Inside the hospital of fear where a mystery poisoner stalks the wards;
*MKILETEWA HAPA NA FLORA LYIMO DESIGNER*
Accused: Nurse Rebecca Leighton faces a number of charges over the Stepping Hill hospital deaths;
A nurse at Stepping Hill Hospital, Stockport, was last night charged in connection with a string of patient deaths after saline drips were contaminated with insulin.
Rebecca Leighton was charged with criminal damage, causing damage with intent to endanger life, and theft after at least five patients died in suspicious circumstances. Here, DAVID JONES — who visited the hospital this week — reports on the fear stalking the wards.
When widower George Keep was admitted to Stepping Hill Hospital in Stockport after fracturing his hip in a fall, he cheerfully reassured his family and friends he would soon be up and about again.
Though he was 84 and fighting cancer, they shared his confidence, for this tall, imposing man prided himself on his physical fitness and independence, and possessed an enormous zest for life.
According to one relative who visited him on July 8, he had been eager to see his grand- children and great-grandchildren, and seemed ‘absolutely fine’. Her only concern was at the shabbiness of the hospital — once among Cheshire’s finest, but now a dilapidated hotch-potch of old red-brick and newer breeze-block buildings shoehorned between a trunk road and a railway line, struggling to live up to its glib NHS slogan: ‘Every patient matters.’
Despite the apparent efficiency of the nurses, she was particularly taken aback by the drabness of Ward A1, where Mr Keep was among half-a-dozen male patients.
In light of the macabre tragedy that would follow, however, her most haunting memory will probably be of sitting beside a transparent plastic bottle that steadily drip-fed saline solution through a tube attached to George’s arm.
For just six days after she visited Mr Keep, she received the shock news that he had collapsed and died.
At first, it was believed he had succumbed to complications as a result of the fracture, but police are now convinced he was murdered by someone who injected his saline drip with a lethal dose of insulin.
Deaths probe: Tracey Arden, 44, George Keep, 84, and Arnold Lancaster, 71, who all died at Stepping Hill Hospital in Stockport'
The realisation that Mr Keep may have been killed in the safest place imaginable, perhaps by a nurse or doctor who was supposed to be caring for him, has understandably sickened and appalled his family — but they are far from alone.
During the 16 days since July 7, five patients have died suddenly and unexpectedly at Stepping Hill; all apparently murdered in a similarly sinister manner.
The killing spree might have gone on unnoticed if not for the vigilance of an experienced nurse, who realised that an unusually high number of patients were suffering from hypoglycaemia — low blood sugar levels — on two adjacent wards, A1 and A3, and raised the alarm.
By that time, two had died: 44-year-old former secretary Tracey Arden, who suffered from multiple sclerosis, but appeared to be recovering well from a chest infection; and retired photographer Arnold Lancaster, 71, who was also thought to have been progressing nicely.
When detectives were called in on July 12, they discovered that 36 bottles of saline solution, kept in a store room between the two wards, had been contaminated with insulin.
Two days after their investigation began, Mr Keep and Vera Pearson, 84, also died. Then, on Thursday, Alfred Derek Weaver, 83, described by his family as ‘a lovely gentleman’, became the hospital poisoner’s latest apparent victim.
Given the fact that at least 14 patients are thought to have been targeted, one of whom remains critically ill, and no one can be sure how long the poisoner may have been at work, his name may not be the last on the death roll.
Fear in the corridors: Stockport NHS Foundation Trust has a team of security guards checking identities and logging car registration plates at Stepping Hill hospital;
The murderer might still be employed in the hospital, preparing to strike again.
For though 27-year-old staff nurse Rebecca Leighton was arrested at dawn on Wednesday, she was last night charged only with criminal damage, causing damage with intent to endanger life, and theft. And, of course, she may yet be found to be completely innocent.
Meanwhile, Stockport NHS Foundation Trust, which runs the hospital, has a team of yellow-jacketed security guards logging the number-plates of incoming cars and checking the identity of everyone entering the warren of buildings.
