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00:00Good afternoon, Doctor.
00:28Hi, Ashleam.
00:30Hello, Charlie.
00:31Boss.
00:32Sparing change, Doc?
00:34My wages are probably richer than me, Charlie.
00:55Again, sorry for the wait, but everything looks better.
00:58Fine.
00:59And you're sure it's not infected?
01:03I'm sure.
01:04You're healing up nicely.
01:05Just, um, it feels so uncomfortable down there.
01:09A little discomfort's to be expected.
01:13How's everything else?
01:15Yeah, fine.
01:17That's not quite true.
01:18You've been struggling to cope.
01:19Ed, I'm doing my best.
01:22She's not been sleeping.
01:23I've been doing most of the feeding.
01:24It's not been easy.
01:28Rosie, tell the doctor.
01:33Having a baby and a toddler, it's hard.
01:39Yeah.
01:40Rosie, why don't we have a quick chat on our own?
01:45Yeah.
01:46Mm-hmm.
01:47Yep.
01:48Yeah.
01:49Yeah, I want it.
01:50Yes, I realise that.
01:51Do you plead me?
01:52Mm-mm.
01:53Mm-mm.
01:54I keep calling about Tony's Mental Health Act assessment.
01:58I called her.
01:59She's not answering.
02:00Fine.
02:01I'll pass that on.
02:02What's wrong?
02:03Tony's meant to be getting sectioned right now, but the team's at her house waiting for
02:10Dr McAllister, and the Amps threatening to cancel the whole thing is she didn't turn up at SAP.
02:13Is she on the way?
02:14She hasn't even left.
02:15She's in her office doing God knows what.
02:16I'm sorry.
02:17I'm sorry.
02:18I'm sorry.
02:19I'm sorry.
02:20I'm sorry.
02:21I'm sorry.
02:22I'm sorry.
02:23I'm sorry.
02:24I'm sorry.
02:25I'm sorry.
02:26I'm sorry.
02:27I'm sorry.
02:28I'm sorry.
02:29I'm sorry.
02:30I'm sorry.
02:31I'm sorry.
02:32I'm sorry.
02:33I'm sorry.
02:34I'm sorry.
02:35I'm sorry.
02:36I'm sorry.
02:37I'm sorry.
02:38I'm sorry.
02:39I'm sorry.
02:40I'm sorry.
02:41I'm sorry.
02:42I'm sorry.
02:43I'm sorry.
02:44Hi.
02:45I'm Dr. Hernandez calling from MAU.
02:46I've got a patient I'd like to see.
02:49She's six weeks postpartum.
02:51It'll just be a straightforward review.
02:54Yeah.
02:55We're room 127.
02:56Mm-hmm.
02:57It shouldn't take too long.
02:59They just need a bit of reassurance.
03:00Sure.
03:01Yeah.
03:02The team's at Tony's flat right now waiting for you so they can start.
03:05The amp says they're going to cancel if you don't get there soon.
03:07No, they can't cancel.
03:08I spent ages trying to get Tony sectioned.
03:10I'm about to start this management meeting.
03:12It's the bloody trust again.
03:13I've got so much on my plate.
03:14She's out there, psychotic, pregnant, using crack.
03:17If she isn't sectioned today, anything could happen.
03:20I know.
03:21I wish I could help, but...
03:23You could.
03:24Actually, couldn't you?
03:25Because they just need a doctor who knows Tony.
03:27Okay, I can't.
03:28I'm on call.
03:29I've just accepted a referral.
03:30Yeah, it's nearly five.
03:31Get the SHO to see them.
03:32I'm not really sure.
03:34It's a straightforward assessment, James.
03:36Tony's symptoms are obvious.
03:37You get it done quickly.
03:38I'm really sorry, but I have to attend an urgent mental health assessment.
03:45It's nearly five, so the on-call SHO can see her after handover.
03:50I've already told the patient and her husband you're coming.
03:53I know, but my consortium needs me to go to the assessment.
03:55So, do this first.
03:56It won't take long.
03:57This patient is acutely unwell.
03:58Is your patient in imminent danger?
04:02Obviously not right now, because she's sitting in my clinic room.
04:05But beyond that, I can't say.
04:06Is she exhibiting any unusual symptoms?
04:09I can't assess that.
04:10I'm not a psychiatrist, am I?
04:12Look, this is time sensitive, all right?
04:15They're waiting for me, and they can't...
04:17Look, we all have time pressures.
04:19You're the on-call psychiatrist.
04:20You can't refuse to come.
