A coroner ruled yesterday that a seventeenth patient of Harold Shipman was killedunlawfully.

A coroner ruled yesterday that a seventeenth patient of Harold Shipman was killedunlawfully.

The outcome of the inquest on Alice Kitchen - the second to be held in the light of Shipman's conviction on 15 counts of murder - was the same as that on Sarah Ashworth earlier this month. The Tameside coroner, John Pollard, who is not empowered to attribute blame or distinguish between murder and manslaughter in such cases, did little to veil his opinion of Shipman.

He commented on evidence that the former GP left a note on the mantelpiece indicating that Mrs Kitchen, who was 70, had had a stroke and should be taken by relatives to hospital. "That I find incredible and I use the word accurately," he said. "I find it unbelievable that a doctor who finds a patient has had a stroke would not summonsan ambulance to take her to hospital."

Shipman failed for a second time to appear on a video link between the court and his cell at Frankland Prison.

Philomena Bardsley, Mrs Kitchen's daughter, broke down as she told how she confronted Shipman over why he had not called an ambulance. "He said 'I think she knew her time had come'," Ms Bardsley said. Shipman told Mrs Kitchen's son Michael that her death was "a blessing", as she would have been confined to a wheelchair by her stroke. There was no need for a post-mortem examination nor police involvement, Shipman said.

Mr Kitchen found his mother's body on a sofa (not, he noted, her favourite chair) when on 17 June 1994 he returned from work to the home they shared. As he waited for an ambulance, he found Shipman's note. He could not read the writing and needed paramedics to decipher it and tell him that Mrs Kitchen had died of a stroke.

Mr Pollard found 15 marked resemblances between Mrs Kitchen's death and those that formed the prosecution's case at Preston Crown Court, where Shipman was convicted inJanuary.

To disregard these similar facts would be "an affront to common sense", the coroner said. After considering evidence given by Detective Superintendent Bernard Postles and forensic tests which showed that morphine was probably present in Mrs Kitchen's body, Mr Pollard added: "It is more likely she did not die from natural causes. Beyond any reasonable doubt, Alice Kitchen was unlawfully killed."

Because Mrs Kitchen had had an operation several weeks before her death, her surgeon and anaesthetist would have investigated her health and found any obvious signs of the heart trouble that Shipman said killed her, the coroner said.

As they left Tameside magistrates' court in Ashton-under-Lyne, Greater Manchester, yesterday the Kitchen family declined to comment.

Their legal representative, Daniel Simons, said: "On that day [of her death] they thanked Dr Shipman and they have no doubt that their mother would have been smiling at him, thanking him too. Today's verdict has confirmed suspicions they had from the outset. They now have a degree of satisfaction and they now have to come to terms with their grief. They have had their day in court... and they all hope that in the weeks to come the other families of Dr Shipman's alleged victims will also get their day in court."

Another 24 inquests are to be held on former Shipman patients. The next, on Elizabeth Mellor, who died aged 75, is next month.