‘It looks more like a bloody nuclear power plant than a hospital,’ said one man this week, as he limped towards A&E. Many other patients are refusing to be treated at Stepping Hill (whose reputation was badly tarnished earlier this year when staff were censured for failing to diagnose swine flu in a three-year-old girl, who later died) and have asked to be referred elsewhere.
The ghastly saga reawakens memories of Beverly Allitt, who murdered four children and attacked nine more at Grantham and Kesteven Hospital, Lincs.
She was given 13 life sentences with a minimum tariff of 40 years.
Her crimes sent such a wave of revulsion through the country that a public inquiry was ordered.
Pinpointing what he called ‘a cascade of collapses’ at the heart of the medical system, inquiry chairman Sir Cecil Clothier QC made a series of recommendations designed to ensure vulnerable patients would never again be left at the mercy of a psychotic killer in a British hospital.
Implemented by the then Health Secretary Virginia Bottomley, one of the new rules made it compulsory for hospital workers to produce a so-called ‘Clothier letter’ from their GP, confirming they had not been treated for any psychological problems in the previous two years.
Pinpointing what he called ‘a cascade of collapses’ at the heart of the medical system, inquiry chairman Sir Cecil Clothier QC made a series of recommendations designed to ensure vulnerable patients would never again be left at the mercy of a psychotic killer in a British hospital.
Implemented by the then Health Secretary Virginia Bottomley, one of the new rules made it compulsory for hospital workers to produce a so-called ‘Clothier letter’ from their GP, confirming they had not been treated for any psychological problems in the previous two years.
Death probe: Alfred Weaver, 83, and Vera Pearson, 84, both died suddenly and unexpectedly at the hospital;
But oh, how times change and how quickly we forget. Under the new Equality Act, passed last year but devised by the Labour government, this has been reversed. It is now illegal for any prospective employer — including a hospital — to demand to see a recruit’s medical history.
Doubtless this has been welcomed by the politically correct brigade, but speaking to me this week one senior nursing lecturer claimed the law has created dangers.
Some will doubtless argue Clothier’s recommendations did not prevent the recruitment of Colin Norris, who killed four elderly patients by injecting them with insulin in a Leeds hospital in 2002.
The smug, bespectacled homosexual, now 34, harboured a pathological hatred of old people, despite being the apple of his grandmother’s eye.
Allitt was said to have been driven by Munchausen Syndrome by Proxy: the urge to harm people in order to gain vicarious attention and praise for tending to them.
With their lax discipline and poor standards of achievement, Allitt and Norris fit into one of the classic stereotypes described by Sheffield University forensic chemistry professor Robert Fox, a leading expert on health care workers who harm patients.
But if a copycat killer has been, or is still, running amok at Stepping Hill Hospital, what is their motivation and profile? This is one of the many questions facing the 60 detectives investigating the case.
Whatever the outcome of their investigation into Rebecca Leighton, from all we have learned so far, at least, there appears nothing unusual about her personality.
As so often happens when young people find themselves in the spotlight in these days of compulsive social networking, much has been made of her frequent postings on Facebook. Having gained an Open University degree in nursing, she followed the career path of her 55-year-old mother, Lynda, a senior nurse training officer at Stepping Hill.
Presumably like the majority of her colleagues, Rebecca bemoans the rigours of night shifts and comes across as a hard-drinking, party girl.
‘Want the money for working tonight, but not actually do the work,’ she told her online friends on June 19.
Probe: Assistant Chief Constable Ian Hopkins, Stepping Hill Hospital Chief Executive Dr Chris Burke and medical director James Catania, right speak at a press conference this week'
‘Oh what will tonight bring . . . drunken nurses,’ she chirped in another posting sent from her iPhone, anticipating a raucous night out.
Then again, boozy nights out are routine among young medics, as is the tendency to complain about long hours and exhaustion.
Moreover, those who know Miss Leighton — who lives with her fiancé above the Stockport darts shop he runs, about a mile from the hospital — describe her as considerate, like-able and well-adjusted.
