorry, I will always be sorry Community nurse Joanne Evans | It was very extreme circumstances and there was an error on my part and I'm really sorry, I will always be sorry Community nurse Joanne Evans |
Ms Evans said: "I was thinking 'Oh my God if I've given her that much she's gone' and I couldn't believe it. | Ms Evans said: "I was thinking 'Oh my God if I've given her that much she's gone' and I couldn't believe it. |
"It was very extreme circumstances and there was an error on my part and I'm really sorry, I will always be sorry." | "It was very extreme circumstances and there was an error on my part and I'm really sorry, I will always be sorry." |
The inquest was also told by a diabetes specialist and a pathologist who examined Mrs Thomas's body that it was likely the overdose led to her death, but they could not be 100% sure. | The inquest was also told by a diabetes specialist and a pathologist who examined Mrs Thomas's body that it was likely the overdose led to her death, but they could not be 100% sure. |
Ms Evans told the court that she was visiting Mrs Thomas as a favour to community nurses in another area on 2 June, 2007. | |
She said she did not know until just before she arrived at Mrs Thomas's house at midday that the purpose of the visit was to administer insulin. | |
Jammed | |
Mrs Thomas was registered blind and could inject herself. | |
Ms Evans said Mrs Thomas gave her an insulin "pen" which she had never used one before as they used a syringe and needle where she normally worked. | |
She told the court the first pen jammed so Mrs Thomas gave her a different one, which she had to assemble herself, and that too jammed. | |
She said she was directed to the fridge where there was a different pen again - one she had used before, but that one was broken. | |
"Margaret kept on saying none of the nurses knew how the pens worked and were always having trouble with them." | |
Ms Evans said she thought she had an insulin syringe in the car, but on fetching she discovered it was a regular syringe, not one for insulin. | |
She said she converted the amount wrongly in her mind and injected Mrs Thomas four times with the syringe with 360ml instead of 36ml of insulin. | |
Very independent | |
"I've gone back over it loads of times thinking why and I honestly don't know why," she said. | |
She had administered hundreds of insulin injections in her nine months as a community nurse. | |
Ms Evans said: "In hindsight, I think I should have turned to Margaret as soon as I entered the house and said 'I'm sorry I can't help you', and handed her over." | |
Asked why she did not do that, Ms Evans said: "I just wanted to help her. I just want to be a good nurse and help patients and do the best I can for that patient. | |
"She was very independent and wanted to go out that afternoon and I wanted her to do that." | |
The inquest continues. | The inquest continues. |