04:21I didn't refuse.
04:22I told you, I'm having to prioritise a high-risk patient.
04:26Fine.
04:27If you're choosing to downgrade a referral you already accepted,
04:30I'll document that in the notes.
04:32Don't do that.
04:33You're not leaving me much choice.
04:36Okay, well, if you're happy to wait with her, then I'll review her when I get back.
04:40You could be ours.
04:41If you don't come now, I'm taking it higher.
04:44I'll move my way.
04:45Have you felt anxious or worried for no good reason?
04:57No.
04:58Do you ever blame yourself unnecessarily when things go wrong?
05:01No.
05:02No.
05:03She blames herself for not being able to breastfeed.
05:05It's making her really anxious.
05:06Isn't that normal?
05:08It can't be.
05:09I'm trying, but I just can't.
05:15Could you turn that off?
05:17No.
05:18I can't, I'm afraid.
05:20Rosie, I'm going to ask you some questions to assess your mental state.
05:24Some of these questions might feel a little strange, but we ask everybody the same things.
05:31Do you have any beliefs that other people think aren't true?
05:34No.
05:35Are you preoccupied by anything?
05:38No.
05:39Have you had any thoughts about harming yourself?
05:41No.
05:42How about harming other people?
05:45No.
05:46Do you ever feel like someone is trying to remove thoughts from your head?
05:51Or trying to put thoughts into your head without your control?
05:55Do you ever feel like other people can hear your thoughts?
05:58No.
05:59Do you hear or feel things when there's nothing there?
06:02Yeah.
06:03Um, what do you mean?
06:05I like hearing somebody talking to you when there's nobody else in the room.
06:10No.
06:15Sorry.
06:25Well, you're clearly sleep deprived, but there's no explicit risks that I'm concerned about.
06:32And you have a supportive, loving partner.
06:45So you're not too concerned?
06:47Currently, no.
06:48No, but I'll refer to the home treatment team for a full assessment tomorrow just in case.
06:51Prescribe lorizopam two milligrams for when she gets home.
06:54Another two before bed.
06:55It will contain any anxiety.
06:56It will help her to sleep.
06:57Benzos aren't saving breastfeeding patients.
06:59They are fine for short-term treatment.
07:01And she's not breastfeeding.
07:03If you ask for my advice, that's what it is.
07:06Wait, you're not coming in to explain the plan?
07:07I can't.
07:08I really have to go.
07:09Just tell her what I said.
07:11Hello?
07:12Yeah, yeah, yeah.
07:13I'm on the way.
07:14Yes.
07:16So that's it.
07:17We just go home and we wait for this home care team.
07:19Dr. Ford also suggested lorazepam to help with your anxiety and sleep.
07:24It's a sedative similar to diazepam.
07:26Is it safe to breastfeed?
07:28There is a small risk of transfer to the baby during breastfeeding.
07:32Rosie, you have not breastfed for days.
07:34I'm trying.
07:35I'll write the prescription.
07:37That way you have the tablets.
07:38If you think you need them, it's up to you.
07:40I'll book you into my clinic later on this week and see how you're doing.
07:58Dr. Ford.
08:00What's going on?
08:01We kicked off while we were waiting for you.
08:02They're not happy with us being here.
08:04Sorry.
08:05Where's Dr. McAllister?
08:06Tony won't come out to hospital if you're not here.
08:08She got caught in a meeting.
08:09Right.
08:10We need to get in there quickly.
08:12Ask the necessary questions, then get out.
08:14Their partner's in there.
08:15We won't let her stay for long.
08:16Who lead?
08:17I'll do the intro.
08:18You can assess her mental state.
08:20Come on.
08:21Let's get this over with.
08:22I'm at Chaffee.
08:24Section 12 Doctor.
08:25It's me.
08:26You've settled down.
08:27Hey, settle down!
08:29Pack it in around that club, aren't you?
08:30Hey!
08:31You've settled down!
08:32Pack it in around that club, aren't you?
08:34Hey!
08:35You've settled down!
08:36Come on!
08:37Come on!
08:38Come on!
08:39Come on!
08:40Tony?
08:41You in there, love?
08:42It's Michelle Dornoway from the adult care team.
08:45I'm here with some colleagues.
08:46We'd like to chat.
08:48Come on!
08:49Come on!
08:50Come on!
08:51Come on!
08:52Antoinette!
08:53This is the police.
08:54I'll count to three.
08:55And if you don't answer, we're coming in by force.
08:59One.
09:02Two.
09:05Three.
