64

David Wolf’s displeasure at the interruption to his evening could not have been clearer if he had written it on a piece of paper and held it in front of Judith’s face. Even so, he was polite, if direct.

‘Miss Burton, you are not the police and I don’t want to see you. Please go. I have to set off shortly on my last round of the day.’

Dawson loomed behind in Judith’s shadow.

‘Hello, Dr Wolf. Sorry to disturb you. Miss Burton is here with me this time. Miss Lamb has gone to fetch some of your staff with one of my other officers. They’ll be here in just a moment.’

David stroked his moustache.

‘Can you tell me what this is all about? I have just explained that I have patients to see.’

‘No sir. But if you wait a few minutes all will be revealed. Is there a larger room we can use, do you think? There are going to be a fair few of us. And could you call your wife please, and ask her to join us too?’

‘Dr Bridges?’

‘That’s the one.’

David headed out into the reception area. The clinics had finished for the evening and they waited there for the others to arrive. He poured himself a cup of water from the fountain.

Some light footsteps in the corridor heralded the arrival of Constance with Nurse Li. And PC Brown followed shortly afterwards with Steven King and Hani Mahmood. Jane Bridges took another five minutes to arrive. Dawson nodded amiably towards Judith to begin.

‘This is outrageous,’ Hani fumed. ‘We have sick patients to administer to. I demand to know what on earth is going on that you should treat me and my staff in this reprehensible way.’

‘Please, everyone, let’s sit down,’ Judith said. ‘I will try to keep this brief but that depends a little on each of you. I am afraid that we are back here talking about Mrs Hennessy’s death, and some of you know more than you have let on. I will start with Nurse Li.’

Lottie shivered as her name was called.

‘Nurse Li. Can you tell everyone here how you spent the morning of Thursday the 11th of May, the morning Mrs Hennessy had her operation – just in general terms, to start with.’

‘She was in the operating theatre, like I told you,’ David interrupted.

‘Nurse Li?’

Lottie gazed around the room for salvation, which did not materialise.

‘I’m sorry, Dr Wolf. I didn’t want to lie to you,’ she began. ‘I took Mrs Hennessy to theatre but then I went back to the ward. I had to do double-shift that day; other nurses were ill. I asked Steven and he said it was all right.’

‘I said we would manage without her,’ Steven acknowledged with a shrug.

David turned to his wife. ‘So who was in theatre for Mrs Hennessy?’ he enquired, wide-eyed.

Judith glared at him. ‘You mean you weren’t there either, Dr Wolf?’

He glanced at Hani, who was staring from one member of his team to the next in astonishment.

‘David, what is going on? In the report you said you had the usual team in theatre. Was that not true?’ Hani’s words rebounded off the walls accusingly.

David sighed but before he could reply his wife took over.

‘Hani didn’t know about any of this,’ she said quickly, standing up and taking centre stage. ‘We have new targets from management,’ she explained, ‘and we decided, David and I, that the only way we could meet them, with our current number of doctors and nursing staff, was by running operations simultaneously with skeleton staff. Aladdin allowed us to do that. David was never in Mrs Hennessy’s operation. Steven presided, with my help. When Lottie was stretched, we released her to help on the ward. Aladdin did all the work. We could call David if we needed him.’

‘So, David, let me get this straight,’ Hani asked, barely controlling his anger. ‘You were never in Mrs Hennessy’s operation. You left her in the hands of that machine and Steven, a one-year qualified doctor?’

‘The operation was simple,’ David replied. ‘Aladdin could do it blindfold. And Jane was present, a highly experienced anaesthetist. And I thought Nurse Li was there too.’

‘But Nurse Li returned to the ward, as we have heard, and then Dr Bridges was called away?’ Judith said. ‘That’s recorded in the report you provided.’

‘Yes.’

‘So Steven was left alone.’

‘Only for ten minutes or so.’ All eyes shifted to Steven, who gulped audibly. Then he lowered his head into his hands.

‘It’s my fault. I shouldn’t have left him,’ Jane continued, ‘but I had another emergency and Mrs Hennessy was routine. I had to prioritise.’

‘I should’ve been able to manage,’ Steven cried in exasperation. ‘As soon as Jane left, the monitors went haywire. I tried to stabilise her but we’d given Aladdin control of everything. I couldn’t stop it in time.’

‘What do you mean exactly?’

Jane stepped in again. ‘David told you that Aladdin is more sophisticated than the older models; that, if we wanted, we could pretty much hand medical procedures over to Aladdin. What he didn’t tell you is that this is what we have been doing, on the simpler operations, for the last six months or so.’

