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Murder charge nurse 'did not deliberately harm patients'

A report into a nurse who was charged with murdering three patients concluded today she was “not a Beverley Allitt” and suggested a “combination of individual and systems failure” were to blame.

The independent inquiry revealed a catalogue of systemic failures in the way Anne Grigg-Booth was allowed to carry out her work as a night nurse practitioner at Airedale NHS Trust.

The damning report said Grigg-Booth was “utterly convinced of her own clinical prowess” and at night “she was effectively in charge of the hospital”.

Grigg-Booth, from Nelson, Lancashire, died before she could go on trial at Bradford Crown Court. She was 52.

The charges related to her injecting patients with high doses of painkilling drugs such as morphine and diamorphine on the night shift at Airedale General Hospital near Keighley, West Yorkshire, where she worked.

After her death, detectives from West Yorkshire Police said they believed she could have killed many more patients in her 25-year career.

But today, an independent inquiry report concluded that it was unlikely that Grigg-Booth “deliberately set out to harm patients” and said the events investigated “occurred as a result of a combination of individual and systems failure”.

The report concluded that the board was wrong to think they were just dealing with a “rogue nurse” instead of systemic failure.

“The most striking failure was in the disconnection between what was happening on the wards at night, and what the board knew,” the report concluded.

Eddie Kinsella, an independent inquiry team report member, said Grigg-Booth should not be “demonised” following the publication of today’s report.

“She and other senior night nurse practitioners reasonably believed they were acting with the authority of the board as a whole. The board did not understand that,” he said.

Today, Bridget Fletcher, chief nurse at Airedale NHS Foundation Trust, said: “We would like to offer our sincere condolences to all those affected by these events.

“We hope that this final stage of the process has now fully explained the details concerning each patient, as well as the actions of Sister Grigg-Booth, other staff and the Trust at the time of the events, eight years ago.

“We are sorry for any additional distress that was caused at what was already an anxious time for relatives, having lost a family member, due to any delays in the investigation or inquiry process.

“As outlined in the report, the Trust has made significant improvements, particularly since 2005, thanks to the enormous efforts by the Trust board and staff at every level and we would like to reassure both patients and the local community that patient safety is, and always will be, our highest priority.”

Readers' comments (13)

  • An extraordinary case, but although I have read reports in a number of newspapers, none of them really explain the mechanics of how this actually happened, which would be really interesting.

    I work as a Registered Nurse supervisor in a large mental hospital in the US and am, in effect, in charge of the hospital at weekends, so in a similar position.

    However, while I do have a pharmacy key, I don't have access to intravenous narcotics like heroin (diamorphine) or even lower level controlled drugs like lorazepam, so I wonder how on earth such addictive substances could have been issued without the pharmacy keeping track of who was prescribing.

    Don't they use computers yet?

    I'm posting anonymously only because I have family members working at Airedale and don't want to embarrass them.

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  • i read the above article & anonymous articles with great interest. it's the 1st time i have come across the above case but somehow its difficult to tell what was actually happening with sketchy facts as outlined by anonymous comments above. however i am reassured that the way forward is not always blaming for all mistakes or fatalities but ensuring that thorough investigations are done & appropriate recommendations made.

    with regard to the above article, there seems to be differences between the US & my local trust policies. I am only a band 5 nurse but we keep stock of many controlled drugs esp those we use often depending on ward environment. so as long the drug is prescribed by the doctor we then use our ward stock. during the week pharmacists come to wards & review all prescriptions but not on weekend & bank holidays.

    i work in a respiratory ward and deal with many palliative COPD & Ca patients, therefore drugs like morphine, oxycontin, midazolam & diamorphine in various strengths are part of our CD stock as we regulary use syringe drivers. Nurses order stock for depleted stock but when we need high doses such as diamorphine 100mg, then we have to provide the prescription to pharmacists as well. However if i have doubts about a dose i always countercheck even with other doctors if unsure.

    furthermore lorazepam is not one of our CDs, but i agree with your comments. it seems like nurses being failed by the system which was in place.

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  • Although the article tells us little detail, I think this is very scary on a lot of different levels here.

    I think first of all it is proof that our training and CPD needs overhauling and CPD must be protected and increased.

    It is also a warning to all of us that no matter how much training and education we have, we must never become complacent in that knowledge or training.

    It is also very scary that this happened at all.

    What I find most worrying however is the statement that 'The report concluded that the board was wrong to think they were just dealing with a “rogue nurse” instead of systemic failure.' I have just been debating on another post about how Nurses are often witch hunted on the flimsiest of evidence, and the fact is our investigative and governing bodies seem to take the automatic view that we are guilty until proven innocent and assume we are all 'beverly allitt's' with the slightest complaint.

    Of course Nurses who are unfit to practice or abuse power etc should be investigated and struck off, and sometimes this happens as seems to be the case above (or would have been if she was still alive), but it is worrying that this seems to be the prevailing stance our governing body takes, even when Nurses are innocent.

