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Malpractice Season 2 Episode 1

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Transcript
00:00Good afternoon, Doctor.
00:28Hi, Ashlyn.
00:30Hello, Charlie.
00:31Boss.
00:32Are you sparing change, Doc?
00:34My ways is you're probably richer than me, Charlie.
00:35We're probably richer than me, Charlie.
00:56Sorry for the wait, but everything looks fine.
01:01And 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 is 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.
01:20I'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.
01:43Rosie, why don't we have a quick chat on our own?
01:46Yeah.
01:47Yeah.
01:48Mm-hmm.
01:49Yep.
01:50Yeah.
01:51I want it.
02:03Yes, I realise that.
02:05Completely.
02:06I keep calling about Tony's Mental Health Act assessment.
02:10I called her, she's not answering.
02:13Fine.
02:14I'll pass that on.
02:16What's wrong?
02:18Tony's meant to be getting sectioned right now,
02:21but the team's at her house waiting for Dr. McAllister,
02:23and the amp's threatening to cancel the whole thing
02:25if she didn't turn up at SAP.
02:27Is she on the way?
02:28She hasn't even left.
02:30She's in her office doing God knows what.
02:32I don't have time for this.
02:40Hello, Dr. Ford.
02:42Sorry, Reg on call.
02:43Hi, I'm Dr. Hernandez calling from MAU.
02:46Yeah, I've got a patient I'd like to see.
02:48She's six weeks postpartum.
02:51It'll just be a straightforward review.
02:54Yeah.
02:55We're room 127.
02:56All right.
02:57It shouldn't take too long.
02:58They just need a bit of reassurance.
03:00Sure.
03:01Yeah, yeah.
03:02I'll be right there.
03:03The team's at Tony's flat right now waiting for you
03:04so they can start.
03:05The amp says they're going to cancel
03:06if 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 don't know.
03:22I 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.
03:34I'm not really sure.
03:35It's a straightforward assessment, James.
03:36Tony's symptoms are obvious.
03:37You get it done quickly.
03:42I'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.
03:49I've already told the patient and her husband you're coming.
03:53I know, but my consortium needs me to go to this assessment.
03:56So, do this first.
03:57It won't take long.
03:58This patient is acutely unwell.
04:00Is 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.
04:07Is 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.
04:22I didn't refuse.
04:23I 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,
04:38then 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.
04:47I'm on my way.
04:54Have you felt anxious or worried for no good reason?
04:57No.
04:58Do you ever blame yourself unnecessarily when things go wrong?
05:01No.
05:02She blames herself for not being able to breastfeed.
05:04It's making her really anxious.
05:06Isn't that normal?
05:07We 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 assert 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?
05:50Or 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?
06:03Um, what do you mean?
06:05I like hearing somebody talking to you when there's nobody else in the room.
06:10No.
06:15Sorry.
06:20Well, you're clearly sleep deprived, um, but there's no explicit risks that I'm concerned about.
06:32And you have a supportive, loving partner.
06:36So, you're not too concerned?
06:47Currently, no, no.
06:48But I'll refer her to the home treatment team for a full assessment tomorrow, just in case.
06:52Prescribe lorizopam, two milligrams for when she was 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, and she's not breastfeeding.
07:04If 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. I really have to go. Just tell her what I said.
07:11Hello?
07:12Yeah, yeah, yeah. I'm on the way, yes.
07:17So that's it. We just go home and we wait for this home care team?
07:20Dr Ford also suggested lorazepam to help with your anxiety and sleep.
07:24It's a sedative similar to diazepam.
07:27Is it safe to breastfeed?
07:29There is a small risk of transfer to the baby during breastfeeding.
07:33Rosie, you have not breastfed for days.
07:34I'm trying.
07:36I'll write the prescription.
07:37That way you have the tablets. If you think you need them, it's up to you.
07:41I'll book you into my clinic later on this week and see how you're doing.
07:54Dr Ford.
08:00What's going on?
08:01Kicked 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 she's not here.
08:08She got caught on a meeting.
08:10Right.
08:11We need to get in there quickly.
08:12Ask the necessary questions, then get out.
08:14There are partners in there who won't let us stay for long.
08:17Who lead?
08:18I'll do the intro.