09:09Police!
09:10Police!
09:11What are you doing at my door?
09:13Get down.
09:14Get down.
09:15You want to fix that?
09:16I don't know what's going on.
09:17Tony, we're worried about mental health.
09:19We're here to assess that we need to come into hospital under section.
09:22Calm down.
09:23The fuck you are!
09:24Take it easy.
09:25Hey!
09:26Get the fuck out of my hand!
09:28Drop the knife!
09:29If you do not, I will do it!
09:30Drop it now!
09:31No!
09:33Oh!
09:34Oh!
09:35Oh!
09:36Oh!
09:37Oh!
09:38Oh!
09:40Oh!
09:41Oh!
09:42Oh!
09:43Oh!
09:44Oh!
09:45Oh!
09:46Oh!
09:47Oh!
09:48Oh!
09:49Oh!
09:50Oh!
09:51Oh!
09:52Oh!
09:53Oh!
09:54Oh!
09:55Oh!
09:56Oh!
09:57Oh!
09:58What about a death?
09:59Oh!
10:00Jane, sorry.
10:01Sorry I missed the handover.
10:02We just did Tony's mental health assessment.
10:03There was...
10:04... nightmare.
10:05Dr. McAllister should have sectioned her when she was on the wall instead of letting
10:07help squand again.
10:08Come on.
10:09She was giving Tony the benefit of the doubt.
10:13I asked her to pee in a pot for a pregnancy test.
10:15She gave me this.
10:18I know.
10:19Er...
10:20But she thinks God impregnated her.
10:23She even has pregnancy delusions, pelvic pain, bloating, nausea.
10:26This is her fifth presentation this year.
10:28A&E keeps sending her home without a test, so...
10:30So you thought you'd challenge her delusions to be fucked?
10:33Yes!
10:34See?
10:35Now I can send her home.
10:36With any luck, she won't come back.
10:37Hmm.
10:38Hmm.
10:45Hmm.
10:48Thank you, Miss O'Reilly.
10:53She's had...
10:54...shown signs of raisins of cranial freshness.
10:56She has a palpable abdominal mass.
10:58It's hard to know for sure without imaging, but I'd guess uterine cancer with brain mass.
11:02Causing the psychotic symptoms.
11:04Yeah, recent onset psychosis in those physical changes at her age.
11:08Should make you rule out any physiological cause.
11:10The pelvic pain and nausea are real.
11:12Not pregnancy delusions.
11:14She's psychotic.
11:16Doesn't mean she's not telling the truth.
11:19Don't worry.
11:20You're not the first doctor to dismiss her symptoms.
11:24I need to go to the psych unit.
11:26Make sure Tony's, uh, section paperwork's not loaded.
11:28Then I have a seclusion review.
11:29Then I'll go home.
11:30But I'm on call tonight if you need anything.
11:33And don't forget to see Tony when you get back to the ward.
11:35She's coming down from crack, so she might give the night staff a tough time.
11:38Come on.
11:39Ciao.
12:08Hello?
12:09James, sorry to wake you, but we've got a situation with a patient and I really need you to come in.
12:19I didn't know what else to do.
12:21So, is it Tony?
12:22No.
12:23Rosie.
12:24Rosie Newman.
12:25What?
12:26I just saw her a couple of hours ago.
12:30I can't enough.
12:31I can't enough.
12:32What the hell?
12:33Are you staring at you fucking face?
12:35Wait till I get my hands with you.
12:36Uh, she's really unwell and I don't know what to do.
12:38A&E won't help but keep saying she's my problem, but she's really agitated and the police are making things worse.
12:43Elise?
12:44What is she on a section 136?
12:46Yes.
12:47A&E done, uh, done blood?
12:49No, nobody wants to go anywhere near her.
12:51Keep her, uh, A&E incel, I'll get there.
12:54She needs to have a baseline, ECG, and...
12:58We need to rule out a physiological cause.
13:01Okay, can you get her as quick as you can?
13:03Because I'm really struggling.
13:04Hi!
13:05Bernadette?
13:06Hello?
13:07Bernadette?
13:08Are you there?
13:09Bernadette?
13:10You need to get here now!
13:11Yeah, yeah, I'm, I'm, I'm, I'm away.
13:13She had four milligrams of erazepam earlier, so...
13:19Give her five milligrams of haloperidol IM, and call the amp.
13:26I'll be there in, um...
13:28I'll be there within half an hour.
13:37I'll be there within half an hour.
13:38I'll be there within half an hour.
13:44I'll be there within half an hour.
