Inquiry to hear from nurse who told doctor to give Raychel less sodium

THE lead theatre nurse and the nurse who ‘corrected’ an Altnagelvin doctor’s prescription of a sodium-rich intravenous solution during Raychel Ferguson’s ultimately fatal appendectomy in 2001 will appear before the Inquiry into the schoolgirl’s death tomorrow.

Raychel died after a saline drip was incorrectly administered in the wake of a routine appendix operation at Altnagelvin almost 12 years ago.

Tomorrow (Tuesday, February 26) Ms Marian McGrath who was a Theatre Nurse in Altnagelvin and along with Staff Nurse Ayton, led nursing care in theatre during Raychel’s appendectomy, is scheduled to give evidence at Banbridge.

Also listed to provide evidence tomorrow is Ms Ann Noble Nurse, Ward 6, Altnagelvin, who was on duty on the Ward when Raychel was admitted on June 7, 2001

According to the Inquiry: “She ‘corrected’ Mr Makar, a Senior House Officer, when he initially prescribed Hartmann’s solution and informed him that Solution No 18 was used on the ward.

“Mr Makar then prescribed Solution No 18. Solution No. 18 is at the heart of criticisms made of the fluid management of Raychel and three of the other children whose cases the Inquiry is investigating (Adam, Claire and Lucy) as its relatively low sodium content has been connected with the development of dilutional hyponatraemia.”

The Inquiry statement adds: “Nurse Noble reported on Raychel’s condition to the dayshift at handover on the June 8. She returned to duty and was in nurse in charge of ward 6 on the night shift on June 8 into June 9, 2001.

She also: “administered Paracetamol at 9.30pm on June 8” and “was responsible for providing care to Raychel including attending to her when her tonic seizures started at 3am hours on June 9.”

Last year the Sentinel reported how Raychel was given the wrong level of fluid required to treat dehydration and died from hyponatraemia - a disturbance caused by a shortage of sodium in the body - in the Royal Victoria Hospital after being treated in Altnagelvin.

It’s just over a year since Senior Counsel to the inquiry Ms Anyadike-Danes raised the question of why, just 14 months after the hyponatraemia-related death of Lucy Crawford in Fermanagh, was a surgeon’s decision to treat Raychel with a sodium-rich intravenous solution overruled due to it not being “consistent with common practice” in the Altnagelvin children’s ward and a weaker sodium mix administered instead?

Ms Anyadike-Danes explained then that the investigation will “involve the reason for and justification of the change from Hartmann’s solution that had initially been prescribed for her during her surgery to Solution No.18 that was administered to her on the ward.

“The difference between those two intravenous solutions lies largely in the level of sodium, which for Hartmann’s is 131mmol/l whilst for Solution No.18 it is 30mmol/l.”