08:19You can assess their mental state.
08:21Come on. Let's get this over with.
08:23I'm at Chaffey.
08:24Section 12, Doctor.
08:25It's me.
08:26He's settled down!
08:27He's settled down!
08:28Pack it in and I'll make it up on you!
08:29Hey!
08:30Tony, you in there, Love?
08:39Michelle Dornoway from the adult care team.
08:41I'm here with some colleagues.
08:42We'd like to chat.
08:43Anne Fournette!
08:46Thank you, Billy.
08:47I'm here with some colleagues.
08:48I'm here with some colleagues.
08:49We'd like to chat.
08:52Antoinette this is the police I'll count to three and if you don't answer we're coming in by force one
09:02Two
09:06Three
09:12My door
09:14Don't get down you would have fixed up
09:16What's going on don't it? We're worried about mental health
09:19We need to come into hospital under section calm down. Fuck you are take it easy
09:28Drop the knife if you do not I will
09:49Oh
09:58Bernadette
09:59Look Jane sorry
10:00Sorry I missed hand over we just did Tony's mental health act assessment. It was
10:04Right now. Dr. McAllister should have sectioned her when she was on the wall instead of like help squand again
10:08Come on she was going to tell me the benefit of the doubt
10:13They also had to pee in a pot for a pregnancy test she gave me this
10:18I know but she thinks God impregnated her
10:24She even has pregnancy delusions pelvic pain bloating nausea this is her fifth presentation this year
10:28And you keep sending her home without a test so
10:31So you thought you challenged her delusions with fact
10:34Yes, see now I can send her home with any luck she won't come back
10:48Thank you miss already
10:50She's out showing signs of raisins of cranial freshener she has a palpable abdominal mass it's hard to know for sure without imaging but I'd guess uterine cancer with brain mats
11:03Causing the psychotic symptoms
11:05Yeah recent onset psychosis and those physical changes at her age should make you rule out any physiological cause
11:11The pelvic pain and nausea are real not pregnancy delusions
11:15She's psychotic
11:17Doesn't mean she's not telling the truth
11:20Don't worry
11:22You're not the first doctor to dismiss her symptoms
11:25I need to get to the psych unit make sure Tony's section paperwork isn't uploaded then I have a seclusion review then I'm going home but
11:31I'm on call tonight if you need anything
11:33And don't forget to see Tony when you get back to the ward she's coming down from crack so she might give the night staff a tough time
11:39Sure
11:49Hello?
11:50James sorry to wake you but we've got a situation with a patient and I really need you to come in
11:51I didn't know what else to do
11:52I didn't know what else to do
11:53Is it Tony?
11:54No, Rosie
11:55Rosie
11:56Newman
11:57What?
11:58What?
11:59I just saw you
12:00I didn't know what else to do
12:01I just saw her a couple of hours ago
12:02I just saw her a couple of hours ago
12:03I've had enough
12:04I've had enough
12:05I've had enough
12:06I've had enough
12:07What the hell are you staring at you
12:13you fucking feet
12:15Wait until I get that
12:18Wait till I get my heart
12:20Hold on
12:22Just present
12:23Who were doing
12:24Tammy
12:25She was waiting for me
12:26Then she didn't know what you're on
12:28Just getting out of her
12:31It didn't know what doing
12:33I think she's so excited
12:34Are you fucking me? Where did I get my hands with him?
12:37She's really unwell, and I don't know what to do.
12:39A&E won't help but keep saying she's my problem,
12:41but she's really agitated, and the police are making things worse.
12:43Police? What, is she on a section 136?
12:46Yes.
12:47A&E gonna dump blood?
12:49No, nobody wants to go anywhere near her.
12:51Keep her A&E incel again.
12:54She needs to have a baseline, ECG, and...
12:58I need to rule out a physiological cause.
13:01Okay, can you get her as quick as you can?
13:03Because I'm really struggling...
13:05Bernadette?
13:07Hello? Bernadette, are you there?
13:11Bernadette?
13:13You need to get here now!
13:15Yeah, yeah, I'm on my way.
13:19She had four milligrams of erazepam earlier, so...
13:24Give her five milligrams of haloperidol IM,
13:28and call the amp.
13:30I'll be there in, um...
