Hospital boss knew nothing of nurse's fatal addiction
THE circumstances leading to the drug overdose death of Toowoomba nurse Katie Lee Howman have been examined in close detail.
Toowoomba Hospital general manager Dr Peter Gillies yesterday told a coronial inquest it was possible that Mrs Howman could have emptied the drug Fentanyl from a patient's syringe into a cup before replacing what was in the syringe with saline.
Mrs Howman subsequently overdosed on the drug while at work on January 13, 2010.
She was saved by her Toowoomba Hospital colleagues and after initially being stood down from work was able to return to her job later as a critical care nurse.
However, the 30-year-old died at her family's Toowoomba home on December 21, 2013, after overdosing on the same opioid.
Dr Gillies was questioned by counsel assisting the coroner Dr Anthony Marinac on the processes of administering pain relief drugs in the hospital's critical care ward.
He said the provision of drugs was closely monitored.
"It's feasible that a nurse could draw the curtains and remove some of the solution, but I anticipate that would be picked up," Dr Gillies said.
He said he was aware of anecdotes from senior staff about nurses taking drugs from patients and using them.
But he said that was very rare.
Questioning also focused on the hospital's management of Mrs Howman's employment after the 2010 overdose.
Dr Gillies said Mrs Howman was issued a show cause notice to which she responded.
The court heard Mrs Howman was a good employee with no previous issues.
Her overdose appeared to be a "one off" occurrence and she had been very remorseful and very open about what she had done.
Dr Gillies said he was unaware of Mrs Howman's opioid addiction between 2010 and her death and was unaware of any issues with her performance on her return to work.
He said her employment had continued on the assumption the overdose had been an isolated incident.
Had the hospital known about her addiction, he said, it would have changed the way in which it monitored Mrs Howman.
A review had been conducted of critical care ward patients who were under Mrs Howman's care during the time of her addiction.
No incidents were detected.
Toowoomba Hospital emergency department physician Dr Pieter Le Roux had worked with Mrs Howman on her return to work and did not suspect she was misusing drugs.
He was asked about the indicators of doctor shopping.
Dr Le Roux said Mrs Howman had consulted him on her return to work and he had prescribed strong painkillers.
He said he not known of her 2010 overdose or that she was under professional supervision.
He agreed with Dr Marinac that Mrs Howman was very clever in the approach she took to doctor shopping.
"I wouldn't be surprised if other doctors had the same issue," De Le Roux said.