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  • Specific to the above case however, I too would question how and why she was able to inject high doses of CD's into patients, especially if this was over an extended period? I don't understand that at all, perhaps because the article gives us so little specific information.

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  • nursteph

    I definitely agree that the article had given very minimal info about the real event of the story of this nurse.

    However what came to my attention is that the "murder charge nurse" is already dead and no one's gonna be blame about this but her and the hospital. They say that it is a “combination of individual and systems failure”. Yeah right. But how about if Grigg-Booth is still living? Will they ever blame and sanction the hospital? I think they will solely blame and penalize the nurse.

    Truly,
    Steph
    http://www.pulseuniform.com

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  • Abolutely they would nurssteph.

    From what little info we have on this (it does not tell us if she was a prescriber, if she was qualified to diagnose and prescribe or the conditions under which she did so, etc etc) it does seem that this Nurse was justifiably investigated (that opinion may change if other evidence comes to light).

    But what about those Nurses who are not justifiably investigated? It seems that the witchfinder generals, oops, I mean the NMC's default stance is to assume we are all rogue nurses or beverly allitts. Very scary.

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  • For those less familiar with the case, what has not been said here is that the nurse in question died as a result of "an accidental overdose of tricyclics". In short it could be said that she was depressed and took an overdose. Could this have been because she was being investigated as a potential multiple murderer (which this report suggests she was not) or could it have been the shame of being publically named as an alleged murderer? As well as the disclosure of details of the local procedures that caused these incidents perhaps we should be more generally worrying about the protection of individuals from the fall out of being named in a criminal investigation in the public domain in advance of a trial.
    I have to wonder if Mrs Griggs-Booth would still be with us today if she hadn't had to put up with the media attention.

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  • Frankly this all sounds very odd indeed as a truly professional nurse should be aware that injecting large doses of controlled drugs intravenously is always dangerous and should be done at all done with extreme caution! By saying that this nurse 'genuinely believed in her own clinical prowess 'suggests a lack of insight into her own professional role and arrogance in her abilities. However, it also sounds as if, what I would regard as routine checks on CD's, did not highlight the problem or if they were highlighted, then nothing was acted upon. CD's should be checked by two trained nurses, the patient checked and admistration witnessed as they are administered. There were clearly system failures by the Trust, but do not forget that, as Professionals, we should be accountable for our own actions. Her 'accidental' death could be to do with shame, fear, or an admission of guilt. I have to say I would feel so guilty if I did harm to patients in a negligent or murderous way once, that I don't think I could live with the consequent guilt of what I had done. I would certainly not trust myself to nurse again. It sounds as if this nurse took her own decisions many times which seem to be outside her true capabilities or professional role. Very frightening indeed.

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  • i wrote 2nd anonymous comment on this article & wish to retract most of my comments. after googling anne-grigg booth, its apparent to me that she very dangerous despite so called systemic failure. the enquiry just ddnt want to find her guilty. i quote... “She and other senior night nurse practitioners REASONABLY believed they were acting with the authority of the board as a whole.” despite documenting & not trying to hide her actions that doesnt make it right. maybe she should have browsed the code of conduct [NMC].

    Why was she prescribing, giving out IV opiates as outlined by fellow nurses above, & also not attending studies/ training? i ddnt know her but who am i to disagree with so many articles which say she bullied other nurses and doctors. Shame on other night nurse practitioners [NNPs] who refused to testify. shame on NMC who also did not bring these NNPs before panel for their shortcomings. & why this enquiry took at least 5yrs God knows.

    i have no sympathy for her name being put in papers, & wholly agree with above Anonymous 9-Jun-2010 3:17 pm that she acted beyond her competencies.

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  • Doesn't murder have to involve intent in some way? As the article goes out of its way to portray this nurse as not intending to deliberately harm her patients - surely she can't be guilty of murder.
    Any other conclusion (such as manslaughter or manslaughter by gross negligence) can only be a poor indictment on Nursing & the NHS - especially of the levels of support in them nowadays.

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  • in response to Anonymous 10-Jun-2010 1:40 pm, assume there was no intent in any way, & say innocent. but i wonder if NMC considers intent during disciplinary hearings. imagine a nurse saying i administered a lethal dose or wrong drug but my intention was to do the best for the patient. am wure there will be no hesitation in striking that nurse off. in my practice i agree i also make mistakes but then you should learn from mistakes & not repeat them esp resulting in loss of life.

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  • yangqing

    I definitely think this is somehow witch hunt for the nurse. it could happen to anyone with power to prescribe and inject. Assuming that you are guilty till prove you innocence is really scary! I wonder did this nurse's death have something to do with the 8 long years murder investigation?

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  • I am truly amazed how one hospital based nurse could be solely resposible for administering lethal doses of iv medication. Who checked the drugs with her,were staff not supposed to check the controlled drugs morning and night? Hello! this article generates more questions that it answers and i get the distinct impression that systems will be put into place but the blame is going to fall solely on her shoulders.

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