‘No!’ Hani called out.

‘It’s no big deal. We tell Aladdin what the plan for the operation is and he performs it. We key in the weight, height, age of the patient, and Aladdin works out all the doses of oxygen, anaesthetic and any other drugs, and monitors and adjusts them throughout the operation. Again, it’s just one step on from what we’ve done before, handing over autonomy to Aladdin to free up nurses and anaesthetists. We can override him but it takes maybe sixty seconds to kick in, and Steven didn’t have a lot of practice in how to do this. Lottie or one of the other senior nurses would usually operate the manual override.’

‘And the incisions, removing the bone which Dr Wolf so meticulously described for us in court?’

‘All Aladdin. And it was done very neatly.’

‘What did you find when you returned to theatre after your emergency call?’

‘Mrs Hennessy was dead.’

‘Oh my God!’ David leaped up and staggered towards his wife. She took two steps backwards but then held her ground.

‘So had Aladdin malfunctioned?’

‘It was a combination of human error and the machine. Steven had keyed in the figures incorrectly at the start, leading to one hundred times the usual dose of Propofol, the anaesthetic. The instructions are unclear primarily because they have been translated, but the machine should have picked this up straight away and corrected it, as it also monitors the depth of anaesthesia. For some inexplicable reason, it didn’t. In Mrs Hennessy’s case she was given this huge dose and the machine kept on increasing the dose as she went deeper to sleep.’

‘The anaesthetic killed her so quickly?’

‘Yes, that dose would have led to toxic levels building up in a matter of minutes, and her heart suddenly stopped. Since the incident, I spoke to the manufacturer and corrections have been made to the Aladdin algorithm to make sure the problem won’t occur, or if it does it will be immediately detected and corrected. I did everything I could, with Steven, to revive Mrs Hennessy but we failed.’ For the first time Jane’s voice cracked mid-sentence. Her husband was staring at her in horror.

‘What happened next?’ Judith asked.

Jane continued in an unsteady voice.

‘Steven was desperate. He had not lost a patient on his watch and he didn’t want to be blamed. And I felt I should share responsibility as I had left him alone. But if we told what happened it would expose the flaws in our system, the one David and I had been operating so successfully, treating many more patients, faster, with less staff and far better outcomes. We were saving lives using Aladdin – more than we had anticipated at the outset – and improving quality of life; I didn’t want to jeopardise that.’

‘And Aladdin?’

‘If we shopped Aladdin that would be very costly for the Trust after its investment, each one costs upwards of a million pounds – funds which we can’t afford to waste. I didn’t want it to be my fault, my misjudging which was the more needy patient, that caused the whole project to be scrapped and patients to die on the waiting list, or from mistakes that surgeons make every day.

‘So I persuaded Steven that rather than make a big fuss, we should talk to Aladdin’s manufacturer, which we have now done, like I said, to remedy the software issues and quietly issue some guidance to nursing staff on keying in the quantities into Aladdin for future reference. We didn’t have to throw the baby out with the bathwater.’

‘And what about “the baby”, poor Mrs Hennessy?’ Judith asked.

‘I told Steven that I would find a way of hiding his involvement in Mrs Hennessy’s death. It wasn’t easy because they were expecting her in recovery. But we had operated in one of two overflow theatres as the others were all full and she was the last operation scheduled in there that day. So I told the recovery nurses that she was a bit slow to come around, and that Steven and I would keep her in theatre and look after her until she did. They had no reason to doubt what I said.’

‘Did no one come in?’

‘No. Those two theatres are only used when we are really stretched. But we left her hooked up to a couple of tubes and switched the monitors back to the display mode. If anyone had come in, she would have appeared asleep. We also used some warming devices – they’re rather like mini fan heaters – to keep her warm until we could decide what to do next.’

‘Did she ever return to the ward?’ Dr Wolf asked this time.

‘No. Steven went up to the ward and made some notes in her medical log, so that it would look as if she had returned, listing the painkillers you asked about. Around 9:45, we wheeled her back up to the ward. We used the service lift out the back, but we didn’t see a soul.’

‘Who decided to drop her off the building?’

‘I did,’ Jane replied, shakily. ‘I realised early on that if we just put her back into bed we would be found out, so I had the idea of dropping her body from a height. We were helped by her room being on the top floor so that it would be seen as a suicide or a terrible accident and the trauma of the injuries would cover anything else up. We turned the covers back on one side of the bed so it would look like she just climbed out herself. I never imagined for one moment that the police would think it was a murder.’