13:36I'll be there within half an hour.
13:38I'll be there in half an hour.
13:39Yeah!
13:40I'll be there in half an hour.
13:41I'll be there in half an hour.
13:42That's what I'll be there Oh
13:52Oh my god!
13:56Yes, 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 a physical, that was all.
14:21You still there?
14:23Great, yeah.
14:24Look, my hands were tied.
14:26Things escalated, there's something else I could do.
14:28I don't know.
14:29I'm starting Europe.
14:52Foxtrot 63, any updates over?
14:55The doctor's only just arrived.
14:57Okay, I need you back on the road ASAP.
14:59Dr Ford.
15:00Reg on call.
15:01We 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.
15:14Mr Newman was locked in the nursery with the baby.
15:17Where is he now?
15:18He's gone to Pete's A&E to get the baby checked.
15:22Those restraints were any necessary?
15:25She attacked the doctor and bit me.
15:27They're disproportionate to her current state.
15:29With respect, you didn't see how she was.
15:31She's caught up now.
15:32She's responding to the sedatives.
15:34Could you let me in please?
15:35Rosie.
15:36Let's take this off, Joey.
15:37Rosie.
15:38Let's take this off, Joey.
15:41Rosie, I'm Dr Ford.
15:51We met earlier.
15:56Let's take this off, Joey.
16:03Rosie, I'm Dr. Ford. We met earlier.
16:08I'm not going to hurt you. I'm just going to remove this.
16:19It's okay, Rosie. It's okay.
16:26I just want to know what happened.
16:31I met you before.
16:33In the other place.
16:34I met you and Alfie. Your baby.
16:38No.
16:40No, there is no baby.
16:46I tried.
16:49I tried, I tried, and I failed.
16:51Rosie, is 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, and it didn't work, but I'll keep trying until he's dead.
17:13I have to go, and I have an appointment, and I need to leave.
17:17I have an appointment.
17:24Please give her five minutes to haloperidorm now.
17:27Uh ... Should we add something to the other one?
17:28No, no, no.
17:30We don't actually have the mats for me, guys.
17:33Help!
17:34Okay, I've got one.
17:35Just move in here.
17:37Yeah, all right.
17:38Yeah, I've got one there.
17:40Projecting five minutes to haloperidorm.
17:41Yeah, I've got it. Secure.
17:42Got it. Secure.
17:47We have all the calls to attend?
17:49Yeah, yeah, you can go. We've got this under control.
17:56Hello, reception.
17:57Hey, can I get someone over across to 136th Suite?
18:00We've got a new patient for Willow Ward.
18:02Sure.
18:04Shouldn't we wait for transport?
18:05No, no, it'll take hours.
18:07I want her in a secure ward before the sedatives wear off.
18:10I don't get it. I saw this afternoon. She seemed fine.
18:16No psychiatry. Unpredictable.
18:19It's not as unpredictable.
18:22Listen to his breathing, and if there's any sign he seems out of the ordinary to you,
18:26just grab one of us and we'll review him.
18:28Okay.
18:29In the meantime, I've booked an X-ray to rule out water in the lungs.
18:40How is he?
18:47Uh, yeah.
18:49Uh, yeah, they think he's going to be all right.
18:51They're keeping him overnight for observation, man.
18:54Uh, how's Rosie? How's Rosie? Is she okay?
18:56If she's calmed down, we're moving her to a ward.
18:58Okay.
19:00Let's check what time Rosie took the lorazepam prescribed.
19:04Um, I don't know.
19:06You don't know what time it is. She, she...
19:07She did take it.
19:11Well, I don't know. I didn't see her physically take any tablets, but she could have done.
19:14You can't be certain.
19:16No, why are you asking?
19:17Just checking.
19:34Where's Rosie?
19:35They've already picked her up.
19:37Why?
19:38Why?
19:47I need to go. I need to go.
19:56I need to go.
19:58Are you okay, Rose?
19:59Oh!
20:02Rosie!
20:15Are you okay?
20:15Yeah, yeah, yeah. She just hit me and ran.
20:18Where'd she go?
20:19The pharmaceutical building.
20:21I'm calling security.
20:22I'm calling security.
20:45Rosa, Rosa, Rosa...
20:51Oh.
20:52I need to go.