13:46Yeah.
13:47I'll be there within half an hour.
13:52I'll be there, uh, in half an hour.
13:53A day later...
13:54I'll be there, uh...
13:55I'll be there.
13:56Oh, I can just ask you to ask you...
13:57Yes, no, no, I understand that.
14:09Hang on a second, he just walked in.
14:11Where the hell have you been?
14:12I'm on the phone with the amp, we were all waiting for you.
14:13Sorry, there was, um, car trouble.
14:16Where, where is she?
14:17She kicked off again, so we had to move her to the 136 suite.
14:19Oh, she hasn't had a physical.
14:20She needed the physical, that was all.
14:21You still there?
14:23Great, yeah.
14:24Look, my hands were tied.
14:26Things escalated, the...
14:27There's something else I could do.
14:51Foxtrot 6-3, any updates over?
14:55Doctor's only just arrived.
14:57Okay, I need you back on the road ASAP.
14:59Doctor Ford, Reg on call.
15:02We need to get going.
15:03Talk me through what happened first.
15:06We received a call at 12.20 from Mr. Newman saying his wife is trying to drown their baby.
15:11When we arrived, she was distressed and very aggressive.
15:15Mr. Newman was locked in the nursery with the baby.
15:17Where is he now?
15:18He's gone to PEDS, A&E, to get the baby checked.
15:23Those restraints were any necessary?
15:26She attacked a doctor and bit me.
15:28They're disproportionate to her current state.
15:30With respect, you didn't see how she was.
15:32She's calm now.
15:33She's responding to the sedatives.
15:35Could you let me in, please?
15:35Let's take this off, Joey.
15:53Let's take this off, Joey.
16:03Rosie, I'm Dr. Ford.
16:05We met earlier.
16:08I'm not going to hurt you.
16:09I'm just going to remove this.
16:12It's okay, Rosie.
16:21It's okay.
16:26I just want to know what happened.
16:31I met you before.
16:33In the other place.
16:35I met you and Alfie.
16:36Your baby.
16:38No.
16:39No.
16:40No, there is no baby.
16:42No, there is no baby.
16:46I tried.
16:49I tried.
16:50I tried.
16:51I failed.
16:52Rosie, there's someone else talking to you apart from me.
16:54I failed to try.
16:56I failed.
16:59Rosie, what do you think you failed at?
17:02Who the fuck are you calling a failure?
17:04I tried.
17:06And it didn't work.
17:07But I'll keep trying until he's dead.
17:10I have to go, and I have an appointment, and I need to leave.
17:21Bonnie!
17:22Bonnie!
17:22Bonnie!
17:23Bonnie!
17:24Bonnie!
17:24Bonnie!
17:24Bonnie!
17:24Bonnie!
17:24Bonnie!
17:25Bonnie!
17:26Bonnie!
17:27Bonnie!
17:28Should we add some of the magic wand?
17:30No, no, no, no.
17:31We have all the calls to attend.
17:48Mia, Mia, you can go.
17:50We've got this under control.
17:51Hi, can I get someone over across to 136 Suite?
18:00We've got a new patient for Willow Ward.
18:01Sure.
18:02Shouldn't we wait for transport?
18:05No.
18:06It'll take hours.
18:07I want her in a secure ward before the sedatives wear off.
18:10I don't get it.
18:12I saw this afternoon.
18:13She seemed fine.
18:14No psychiatry.
18:16Unpredictable.
18:17It's not as unpredictable.
18:20Listen to his breathing, and if there's any sign he seems out of the ordinary to you,
18:25just grab one of us and we'll review him.
18:27Okay.
18:28In the meantime, I've booked an x-ray to rule out water in the lungs.
18:33How is it?
18:46Rosie?
18:47Uh, yeah.
18:48Uh, yeah, they think he's gonna be all right.
18:51They're keeping him overnight for observation, man.
18:54Uh, how's Rosie?
18:55How's Rosie?
18:56Is she okay?
18:57She's calmed down.
18:58We're moving her to a ward.
18:59Okay.
19:00Let's check what time Rosie took the lorazepam prescribed.
19:03Um, I don't know.
19:05I don't know.
19:06You don't know what time, but she, she, she, she did take it.
19:10Well, I don't know.
19:11I didn't see her physically take any tablets, but she could have done.
19:14You can't be certain.
19:15No, why are you asking?
19:20Just checking.
19:34Where's Rosie?
19:35They've already picked her up.
19:37Why?
19:38She, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she, she.
