A nurse accused of the manslaughter of a seven-year-old boy at Britain's largest private children's hospital has told a court she was left 'traumatised' by his death and no longer wanted to work.
A Fatal Night in Paediatric Intensive Care
James Dwerryhouse, who had Down's syndrome and a complex medical history, was admitted to The Portland Hospital in London for routine bowel surgery on 25 August 2016. The operation was successful, but due to his sleep apnoea – a condition that made him prone to stopping breathing while asleep – he was placed in the Paediatric Intensive Care Unit (PICU) for close observation overnight.
The court heard that in the early hours of 26 August, a junior nurse, Stephen Cachero, temporarily removed James's blood saturation monitoring equipment because the child was becoming distressed and pulling at the wires. When Cachero went on a break at around 2.10am, he handed over care to Anuradha Bhupathiraju, 64, an agency nurse who was in charge of the PICU for that night shift.
Prosecutor Andrew Thomas KC said that after James fell back asleep, Bhupathiraju failed to ensure the vital monitors were reconnected. "The need for monitoring was the central reason why he had been admitted to intensive care in the first place," Mr Thomas told Southwark Crown Court. "The risk that he might stop breathing and go into cardiac arrest was the very risk that the doctors were guarding against."
'A Stark and Fatal Error'
For nearly three hours, James slept without electronic monitoring. When Cachero returned from his break just before 4am, he discovered the monitors were not attached. After several attempts to get a signal, he realised the horrifying truth: the problem was not faulty equipment, but that James had stopped breathing and had no pulse.
Although staff managed to restart his heart with CPR, the young boy had been starved of oxygen for too long, causing severe and irreversible brain damage that was deemed unsurvivable. After consultation with his family, James was transferred to a hospice near his home in Ipswich, where his life support was switched off the following day.
"It was a stark and fatal error," the prosecutor concluded.
The Nurse's Defence and Trauma
Anuradha Bhupathiraju, of Wandsworth, denies manslaughter by gross negligence. Giving evidence, she described the profound impact of the incident. "I was so traumatised by the incident, I didn't want to work in my place, or in any place," she told the jury.
She explained that she had initially declined the agency shift at the Portland Hospital but eventually agreed. "I made a choice, I say yes to everything," she said. Bhupathiraju, who grew up in India and came to the UK in 2000, also spoke of the pressure she felt working as an agency nurse in unfamiliar environments.
Under questioning from her defence barrister, Katie Thorne, she accepted she had given differing accounts of the events in the years since but attributed this to the "tremendous stress" she was under. When asked if this stress affected her memory, she replied, "Yes."
The nurse, who said she had never faced a single complaint in her career and regularly did unpaid charity work abroad with children, stated, "It is the first time in my life that I have had this kind of incident, an unexpected and unfortunate incident."
The trial continues.
