A DOCTOR who administered a lethal dose of morphine more than three times recommended levels has appeared in court.
Dr Narendra Sinha appeared before Chester Crown Court to face a charge of manslaughter by gross negligence after giving the injection to an Ellesmere Port woman while working as a locum in the town.
The charge against the GP, from Freehold Street, Fairfield, Liverpool, relates to an incident on September 14, 2001, and alleges the administering of excessive morphine to 63-year-old mother-of-three, Maureen Lyth, from Whitby, near Ellesmere Port, who subsequently died.
Mr Leighton Davies, prosecuting, told the court that Sinha, now 68, had been employed as a locum for Nestor Medical Services based in Liverpool and had been called to the house on Grappenhall Road to deal with a patient suffering from acute pain due to osteoarthritis.
Mrs Lyth's arthritis had got steadily worse over a 20 year period and her pain at the time was said to have been "immense and unbearable".
She had also had a kidney removed in the 1970s and in 1999 had a stroke, forcing her to use a wheelchair. Her remaining kidney was said to be failing.
The court heard how Mrs Lyth required 12 different kinds of medication for her range of problems and her husband John, who looked after her round the clock, kept a list of this medication prescribed by doctors at the York Road medical practice in Ellesmere Port.
Dr Sinha arrived after being called to assist, and administered a dose of 30mg of morphine for pain.
The prosecution alleges that he failed to check the list of medication held by Mr Lyth which would have given him an indication that such a dose in a person with renal problems would have been highly dangerous.
Mr Leighton Davies said: "We say that the mention by Mr Lyth to a kidney problem would have flashed a red light to a reasonably competent GP as it should have to the defendant.
"A problem with a kidney was a significant factor in deciding what treatment should have been given to Mrs Lyth to alleviate the pain she was experiencing.
"He (Mr Lyth) had a list in his hand and thought that he would look at it, but Dr Sinha gestured with his hand that he didn't want to look at it and that surprised him," said the prosecution.
It was alleged that after giving the single shot of morphine in Mrs Lyth's upper arm that Sinha waited barely a minute before leaving the house, when usual practice was to wait for around half an hour.
Dr Sinha has denied unlawful killing, but has never denied administering 30mg of morphine, and his records of his visit to the house record the amount of drug given.
"It was quite deliberately delivered to her. He didn't administer 30 mg thinking it was 10mg," said Leighton Davies.
Mrs Lyth went to sleep after the shot of morphine, but failed to wake the next day and her husband became concerned. Paramedics were called but she was pronounced dead.
An overdose of morphine was confirmed as the cause of death and police were called due to the high levels administered.
Mr Leighton Davies said the prosecution had to prove that Sinha had unlawfully killed Mrs Lyth. "The defendant in administering the lethal and large dose to this lady breached the duty of care he owed to her. His actions were careless and negligent," he said. Sinha has claimed, under interview, that he gave the high dose to Mrs Lyth as she was a large lady, around 14 1>2 stone, and a higher dose would have been the correct thing for him to do.
The trial continues.