19:56Are you okay, Rosie?
20:02Rosie!
20:14Are you okay?
20:15Yeah, yeah. She just hit me and ran.
20:17Where did she go?
20:18The pharmaceutical building.
20:20I'm calling security.
20:26Violin's brand of phone have been on LVs with gas plants.
20:32You can tell you stories about how to build your gas, like they're growing up to their memories.
20:38So, yeah, I mean it's in the commercial room to find shotguns
20:46But you can explain the performance.
20:49You won't please the possibility of having a future.
20:51Rosie!
20:52Rosie!
20:53Rosie!
20:54Rosie!
20:55Please!
20:56Don't move!
20:59Rosie, come away from the edge!
21:05Please, Rosie!
21:08Please!
21:09Please!
21:10Don't...
21:11Don't move!
21:12Rosie, come away from the edge!
21:15Please, Rosie!
21:16That's it.
21:17That's it.
21:18That's it, Rosie.
21:19It's Dr. Ford.
21:20You know who I am.
21:21You remember.
21:22I can't.
21:23I can't.
21:24Please.
21:25Stay where you are.
21:26I can't.
21:27I can't.
21:28I can't.
21:29I can't.
21:30I can't.
21:31Please.
21:32Stay where you are.
21:33I can't.
21:34I can't.
21:35I can't.
21:36Please.
21:37I can't.
21:38I can't.
21:39I can't.
21:40I tried.
21:41I tried.
21:42I tried.
21:43I tried.
21:44I tried.
21:45I failed.
21:46I...
21:47You haven't failed.
21:48What...
21:49What do you think you failed at?
21:51Rosie!
21:52Rosie!
21:53Rosie!
21:54Stop!
21:55I know you're scared.
21:58Please.
22:00I got scared, too.
22:03I got scared, too.
22:07That's right.
22:11I get scared, too.
22:16So why don't we...
22:17come down and...
22:20go inside and...
22:24We'll just talk.
22:25That's all, Rosie. We'll just talk.
22:32Yeah.
22:43We'll just talk.
22:55No, no, no.
23:25If we have any more questions, we'll be in touch, Dr. Ford.
23:45How the hell did this happen?
23:49She was much more unwell than you or I thought.
23:51Well, this has nothing to do with me.
23:53I asked for your help and you spent about two seconds reviewing her.
23:56That's not true.
23:57You couldn't get away faster.
23:58I don't want to do this now, but I haven't slept and I've just been through it with the police.
24:02Well, the coroner, the trust, they'll all have questions.
24:05You said it was safe to send her home.
24:07She seemed okay when I saw her.
24:08Then why did she throw herself off a building a few hours later?
24:11You said you didn't think she was that unwell. You said that yourself.
24:13I was concerned. That's why I called you. I trusted your advice.
24:17Did you? Because Rosie didn't take the lorazepam.
24:20If she had, none of this would have happened.
24:22Don't you dare put the blame on me.
24:24I described it exactly as you said.
24:26Okay, Dan, could you take everyone back to the lunch, please?
24:28Sure, sure.
24:29Keith.
24:30The medicine because they sailed through their exams first time.
24:32Never stopping for a career break.
24:35Trip up eventually.
24:37This is on you, not on me.
24:39That's for both of us.
24:40Hey, hey, hey.
24:41Not an appropriate time or place to discuss this, okay?
24:45I've got to get to your ward round.
24:52You okay?
24:58No, not really.
24:59Okay.
25:00Well, go home, James.
25:02Get some sleep.
25:03I'll see you tomorrow.
25:04I'll see you tomorrow.
25:05Bye-bye.
25:06You okay?
25:07Ready?
25:08Just a sec.
25:11You
25:25Ready just a sec
25:33Imagine being widowed this way with a toddler and a newborn
25:41It's unthinkable
25:49This isn't gonna be easy
25:51I know
25:55Can you tell us what happened during Rosie's psychiatry review? How did you find Dr. Ford?
26:01He was in a rush
26:03His phone kept going off. He just asked a few questions then he left. Dr. Ford recommended a sedative
26:09Lorazepam, but Rosie didn't take it. I mean, she was she was anxious about breastfeeding, but
26:19When we returned home from the hospital Rosie went straight up to bed. I
26:24Assumed that she'd taken
26:30But I should have checked to be sure
26:32Did Dr. Ford explain why he prescribed Lorazepam? No
26:37Dr. Hernandez did he'd left by the
26:43Would you mind talking us through what what happened that night?
