Inquiry to hear from nurse who told doctor to give Raychel less sodium

Raychel died after a saline drip was administered in the wake of a routine appendix operation at Altnagelvin almost 12 years ago.

Tomorrow (Tuesday, February 26) Ms Marian McGrath who was a Theatre Nurse in Altnagelvin and along with Staff Nurse Ayton, led nursing care in theatre during Raychel’s appendectomy, is scheduled to give evidence at Banbridge.

Also listed to provide evidence tomorrow is Ms Ann Noble Nurse, Ward 6, Altnagelvin, who was on duty on the Ward when Raychel was admitted on June 7, 2001

In his opening statement to the Inquiry into Hyponatraemia Related Deaths in Northern Ireland (IHRDNI), Chairman John O’Hara, stated: “The records show that Raychel was commenced on Solution No. 18 at 22:15 at an infusion rate of 80ml/hour.

“Mr Makar had initially prescribed intravenous Hartmann’s solution for Raychel in the Accident and Emergency department, but upon being informed by Staff Nurse Noble that this was inconsistent with common practice on the ward, Mr. Makar changed the fluid prescription to Solution No. 18.”

She also: “administered Paracetamol at 9.30pm on June 8” and “was responsible for providing care to Raychel including attending to her when her tonic seizures started at 3am hours on June 9.”

Last year the Sentinel reported how Raychel was given the wrong level of fluid required to treat dehydration and died from hyponatraemia - a disturbance caused by a shortage of sodium in the body - in the Royal Victoria Hospital after being treated in Altnagelvin.

It’s just over a year since Senior Counsel to the inquiry Ms Anyadike-Danes raised the question of why, just 14 months after the hyponatraemia-related death of Lucy Crawford in Fermanagh, was a surgeon’s decision to treat Raychel with a sodium-rich intravenous solution overruled due to it not being “consistent with common practice” in the Altnagelvin children’s ward and a weaker sodium mix administered instead?

Ms Anyadike-Danes explained then that the investigation will “involve the reason for and justification of the change from Hartmann’s solution that had initially been prescribed for her during her surgery to Solution No.18 that was administered to her on the ward.

“The difference between those two intravenous solutions lies largely in the level of sodium, which for Hartmann’s is 131mmol/l whilst for Solution No.18 it is 30mmol/l.”