Pulse(65)

‘You thought he might die if you waited?’ asked the coroner, looking me directly in the eye.

‘Yes, sir,’ I said.

‘But he died anyway.’

‘Yes, sir.’

It didn’t sound particularly good, even to my ears.

‘Thank you, Dr Rankin, you may step down now but please remain in the court. I may wish to recall you later.’

I went back to my seat while the coroner called the next witness, the senior county pathologist who had performed the post-mortem examination of the man’s body. His report was already on the coroner’s bench.

‘Please tell the court the cause of death,’ the coroner said after the pathologist had introduced himself.

‘Acute cocaine poisoning,’ the pathologist said confidently, ‘resulting in cardiac arrest.’

‘Did the administration of adenosine at Cheltenham Hospital have any effect on his death?’ the coroner asked.

I held my breath.

‘I very much doubt it. I suppose it might have hastened it a fraction – by a few minutes, that’s all. And if the patient had indeed been suffering from simple supraventricular tachycardia, the adenosine might have saved him. In my opinion it was a risk worth taking.’

The coroner was looking at me and saw me sigh in relief.

‘And was the absence of a specialist cardiologist at the hospital a factor?’

‘No, sir,’ said the pathologist. ‘The amount of cocaine in the brain tissue was incompatible with life. In fact, I’m surprised he lived as long as he did.’

The coroner wrote something in his notebook then looked up at the pathologist. ‘Have you seen the report from the police forensic laboratory concerning the whisky bottle found in the waste bin in the gentlemen’s lavatory?’

‘Yes, sir,’ replied the pathologist. ‘I have. The concentration of cocaine found in the residue would be consistent with it being the source of the drug in the cadaver. Only a single teaspoonful of the liquid ingested orally would have been sufficient to cause death. Analysis of stomach contents was compatible with the deceased having consumed such a lethal dose.’

‘Thank you, doctor,’ the coroner said.

‘What?’ had now been covered.

The last witness was the junior doctor who had certified the death, the doctor that I had shouted at, and the doctor who had made the initial complaint against me. I looked at him with contempt as he made his way to the witness box. What more was I now going to have to suffer from his mouth?

No wonder the coroner had told me to remain.

But, much to my surprise, the doctor restricted himself solely to the ‘Where?’ and ‘When?’, referring only to the facts recorded on the man’s medical records indicating at what exact time and place life had ceased and the patient had been declared dead.

‘And were you present at that point?’ the coroner asked.

‘Yes, sir, I was. I had been leading efforts to resuscitate the patient for the preceding hour but without any success. It was me who called a halt to those efforts.’

‘Was Dr Rankin not present as well?’

‘No, sir. Dr Rankin was dealing with a young woman who had been seriously injured in a motorcycle accident.’

‘Was it usual for a seriously ill patient to be left unsupervised by a consultant?’

The junior doctor glanced briefly across the courtroom at me.

‘Dr Rankin was busy saving the life of another patient.’

‘I asked you if it was usual,’ the coroner said.

‘No, sir, not usual, but certainly not unique.’

The coroner made some more notes.

‘Thank you, doctor,’ he said. ‘You may step down.’

The junior doctor left the witness box and walked back to his place at the back of the court, seemingly taking extra care not to look in my direction.

There was a lengthy silence as the coroner wrote some more in his notebook.

‘Ladies and gentlemen,’ he said eventually, ‘I am satisfied as to the identification of the deceased as Rahul Kumar, citizen of the Republic of India. I am also satisfied that the direct cause of death was acute cocaine poisoning as a result of consuming contaminated whisky. There may be speculation that the death of Mr Kumar was due to suicide but I am unable to come to that determination. In spite of him being found unconscious in a self-locked cubicle, and the existence of his fingerprints on a duty-free whisky bottle in which cocaine was found in extreme concentration, there is no evidence that Mr Kumar intended to consume a dose sufficient to end his own life. Therefore it is the conclusion of this court that the death of Rahul Kumar was due to misadventure.’

There was a slight murmur in the courtroom but the coroner wasn’t quite finished.

‘Furthermore,’ he said, ‘I will be writing to the Secretary of State for Health asking for clarification on some of the processes in our hospitals.’

Good luck with that, I thought. Doctors had been trying to get that sort of clarification from the Health Secretary for decades.

‘All stand,’ shouted the usher.

The coroner stood up as well, bowed towards us, and then departed.

‘Misadventure,’ said DS Merryweather, turning to me. ‘I’m happy with that.’

I wasn’t. Misadventure implied that Rahul Kumar’s death had been unintentional – an accident or mishap brought on by his own actions.