20:53I need to.
20:56Rosie, Rosie, please don't, don't move, Rosie come away from the edge, please Rosie, that's
21:23it, that's it, that's it Rosie, it's Dr. Ford, you know who I am, you remember, please, stay
21:37where you are, I can't, I can't, I tried, I tried, I tried, I tried, I tried, I failed, you
21:46haven't failed, but what do you think you failed at, Rosie, Rosie, Rosie, stop,
21:53I know you're scared, please, I get scared too, that's right, I get scared too, so why
22:16don't we come down and go inside and, and we'll just talk, that's all, Rosie, we'll just
22:30talk, yeah?
22:37who just talk?
22:44No.
23:14If you have any more questions, we'll be in touch, Dr. Ford.
23:44How the hell did this happen?
23:48She was much more unwell than you or I thought.
23:50Well, this has nothing to do with me.
23:52I asked for your help and you spent about two seconds reviewing her.
23:55That's not true.
23:56You couldn't go away faster.
23:57I don't want to do this now, but I haven't slept and I've just been through it with the police.
24:01Yeah, well, the coroner, the trust, they'll all have questions.
24:04You said it was safe to send her home.
24:06She seemed okay when I saw her.
24:07Then why did she throw herself off a building a few hours later?
24:10You 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.
24:19If she had, none of this would have happened.
24:21Don't you dare put the blame on me.
24:25Okay, Dan, could you take everyone back to the lunch, please?
24:29The medicine because they sailed through their exams first time, never stopping for a career break.
24:35Trip up eventually. This is on you, not on me.
24:38That's for both of us.
24:39Hey, hey, hey. Not an appropriate time or place to discuss this.
24:43Okay?
24:45I've got to get to your ward round.
24:51You okay?
24:57No, not really.
25:01Well, go home, James. Get some sleep.
25:03I'll see you tomorrow.
25:25Ready?
25:27I'll see you tomorrow.
25:28I'll see you tomorrow.
25:29I'll see you tomorrow.
25:33Imagine being widowed this way with a toddler and a newborn.
25:41It's unthinkable.
25:43This isn't gonna be easy.
25:49I know.
25:55Can you tell us what happened during Rosie's psychiatry review?
25:59How did you find Dr. Ford?
26:01He was in a rush.
26:03His phone kept going off.
26:04He just asked a few questions, then he left.
26:06Dr. Ford recommended a sedative, lorazepam, but Rosie didn't take it.
26:11I mean, she was...
26:12She was anxious about breastfeeding, but...
26:19When we returned her from the hospital, Rosie went straight up to bed.
26:24I assumed that she'd taken it.
26:30But I should have checked to be sure.
26:31Did Dr. Ford explain why he prescribed lorazepam?
26:35No.
26:37Dr. Hernandez did.
26:38He'd left by the...
26:43Would you mind...
26:44Talking us through what...
26:45What happened that night?
26:49Um...
26:57I woke up around midnight.
26:58Alfie was crying.
27:01But it didn't sound right.
27:02It was more like...
27:04Gasping.
27:05Rosie wasn't in bed.
27:06They were both in the bathroom.
27:09She was shushing him.
27:10And crying.
27:11Holding him under the tap.
27:14As the bath filled her.
27:16So...
27:18What did you do?
27:21I grabbed Alfie.
27:23We struggled.
27:24I don't know how long for.
27:25I think Rosie fell here.
27:26So I locked me and Alfie in the nursery.
27:28Um...
27:29You then called the police.
27:30I came out of the nursery when I...
27:32Heard her shouting at them.
27:33They were all outside.
27:35On the front gun and...
27:38Rosie...
27:44She was screaming.
27:47Biting.
27:52It was awful.
27:53I knew that she wasn't okay.
27:54They should never, never have sent her home from hospital.
28:08She should have stayed there, been seen properly.
28:12And then made to take the medication there.
28:16How could something like this happen?
28:19I don't know.
28:22But rest assured.
28:24We are going to get to the bottom of this.
28:26You have my word.
28:27You know what my favourite thing in the world is really?
28:37It's singing.
28:39I love singing.
28:41Yeah!
28:42We can sing together.
28:44Why don't I teach you a song?
28:46So moving on to Antoinette Campbell-Brown.