26:49Um
26:51I woke up around midnight
27:01Alfie was crying, but it didn't sound right. It was more like
27:05Gasping Rosie wasn't in bed. They were both in the bathroom
27:09She was shushing him and crying holding him under the tap
27:14As the bath filled her
27:16So
27:18What did you do?
27:21I grabbed Alfie we struggled. I don't know how long for I think Rosie fell here
27:26So I locked me and Alfie in the nursery done you then called the police I came out of the nursery when I heard her shouting at them
27:34They're all outside on the front garden
27:39Rosie
27:41They should never never have sent her home from hospital
28:08She should have stayed there being seen properly and then made to take the medication there
28:17How could something like this happen I don't know
28:22But rest assured we're gonna get to the bottom of this you have my word
28:38So moving on to Antoinette Campbell Brown obviously we've been here before but how has Tony been this since her section in Kwame?
28:54Yeah, she's stable eating well tends to her personal hygiene
28:58Today she attended music therapy. I meant her mental state
29:06She's refusing to cutiope in and yet you say she's well unstable
29:13Tony's refusing to come in
29:15What's she doing staring at the TV shows reminds her of her new baby Sam
29:20Oh, it's actually Samsung that named after the TV
29:25Yeah, her first baby was called Apple so I should make sense. Well at least she's acknowledging the pregnancy now
29:32Does the patient need to be here?
29:34Sorry, just uh, explain to me how you couldn't make a plan for a patient you never met. Mr. Mansell gave me the key details. Oh
29:40fine I
29:42I think we scheduled Tony for elective cesarean. She's a healthy 32 year old lady
29:46She doesn't need major surgery. She can have a normal vaginal delivery. She's forwardly psychotic and can't follow instructions
29:51Just tell me how you plan to talk her step-by-step through her labor. Mr. Mansell delivered Tony's first baby naturally without any significant complications
29:59What constitutes significant? We just need to ensure that the baby is delivered safely and with no undue harm done to mum
30:05It's not in her best interests to have a cesarean
30:08She takes crack, but if she continues to take crack on the ward
30:12She's at risk of a placental abruption and therefore a premature delivery
30:16Then don't let her use crack on the ward. Sometimes these things are beyond our control
30:20This psychiatric and physiological reasons for elective cesarean her meds are at risk of endocrinological complications if she gives birth naturally
30:28Will likely be traumatic and will end with an emergency cesarean any so now you're an expert in obstetrics
30:34Dr. MacArthur sure you agree
30:36Um, I think sophia's right in that according to the notes apple was delivered naturally and there were no issues
30:49Fine
30:51She can't stay here though because if she goes into labor we don't have the right equipment
30:54We'll do what we did last time one of your nurses can escort her over then we'll take over
30:58So after everything that's happened the plan is to escort a floridly psychotic woman in labor across to the hospital
31:04Well at least she won't be able to run away
31:10All right, so let's keep her here
31:12We'll put her on one-to-one obs and with more medication she might improve enough to follow birthing instructions
31:19She has four weeks left to go so hopefully a bed on a psych mother baby unit will become free before then
31:26And then the problem disappears
31:29Do not put that in the notes
31:43So you really think that birth plan is good well, I'm just trying to keep the peace
31:48Enough to what happened with Rosie Newman. We can't afford another fallout with obstetrics
31:51There's something else the MIU contacted me they're starting an investigation into Rosie's death and they want to speak to you
32:02So you need to get your story straight
32:05When you saw Rosie in outpatients, why didn't you spot how unwell she was?
32:10I was I was in a rush she'd asked me to go and see Tony
32:13Yeah, and if you'd gone straight to Tony's assessment like I asked you wouldn't be in this position would you?
32:17So tell the MIU you did a thorough assessment and Rosie wasn't exhibiting any signs of a severe psychotic illness
32:23If she had then a doctor of your experience would have spotted them wouldn't they?
32:28So if this becomes about your incompetence they will go over every inch of your work and your life
32:33You don't want that trust me
32:35I'm sorry
33:06Do you ever feel like someone is trying to remove thoughts from your head?
33:11Or trying to put thoughts into your head without your control?
33:15Do you feel like other people can hear your thoughts?
33:18No.
33:20Do you have any beliefs that other people think aren't true?
33:23No.
33:25Have you had any thoughts about harming yourself?
33:35This is Francis. He's always the same.
33:54Morning, mate.
33:55Morning.
33:56Morning.
33:57Want some breakfast?
33:58Oh, no, no. I've already eaten.
34:00How's the... How's something going?
