Shipman's youngest victim identified as four-year-old girl murdered in hospital

Harold Shipman's youngest known victim was a four-year-old girl, killed in the 10 minutes her mother was away from her cot, having a cup of tea.

Harold Shipman's youngest known victim was a four-year-old girl, killed in the 10 minutes her mother was away from her cot, having a cup of tea.

The death of Susie Garfitt was described at the public inquiry into Shipman's crimes, which wound up yesterday. The inquiry found that he probably killed up to 15 patients in his first job as a junior doctor at Pontefract General Infirmary in West Yorkshire, taking his probable murder toll to 250. During a particularly suspicious six-month stint on a medical ward in 1972 Shipman probably roamed unmonitored in the late evening, recklessly testing the boundaries of drugs at his disposal.

Susie, a quadriplegic suffering from cerebral palsy, was desperately ill with pneumonia when her mother, Ann, met Shipman beside her cot in November, 1972. "I could see Susie was dying [and] I told the doctor to be kind," Mrs Garfitt told the inquiry. "I gave [her] a kiss and gave a little prayer for her and went out for a cup of tea."

Mrs Garfitt said Shipman seemed to suggest that medication would only prolong Susie's suffering. She had not given permission to hasten her daughter's likely death but on her return she found the child's door closed. "A nurse came out and said she was sorry but Susie had died," Mrs Garfitt said. "I was very shocked. I had not expected this."

The inquiry chairman, Dame Janet Smith, said: "Her mother did not give permission for Shipman to do anything that would speed the child's death. The mother left the room to get a cup of tea and when she returned the child was already dead. The fact that the death occurred so soon gives rise to the suspicion that Shipman somehow precipitated the death."

The inquiry said it considered three other deaths highly suspicious, though not clear cases of unlawful killing. A total of 137 deaths at Pontefract were investigated after a former student nurse, Sandra Whitehead, remembered up to three deaths a day while working with Shipman in the infirmary.

The inquiry found that in a third of the deaths Shipman was alone with the patient at the time of death, compared with only 1.6 per cent for other doctors. Of the deaths Shipman certified, 47 per cent were between 6pm and midnight, against a norm of 25 per cent, and very few (5.9 per cent) were in the early hours. Shipman ingratiated himself with his superiors to reach a position where he was, in effect, running two medical wards by 1972. He operated "when the wards were quiet, when there would be no other doctor about and when there would be a reduced level of nursing", Dame Janet concluded, in her sixth inquiry report at Manchester Town Hall. "I think, in the early days, one of Shipman's motivations may well have been a desire to experiment with drugs. I think that he was fascinated by drugs and liked to experiment with them.

"It is quite likely that some of the deaths [he] caused resulted from [this]. He may well have tried out larger than usual doses, being reckless as to the consequences for his patients who were often elderly and ill."

Though his "positive intent to kill" was less pronounced than in later years, he displayed many of the hallmarks of his time at Hyde, Greater Manchester. After the late-night death of a bus-driver, Tom Cullumbine, 54, recorded as an unlawful killing, Shipman wrote typically elaborate medical notes to cover himself. The notes also showed the young Shipman's "clear signs of irritation, even hostility" towards Mr Cullumbine, another hallmark of his later years.

Dame Janet also found that Shipman unlawfully killed John Brewster, 84 and James Rhodes, 71, in April and May 1972. Between 10 and 15 deaths at the infirmary were judged to be likely killings, and there was "some suspicion" that he may have been involved in 17 more deaths.