28:49Obviously we've been here before, but how has Tammy been since her section in Kwame?
28:54Yeah, she's stable, eating well, tends to her personal hygiene.
29:02Today she attended music therapy.
29:04I meant her mental state.
29:06She's refusing to cutiope in.
29:08And yet you say she's well and stable.
29:10Tony's refusing to come in.
29:14What's she doing?
29:16Staring at the TV.
29:17She just reminds her of her new baby, Sam.
29:20Oh, it's actually Samsung.
29:22That named after the TV.
29:25Yeah, her first baby was called Apple.
29:27So it actually makes sense.
29:29Well, at least she's acknowledging the pregnancy now.
29:31Does the patient need to be here?
29:33Sorry, just explain to me how you couldn't make a plan for a patient you never met.
29:37Mr. Mansell gave me the key details.
29:39Ah, fine.
29:42I think we just scheduled Tony for a lactive cesarean.
29:44She's a healthy 32-year-old lady.
29:46She doesn't need major surgery.
29:47She can have a normal vaginal delivery.
29:49No, she's floridly psychotic and can't follow instructions.
29:51Just tell me how you plan to talk her step-by-step through her labour.
29:55Mr. Mansell delivered Tony's first baby naturally without any significant complications.
29:59What constitutes significant?
30:00We just need to ensure that the baby is delivered safely and with no undue harm done to mum.
30:05Yeah, it's not in her best interests to have a cesarean.
30:08She takes crack, right?
30:10If she continues to take crack on the ward, she's at risk of a placental abruption and therefore a premature delivery.
30:16Then don't let her use crack on the ward.
30:18Sometimes these things are beyond our control.
30:20No, there's psychiatric and physiological reasons for an elective cesarean.
30:24Her meds are at risk of endocrinological complications.
30:25If she gives birth naturally, we'll likely be traumatic and will end with an emergency cesarean anyhow.
30:32So now you're an expert in obstetrics?
30:34Dr. MacArthur, surely you agree?
30:36Um, I think Sophia's right in that according to the notes, Apple was delivered naturally and there were no issues.
30:48Fine.
30:49She can't stay here though, because if she goes into labour, we don't have the right equipment.
30:54We'll do what we did last time.
30:55One 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 labour across to the hospital.
31:04Well, at least she won't be able to run away.
31:06All 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?
31:29Did not put that in the notes.
31:30So you really think that birth plan's good?
31:45Well, I'm just trying to keep the peace.
31:47Enough to what happened with Rosie Newman, we can't afford another fallout with obstetrics.
31:54There's something else.
31:55Um, the MIU contacted me.
31:57They're starting an investigation into Rosie's death, and they want to speak to you.
32:01So you need to get your story straight.
32:04When you saw Rosie in outpatients, why didn't you spot how unwell she was?
32:09I was in a rush. She'd asked me to go and see Tony.
32:12Yeah, and if you concentrated Tony's assessment like I asked, you wouldn't be in this position, would you?
32:16So tell the MIU you did a thorough assessment and Rosie wasn't exhibiting any signs of a severe psychotic illness.
32:22If she had, then a doctor of your experience would have spotted them, wouldn't they?
32:25So if this becomes about your incompetence, they will go over every inch of your work and your life.
32:32You don't want that, trust me.
32:34I definitely need it.
32:35You can't get them off of the matter.
32:41You don't want to get him out of my office, trust me.
32:45Who are you?
32:47They're here.
32:51I'm going to get her home.
32:54We don't want to get her home enough, trust me.
32:56Do 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?
33:16Do you feel like other people can hear your thoughts?
33:19No.
33:21Do you have any beliefs that other people think aren't true?
33:24No.
33:24Do you have any thoughts about harming yourself?
33:51This is Francis.
33:52He's always the same.
33:54Morning, mate.
33:55Morning.
33:56Morning.
33:57Want some breakfast?
33:58Oh, no, no.
33:59I've already eaten.
34:00How's the, uh, how's something going?
34:04Good, yeah.
34:05Yeah, yeah.
34:05I've got a couple lined up this week.
34:08What are you going today?
34:11Same old.
34:12Another dose of the crazies?
34:13Oh, uh, before I forget, Dad wants to drive over next weekend.
