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Article 11. Capital planning, the coroner, and there is a transit van in your resuscitation room
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  1. Correspondence to:
 Mr J Wardrope, Department of Accident and Emergency Medicine, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK;
 Jim.Wardrope{at}sth.nhs.uk
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Wardrope J, McCormick S, Dorries C
Article 11. Capital planning, the coroner, and there is a transit van in your resuscitation room

Publication history

  • First published November 1, 2002.
Online issue publication 
November 01, 2002
  • SIMS ARTICLE 11: INTERNET PAGES

     


    DESCRIPTION OF MAJOR INCIDENT

    October 31st 2002
    St Jude�s Accident and Emergency Department

    20.47
    It is an unusually busy night in the A&E department at St Jude�s although the majority of the cases are �minors� and the wait has never been too long. There have been a number of children in, mostly with D&V and viral URTIs but Omar Bathi is the SpR on and he is very good with the young ones. Unusually, Mr London is in the department and has also been seeing some of the little ones. He had been staying late working on the winter plans but had taken a break from management issues to get his hands dirty.

    21.00
    Philip Wales arrives to take over from Omar but before beginning work goes to discuss something with Mr London in the consultant�s office.

    21.02
    Lish Ash calls Omar to the nurses� station, where Andra Cork has arrived to collect her husband and bring him home from work.

    21.04
    Philip Wales and Mr London step out of the office and are stood infront of the ambulance doors finishing their conversation when they notice some head lights through the frosted glass.

    There is a loud crash and a blue Transit van smashes through the doors hitting the two doctors. It skids on the floor and hits the wall of the resus area. The wall collapses and brings down part of the ceiling above. The department is open plan and everyone, patients and staff, move in to the open to see what has happened.

    21.05
    Suddenly there is an explosion as one of the oxygen pipelines fractures and this brings down the rest of the ceiling in this part of the department. Above resus is the A&E coffee room and staff changing area, the showers of which are now pouring water in on top of the debris. A fire is still burning from the oxygen line.

    21.06
    Panic breaks out amongst the patients and there is the crying and shouting of both adults and children. Many try to escape from the back of the department in to the waiting area whilst others stand and watch.

    Philip Wales is obviously dead, the van is actually resting on top of him. He is clearly visible to all the staff. Mr London is lying unconscious, face down with a serious head injury and his legs are trapped under the Transit van. The driver of the van is still alive. He is trapped behind the wheel and is screaming in pain. A staff nurse has been hit by a piece of pipeline that was thrown out by the explosion. It has pierced her lower abdomen and she is lying on the floor sobbing. She looks very pale. It is unclear what has happened in resus. There was certainly a patient with chest pain in there and atleast one member of staff but was it was a nurse or an SHO? In any case, whoever was in there is likely to be seriously injured if not dead. A number of the people who were in the open when the explosion took place have cuts and bruises from shrapnal but none appear serious at first glance.

    Omar Bathi is relatively unscathed, he has a few minor cuts but knows in himself that he is well. Lisa Ash appears to have frozen completely. She is sat, leaning against the nurses station, motionless. It is clear that she will be of little use at this time.

    21.07
    There is a shout from inside the van and the back doors are kicked open. A young man jumps out shouting abuse and runs past the watching staff straight in to the main body of the hospital.

    There is the sound of a siren as a police car pull up and two police officers run in to the department. They had been following the stolen van covertly expecting another pharmacy ram raid. One of the police officers radios for back up and calls for the fire brigade.

    Omar Bathi reaches for a phone to call Dr York but the phone at the nurses� station isn�t working. His wife collapses at his side and tells him that she has suddenly started getting rapid, strong contractions.

    It is now 21.08



    CORRESPONDENCE

    Dear Dr York,

    Last week we were asked to repair the PC in the A&E resource room. Apparently the PC had crashed whilst a member of staff was using the Internet connection and the computer was removed to the IT department for inspection. During this inspection a number of irregularities were noted which breach the Trust�s guidelines on the use of computers and the Internet. I would particularly draw your attention to points 1-3, which are extremely serious.

    1. A number of pornographic images were found on the hard drive.
    2. Software to enable downloading from �Premium Rate� websites installed on the hard drive.
    3. Software allowing bypassing of the Trust�s normal Internet monitoring program installed on the hard drive.
    4. Various games software installed on the hard drive.
    5. Large blocks of data on the hard drive consistent with commercial music CD copying being carried out.
    6. The wording that appears as the screen saver contained a number of profanities.

    Unfortunately the password sytem for access does not allow us to establish exactly who carried out any of the activities listed. I must remind you that access to the Internet for a department is controlled centrally and can be blocked completely if abused. I would appreciate your comments on these events and any action that you plan to take to prevent any repetition. Failure to address this problem will result in removal of Internet access from the A&E computers.

    Yours

    Chip Cache

    Head of Information Technology

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