Nigel Cox, 46, rheumatology consultant at the Royal Hampshire County Hospital in Winchester, denies attempting to murder Lillian Boyes, 70, in August last year by giving her a lethal dose of potassium chloride.
Mrs Boyes, who was terminally ill with acute rheumatoid arthritis and severe complications, had asked Dr Cox and other medical staff to help her die. She refused all medication except painkillers.
Patrick Toseland, a consultant in clinical chemistry at Guy's Hospital in London, told the court that the consequence of administering undiluted potassium chloride at a rapid rate, as in this case, would certainly be fatal. Asked by Neil Butterfield QC, for the prosecution, what effect it would have on a patient in Mrs Boyes's condition, he replied: 'She'd be dead in minutes, if not seconds.'
A post-mortem examinaton was not conducted because her body was cremated before the full facts emerged. Dr Toseland said reliable measurements of potassium in the body could only be taken within 20 minutes of death.
Andrew Herxheimer, a retired senior lecturer in clinical pharmacology at Charing Cross Hospital in London, told Mr Justice Ognall that potassium chloride was administered only in cases of potassium deficiency. The drug in its undiluted form had no clinical or analgesic use. It would almost certainly cause cardiac arrest within one to two minutes if injected.
Albert Vincenti, a consultant pathologist at the Winchester hospital, said he did not notice the entry about potassium chloride in Mrs Boyes's medical notes when he signed documents releasing her body for cremation. He agreed he would have spoken to Dr Cox about the cause of death, given as broncho-pneumonia, if had he read the notes more carefully.
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