‘But when Ahmad was arrested, you stayed silent.’

‘You can’t blame me. I was hardly going to own up then. I decided that if it looked as if he was going to be convicted then I would speak up. But you did your job very competently and he wasn’t.’

‘That’s very convenient for you to say now, after the event.’

‘I was in a difficult situation.’

‘Of your own making. And I suppose you are a doctor with, what, a decade of training, and my client was only a cleaner! What about when Lottie rang to find out where Mrs Hennessy was?’

‘I told her she was with the physiotherapist,’ Steven piped up.

‘Weren’t you suspicious?’ Judith asked Lottie, who hung her head. ‘And you told us you saw Mrs Hennessy, when that wasn’t true.’

‘I persuaded Nurse Li to say what she did,’ Jane intervened. ‘And I pretended it came from Hani. I knew she would accept what he said without questioning. And she knew she should have been in theatre so I was doubly sure she would co-operate. She didn’t know what we did though. We waited till she was occupied with another patient to throw Mrs Hennessy off the fire escape.’

Hani Mahmood gasped and shook his head repeatedly from side to side.

‘But Dr Wolf, you lied too. I asked you how Mrs Hennessy was after her operation? You said she was “fine”. I remember the exchange vividly,’ Judith continued.

David remained wide-eyed, standing in the centre of the room.

‘Dr Wolf?’

‘Jane. How could you do this? If you’d asked me I would’ve helped you. We would have found another way of dealing with this. Not this.’

‘Dr Wolf. Can you answer my question? Why did you lie to me? Why did you lie in court?’

‘As far as I knew, Mrs Hennessy was “fine” after her operation. Don’t you see? I had no part in her death or cover up. OK, I didn’t do the surgery and I asked Steven to go up and see Mrs Hennessy post-op and to up her pain relief if she needed it. He told me he had. I didn’t want to admit that I delegated, that’s all. A tiny white lie in the scheme of things.’

‘You pretended you operated on her when you were never there. You confirmed the state of her health afterwards when you never even saw her. These were significant events you lied about.’

David continued to stare accusingly at his wife.

‘I did it for the best!’ Jane shouted at him.

‘Best for whom? Hardly for Mrs Hennessy,’ Judith replied.

‘We couldn’t bring her back. We tried. We were trying to salvage something.’

‘So when Lucy asked me to persuade you to remove the Aladdin forms, that was all a pretence?’ Hani asked. ‘You and Lucy had already planned everything together.’

‘Lucy didn’t know about how Mrs Hennessy died. She was just “risk-averse” and didn’t want Aladdin mentioned in court.’

‘How did you know I would agree?’

‘Lucy didn’t give you much choice, from what I remember.’

‘Yes. That’s true.’

‘What did she say to you, Dr Mahmood? That you’d get the sack if you didn’t toe the line?’ Judith asked.

‘Pretty much,’ Jane said. ‘I didn’t mean to deceive you, Hani, but I thought that was the best way to keep you quiet. And it worked. And David. You would never have gone along with it, I knew that. So it was better to keep you in the dark too; I’m sorry. Aladdin is a great addition to our hospital workforce. Its importance cannot be underestimated. We did this for patient care; nothing more. We knew we were risking our own positions.’

‘But Lucy challenged you in the review meeting, about taking that call. She embarrassed you. Why did she do that, if you were working together?’ Hani needed to understand it all, how he had been taken in so entirely.

‘Yes. That was a bit of a surprise, I admit. She wanted to keep me in line too. To make it clear that it would be easy to make me a scapegoat, if the Trust wanted. I don’t blame her.’

‘Why didn’t the high level of anaesthetic get picked up on the post mortem?’ Judith asked.

‘Probably not enough blood left for any meaningful testing,’ Jane said. ‘I had hoped that would be the case. And there was no reason to carry out those additional “toxicology”-type tests you would have to do anyway to detect it, given the obvious “cause of death”. Our pathologists and laboratories are frantically busy. Why manufacture extra work when things are so clear-cut?’

Judith strode around the room, circling all its inhabitants, finishing next to Inspector Dawson.

‘Inspector Dawson, I believe you need to take Dr Bridges and Dr King into custody then. Am I correct?’ she asked soberly.

‘You are,’ he replied. ‘And the rest of you need to be available to answer questions at the station tomorrow morning. For tonight, you are free to go. But please don’t think of taking any holidays for quite a while.’