Her family and friends are incredulous she is a suspect, and have launched an internet campaign to state their belief in her innocence.
Unless they have all been deceived, she couldn’t sound less like twisted Beverley Allitt, who sought attention by grinding broken glass into her hands as a girl and was the product of a deeply troubled background.
At all events, the quest to find the Stepping Hill killer is likely to be long and laborious — on this, all the experts agree.
For according to Professor Vincent Marks, author of Insulin Murders and an expert prosecution witness at the Allitt trial, it is notoriously difficult to prove conclusively that someone has been murdered with insulin.
Charge: Rebecca Leighton, 27, who lives in Stockport and has been a nurse since 2008 is accused over the deaths;
A hormone that regulates blood sugar levels, it is produced naturally and pharmaceutically. Healthy people secrete just the right amount to perform this task, but diabetics don’t make enough and so need regular injections.
Without it, they quickly begin trembling and suffer other symptoms such as blurred vision, anxiety and a rapid heartbeat. But when an overdose is administered, the victim’s blood sugar level plummets and they rapidly descend into a coma.
If they are old or weakened by illness — as with the Stepping Hill Hospital victims — and don’t receive a powerful glucose shot promptly, this can be fatal.
However, one problem is that when a person dies, insulin rapidly disappears from their blood.
And as staff at Stepping Hill would have had no reason to suspect foul play, the victims — or at least the early ones — probably died without their blood being tested for insulin.
And as staff at Stepping Hill would have had no reason to suspect foul play, the victims — or at least the early ones — probably died without their blood being tested for insulin.
In such cases, the only way to measure it is to exhume the body and test tissue samples from the site around the puncture wound if the insulin was administered by injection or the brain, which is damaged by hypoglycaemia.
During the Norris investigation, the remains of 88-year-old Bridget Bourke — the only victim not cremated — were dug up 14 months after she died. Brain tissue samples proved she had died from an insulin overdose, not a stroke, as a junior doctor had asserted.
Former Detective Chief Supt Chris Gregg, the man who caught Norris, says it will be extremely difficult to find the Stepping Hill killer and build a convincing case on lab-based evidence alone.
The police will have to create a broader picture. First, they will investigate who had the opportunity to access the store cupboard where the contaminated saline bottles were kept and check them for fingerprints and other forensics.
As Stepping Hill Hospital says the storage of medicines has been controlled more stringently since a clinical audit revealed disturbing flaws in the system, this should help to narrow down the number of potential suspects. Detectives will also examine shift patterns and staff behaviour, check on the source of the saline bottles — and the insulin that was injected into them — and assess whether they might have been tampered with before reaching the hospital.
They will also explore the possibility this may have been the work of a deranged hospital visitor or patient.
In perhaps the most difficult element of the investigation, they will also work with medical experts and scientists to trawl through the medical case files of dozens and perhaps hundreds of deceased patients, trying to find other, as yet unidentified, victims.
‘This is what was hugely complex in the Norris case,’ says Mr Gregg, who also led the investigation into Britain’s biggest serial killer, Dr Harold Shipman, and is now director of the forensics firm Axiom International.
They will be working blind, looking at symptoms and blood sugar readings, then trying to fathom whether or not this should have happened to each patient and asking the million-dollar question: is this a suspicious death?
‘With Norris, we operated a filter system. We started with 200 deaths and ended up with four, which all the experts concluded weren’t natural.’
Detectives at Stepping Hill will probably use a similar method and will review deaths where unexplained hypoglycaemia was identified on wards A1 and A3, and perhaps on other wards as well.
‘What they have got to get to the bottom of is this: has someone been perfecting a method of killing in that hospital? And if so, how long have they been doing it?
‘Was it perhaps even longer than they first realised?’
And they must move quickly. For until the hospital killer is caught, every doctor and nurse in Stepping Hill is under a cloud of suspicion and no patient will rest easily in their bed.
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