Patient’s death no accident - coroner

The death of Auckland woman Heather Bills was no accident, the chief coroner has confirmed – but her death largely remains a mystery.

Chief Coroner Judge Deborah Marshall released her findings into the death yesterday following an inquest in September.

Bills, 64, died in 2013 while in the care of Middlemore Hospital in South Auckland, having survived a huge fire at her O¯ ra¯ kei home six weeks earlier. It was later discovered she had suffered an irreversible brain injury after being given a massive dose of insulin on the evening of December 26, 2012. It is still not known who administered the fatal dose.

She had been rescued from the explosive blaze by neighbours and admitted to hospital with serious burns. Bills refused visitors, often expressed suicidal thoughts, and offered to pay hospital staff to end her life. But her condition began to improve and staff expected she would recover from her injuries.

On the evening of December 26, Bills became extremely unwell while still in hospital. A house surgeon admitted her to the intensive care unit. Tests revealed her blood sugar levels were ‘‘extremely low’’, which in turn was injuring her brain. It became clear the hypoglycaemic event was caused by an overdose of insulin.

Earlier coronial inquiries had tried to establish how Bills, who was not diabetic, had been given the dose. Nurses who were witnesses at the inquest gave conflicting accounts of what happened that night.

Judge Marshall’s findings were that the fatal dose of insulin was either handed to Bills or administered to her. Bills could not get out of bed to source insulin herself, and opening a vial and preparing an injection would have been beyond her abilities, Marshall found. But she may have been able to inject insulin if it was given to her.

Judge Marshall said she was satisfied Bills was administered an overdose of insulin, and that the overdose must have been administered by someone who had access to insulin and the secure National Burn Centre.

Detective Senior Sergeant Ross Ellwood told the coronial inquest that police were called to investigate Bills’ death as there ‘‘was a clear suspicion she had been injected with insulin’’.

‘‘We are looking at someone working in a hospital potentially causing the death of patients,’’ Ellwood said at the time of the inquest.

It was the only case in New Zealand of its kind, he said.

While the police had not charged anyone for administering the fatal dose, police had three suspects who worked at the hospital. Three nurses who were suspects in the police inquiry were still employed by Counties Manukau District Health Board as of September.

A spokesperson from the Counties Manukau DHB, which runs the hospital where Bills’ was given the overdose, had earlier, said it was ‘‘never advised that police had any particular concerns about the acts or omissions of any particular individual’’.

‘‘In the absence of any proof of wrongdoing, the DHB could not take action against an employee,’’ she added.

Yesterday, the spokesperson issued a statement: ‘‘The DHB is considering the coroner’s findings and what, if any, action it may need to take.’’

The criminal case remains open.