34:23I can't remember.
34:24One call.
34:27See you later.
34:27You don't know where the M.I.U. is, Dad.
34:54Yeah, yeah, yeah, same thing.
34:55Some fire.
34:56We've received the complaints about Rosie Newman's treatment
35:26prior to her death. We 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.
35:35Okay. I was on call when I received a referral for Rosie around 4pm.
35:42Dr. Handers didn't think the review would take long. The 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. Rosie 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. The 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. Rosie didn't express any desire to harm herself.
36:20What was your plan?
36:23But, um, I asked Dr. Hernandez to prescribe two milligrams of erizepam then,
36:29and then a further two milligrams before bed.
36:30I also referred Rosie to the home treatment team for a review the following morning.
36:34Dr. Hernandez's statement says you didn't feel it necessary to explain the plan to Rosie yourself.
36:43No.
36:44Because the plan was simple.
36:45Did you consider Rosie might have been masking her symptoms?
36:50She was a little guarded, yes, but, um...
36:53That's why I was so keen for a further review from the home treatment team.
36:56From 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.
37:23He also said you were in a rush.
37:31Dr. McAllister had asked me to attend a mental health act assessment,
37:35so there was a team waiting 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 act assessment.
37:54No.
37:55Team were happy to wait.
37:57You reviewed Rosie in front of her husband and baby.
38:00Did you consider seeing her alone?
38:02I mean, yeah, if I had had more time, then, ideally, I would have done yes.
38:06But you weren't in a rush.
38:07No.
38:08Given the circumstances, it seemed to be the most efficient thing to do.
38:13At 2am, Dr. Asamoah 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 gagged her and bound her arms and legs.
38:26It seemed excessive.
38:26But they did that based on the extremely agitated behaviour they witnessed when you weren't there.
38:32Do you think your judgement was clouded by the version of Rosie you saw in our patients earlier?
38:35Absolutely not, because I believed that she'd had 4mg of lorazepam and 5mg of haloperidol, and 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.
38:52Did 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.
39:05But 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.
39:20An ambulance takes forever. It's a short distance.
39:23Look, 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.
39:53But 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 drugs, so if Rosie didn't take it, then that's down to her.
40:02In your 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.
40:32So, 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?
40:47No.
40:47No, are you sure?
40:48Did you have to wear special gloves?
40:54Um, right, let's go in, quickly.
40:56Is 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.
41:10He 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.
41:47Within 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.
42:05Yes, we walk patients across, but only when they've been properly risk assessed.
42:10And you don't think Dr Ford did that?
42:13Rosie Newman assaulted me.
42:15Then I had to watch her fall to her death.
42:19So no, I don't think he did.
42:27What drugs was Rosie prescribed?
42:30She had heliperidol.
42:32Um, but she kicked off again.
42:34And 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?
42:44I'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 a physiological cause.
42:58Dr Ford told me to keep Rosie in A&E until he arrived to ensure that happened.
43:02Um, so 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.
43:39Bernadette, it's important that we understand the timeline accurately.
43:48Now 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 of the hospital.
44:03What time did Dr Ford arrive?
44:13Maybe just before 3.
44:19That's almost an hour after you called him.
44:24If he'd been on time, he'd have seen for himself why the police restrained Rosie so forcefully.
44:30He could have spoken to Ed Newman.
44:31He'd have known that she was undesedated.
44:45This could all have been avoided.
44:57Why was Dr Ford so late?
45:01What is the deal?
45:03Why was he just opened that hall boy?
45:05Well, we didn't find that.
45:06What happened to our family?
45:07Did a boy go to Dr Ford?
45:08Did a boy go to Dr Ford?
45:10How did a dog go to Dr Ford?
45:11He a gon jump, and he haters side where he searches the tree.
45:13Are you Listened at the front?
45:14What do you want to hear?
45:15Well, my god was so tough.
45:15I'm so happy that I won't do it.
45:16I'm so happy that I didn't even read.
45:18The men in the morning in the morning where I killed someone at the death.
45:23Heavier.
45:24He was a jerk.
45:25Nothing was still keeps me Mark.
45:27The back is blanc.
45:28I'm so happy with Masky and blood.
45:29He was so happy that I was 만나.