34:03Good? Yeah, yeah, yeah.
34:05I've got a couple lined up this week.
34:07Where are you going today?
34:10Same old.
34:11Another dose of the crazies?
34:16Oh, uh, before I forget...
34:19Dad wants to drive over next weekend.
34:22I can't remember. I'm on call.
34:26See you later.
34:32You don't know where the M.I.U. is, dear?
34:33Yeah, yeah, 7-4.
34:347-4, yeah.
34:357-4, yeah.
34:36You don't know where the M.I.U. is, dear?
34:37Yeah, yeah, 7-4.
34:387-4, yeah.
34:397-4, yeah.
34:40You don't know where the MIU is, dear?
34:54Yeah, yeah, 7-4.
34:557-4, yeah?
35:10We've received a complaint about Rosie Newman's treatment prior to her death.
35:27We've received several complaints like this and we are duty-bound to assess each one.
35:31We just want to get a clearer picture of your involvement in her care.
35:34Okay.
35:37I was on call when I received a referral for Rosie.
35:40Around 4 p.m.
35:42Dr. Handers didn't think the review would take long.
35:44The couple just needed reassurance.
35:47What did you make of Rosie's symptoms?
35:49At that point, she wasn't displaying any psychotic symptoms.
35:53You did a full mental state examination?
35:55Yes.
35:56But you didn't document the full details in her notes?
35:58No, because there were no positive findings.
36:00Rosie was...
36:02She was tired, but nothing out of the ordinary for someone with a newborn.
36:06Did you assess risk of harm?
36:08Yes.
36:09The risk of harm to herself and others was low at that point.
36:12And plus, she had protective factors like a supportive partner.
36:14And you asked specifically about thoughts of self-harm?
36:17Yes.
36:18Rosie didn't express any desire to harm herself.
36:22What was your plan?
36:23But, um, I asked Dr. Hernandez to prescribe two metagrams of lorizopam then and then a further
36:29two metagrams before bed.
36:30I also referred Rosie to the home treatment team for a review the following morning.
36:36Dr. Hernandez's statement says you didn't feel it necessary to explain the plan to Rosie
36:42yourself.
36:43No.
36:44Because I'm a symbol.
36:45Did you consider Rosie might have been masking her symptoms?
36:50She was a little guarded, yes.
36:52But, um, that's why I was so keen for a further review from the home treatment team.
37:00From these notes, it seems your assessment of Rosie was very brief.
37:05It was long enough to ascertain the relevant details.
37:13Ed Newman said your phone kept going off, disrupting the assessment and distracting Rosie.
37:19I was on call.
37:22There's nothing I can do about that.
37:24He also said you were in a rush.
37:28Dr. McAllister had asked me to attend a mental health act assessment, so there was a team
37:36waiting for me there, but I wasn't in a rush.
37:40But you were on call.
37:43Rosie should have been your priority.
37:45I thought I could do both.
37:46You must have felt under considerable pressure knowing you were holding up a mental health
37:52act assessment.
37:53No.
37:55Team, I'll have you to wait.
37:57You reviewed Rosie in front of her husband and baby.
38:00Did you consider seeing her alone?
38:02Yeah, but if I had had my time, then ideally, I would have done yes.
38:06But you weren't in a rush.
38:08No.
38:08Given the circumstances, it seemed to be the most efficient thing to do.
38:11At 2 a.m., Dr. Asimov called, asking you to come help with Rosie.
38:17Yes, I came straight in.
38:18How was Rosie when you arrived?
38:20Calm.
38:22I asked the police to remove the restraints.
38:23They'd gagged her and bound her arms and legs.
38:25It seemed excessive.
38:26But they did that based on the extremely agitated behaviour they witnessed when you weren't there.
38:31Do you think your judgement was clouded by the version of Rosie you saw in outpatients earlier?
38:35Absolutely not, because I believed that she'd had 4 mg of lorazepam and 5 mg of haloperidol,
38:40and therefore that had settled her.
38:42Your assumption was wrong.
38:46As a result, Rosie was under-sedated when you saw her in A&E, and when she ran from the nurse.
38:51Did it not occur to you to get a collateral history from Mr. Newman before sending Rosie to Willow Ward?
38:57As soon as I realised that Rosie hadn't taken the lorazepam, I rushed back to give her some.
39:02I had no idea that they would have already tried to take her across to the ward.
39:07But you called the ward and asked them to collect Rosie before you went to see Mr. Newman.
39:11Usually they don't come that quickly.
39:14But it was your decision to wheel Rosie over to psych rather than wait for transport.
39:18Yeah, but we do that all the time. An ambulance takes forever. It's a short distance.
39:28Look, is this complaint specifically about me?
39:30If Rosie's symptoms were picked up earlier, this entire tragedy could have been avoided.
39:36You say your initial assessment wasn't rushed, but I find that hard to believe, given what you've said.
39:42You then had a second opportunity to fully assess Rosie, but you didn't manage any of the risks.
39:48If Rosie had taken the lorazepam, none of this would have happened.
39:52I agree. But you didn't explain its importance to Rosie or her husband.
39:57I made it clear to Dr. Hernandez, and she's the one who prescribed the drug, so if Rosie didn't take it, then that's down to her.
40:02In your opinion?
40:03It's my opinion. It's my opinion that the care you provided, Rosie, fell below the minimum standard expected.
40:12Therefore, we'll be looking further into events that night, and in the run-up to her death.
40:18Am I under investigation?
40:20We'll look over everything and decide whether a full fitness to practice investigation is needed.
40:25We'll inform you of our decision in due course.
40:27So, really, you think there are about 50 of them?
40:41You didn't hold 50 of them, did you?
40:44You just held one.
40:45Did it pinch you?
40:46No.
40:47No, are you sure?
40:48Did you have to wear special gloves?
40:50Um, right, let's go in, quickly.
41:00Is it plausible Rosie didn't show any symptoms during the first review?
41:05More likely he missed them because he was rushing to attend the Mental Health Act assessment.
41:09He was on call. He should have been firm and told his consultant no.
41:13I mean, it's not always easy to do.
41:15Failure to prioritise because you're scared of your boss is not a defence, George.
41:20The police brought Rosie to A&E. Within minutes, she was shouting and screaming at me.
41:50It was awful, so I called Dr Ford.
41:53He called the ward, asking for someone to walk a patient over.
41:58He didn't say how unwell she was.
42:00So I went to the 136 suite on my own.
42:02Yes, we walked patients across, but only when they'd been properly risk assessed.
42:10And you don't think Dr Ford did that?
42:13Rosie Newman assaulted me.
42:16Then I had to watch her fall to her death.
42:19So no, I don't think he did.
42:21What drugs was Rosie prescribed?
42:30She had heliperidol, but she kicked off again, and a bit a police officer.
42:37A&E were yelling at me to get her out of the department.
42:39I didn't know what to do.
42:40Why was she still in majors and not in the 136 suite?
42:43I'd seen a patient earlier whose psychiatric symptoms were masking an underlying cancer.
42:51Rosie needed a proper medical review, an ECG, blood tests, to rule out physiological cause.
42:56Dr Ford told me to keep Rosie in A&E until he arrived to ensure that happened.
43:07So you called Dr Ford at two.
43:10He arrives roughly 30 minutes later.
43:15Haliperidol wore off very quickly or had no effect at all.
43:20I heard what happened to Rosie Newman.
43:29What the hell are you doing here?
43:31I know this was something to do with you.
43:33You can't hide the truth anymore, Sophia.
43:35And when they find out, it'll be your career.
43:37That's over.
43:39Not mine.
43:44Bernadette, it's important that we understand the timeline accurately.
43:47Now that I think about it, Polly was closer to 2.40, 2.45, when Rosie lashed out again.
43:55Dr Ford should have been there by then.
43:59You're aware that the Reg on call must be within 30 minutes at the hospital.
44:09What time did Dr Ford arrive?
44:13Maybe just before three.
44:14Three.
44:17That's almost an hour after you caught him.
44:24If he'd been on time, he'd have seen for himself why the police restrained Rosie so forcefully.
44:30Could have spoken to Ed Newman.
44:32He'd have known she was undesedated.
44:34This could all have been avoided.
44:57Why was Dr Ford so late?
44:59Have a chance if he met my head.
45:00He knows he was undised.
45:00He was awake at night.
45:02Always съ dansent the hospital.
45:03Trust me.
45:04Yeah.
45:05Stay away.
45:06I had strength.
45:06Have a chance.
45:07Have a chance.
45:08Bye.
45:08Bye.
45:11Bye.
45:11Bye.
45:11Bye.
45:12Bye.
45:13Bye.
45:14Bye.
45:16Bye.
45:22Bye.
45:22Bye.
45:24Bye.
45:24Bye.
45:25Bye.
45:26Bye.
45:26Bye.
45:27Bye.
45:27Bye.
45:28Bye.
45:29Transcription by CastingWords