Nurse 'switched off life support'

24 October 2010 Last updated at 19:25 ET <!-- Embedding the video player --> <!-- This is the embedded player component -->

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Nurse Violetta Aylward was captured on film accidentally switching off her patient's ventilator, leaving him brain-damaged.

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An agency nurse working for the NHS was filmed switching off her patient's life support machine by mistake.

Tetraplegic Jamie Merrett, 37, had a bedside camera set up at his home in Wiltshire, after becoming concerned about the care he was receiving.

Within days, it captured the moment Violetta Aylward switched off the ventilator, leaving him brain-damaged.

Ambition 24hours, which supplied her, said it could not comment as an internal investigation was continuing.

A confidential report by Wiltshire social services into the incident - leaked to the BBC's Inside Out programme - concluded the agency was fully aware it was required to supply a nurse with training in the use of a ventilator, but the company did not have adequate systems in place to check what training their staff had received.

Mr Merrett, from Devizes, has been cared for at home on a life-support machine since 2002 after being left paralysed from the neck downwards following a road accident.

Despite his disabilities, he was able to talk, use a wheelchair and operate a computer using voice-activated technology.

His sister Karren Reynolds said he had become increasingly worried about serious errors involving nurses operating his ventilator, but claimed that health bosses did not act on e-mails of concern which he sent them.

In January 2009, he arranged to have a camera installed in his room. A few days later, the ventilator was switched off.

After 21 minutes, the machine was eventually restarted by paramedics but by then Mr Merrett had suffered serious brain damage.

Legal action

Ms Reynolds, who is considering legal action, said his level of understanding had dropped to that of a young child.

"His life is completely changed. He doesn't have a life now," she said.

"He has an existence but it's nowhere near what it was before. He is very brain damaged compared to what he was before. He was a highly intelligent man and you could have long in-depth conversations with him and now it tends to be more simplistic."

The solicitor acting for Mr Merrett, Seamus Edney of SJ Edney in Swindon, said: "In my experience, this is the worst case of negligence on the part of a nurse.

"No-one has come forward to make any admission, so now almost two years after the event we are trying to get someone to admit liability for what has happened."

The NHS Wiltshire Primary Care Trust said in a statement: "[We have] put in place a series of actions to ensure that such an event will not occur again either for this patient or others. The incident is the subject of likely litigation so the PCT is restricted in what further it may say in public."

Ms Aylward has been suspended while the incident is investigated by the Nursing and Midwifery Council.

Their guidelines say a nurse should work within their level of competence and have the skills to undertake whatever care they are delivering.

Ms Aylward, who is from Reading, has not responded to requests for an interview.

The programme will be shown on Inside Out West and Inside Out South on BBC One at 1930 BST on Monday 25 October.

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Women &#39;miss father health clues&#39;

24 October 2010 Last updated at 19:01 ET

Women at risk of breast cancer miss out on tests and early diagnosis because their father's family's health history is disregarded, a study has suggested.

Canadian researchers say in Lancet Oncology that women were more likely to report a history of the disease on their mother's side.

They found women with a maternal cancer history were five times more likely to be referred by family doctors.

A UK cancer charity said a father's history was "often overlooked".

It is thought that between 5% and 10% of breast and ovarian cancers are the result of a genetic inheritance.

This is equally likely to have come from either the father or mother.

A significant chunk of this genetic risk is known to come from defects on either the BRCA1 or BRCA2 genes, which make it much more likely that a woman will develop breast or ovarian cancer in her lifetime.

If a woman has a strong family history of breast cancer, she can be referred for further testing to see if she has a known gene defect.

She can then take steps to reduce the risk, or simply get checked more regularly to catch the cancer early.

'Sometimes overlooked'

The Lancet Oncology research, led by Jeanna McCuaig from the Princess Margaret Hospital in Toronto, found that despite the equal chance of inheritance from mother or father, the maternal history seemed to be taken more seriously.

They looked at records from their own clinic, and found the difference in referral rates.

Continue reading the main story

"Start Quote

It's important to know that faulty genes can be inherited from the father, as well as the mother. "

End Quote Dr Caitlin Palframan Breakthrough Breast Cancer

They concluded that there were two reasons for this - a lack of knowledge in women about the risks, and a similar problem among family doctors, who did not ask women about the history of breast cancer on their father's side.

She wrote: "Anecdotally, we know of two patients - a man with a substantial history of breast and ovarian cancer, and a woman with a known BRCA2 gene mutation in her paternal family - who were both falsely reassured by their healthcare providers that this history did not increase their, or their daughters' cancer risks.

"The patients were not offered genetic assessment and testing or the appropriate medical options"

The charity Breakthrough Breast Cancer said similar problems could occur in the UK.

Dr Caitlin Palframan, policy manager, said: "We know that a family history on the father's side is sometimes overlooked as a risk factor for breast cancer, but it's important to know that faulty genes can be inherited from the father, as well as the mother.

"However, this is unusual as only around one in 20 of all breast cancers are due to inherited faults in known genes.

"A family history means having an unusually high number of close relatives with breast cancer on one side of the family."

She urged anyone concerned about breast cancer cases in their family history to speak to their doctor.

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Bitter tastes &#39;could ease asthma&#39;

24 October 2010 Last updated at 14:39 ET

The discovery of "taste receptors" in the lungs rather than on the tongue could point the way to new medicines for asthma, it is suggested.

Experiments in mice revealed that bombarding the receptors with bitter-tasting compounds helped open the airways, which could ease breathing.

The University of Maryland study, published in Nature Medicine, may have implications for other lung diseases.

Asthma UK warned that any new drug would not arrive for some time.

The "taste receptors" discovered in the smooth muscle of the lungs are not the same as those clustered in taste buds in the mouth.

They do not send signals to the brain, and yet, when exposed to bitter substances, they still respond.

Continue reading the main story

"Start Quote

This approach could potentially pave the way for a new range of asthma treatments based on bitter substances. "

End Quote Leanne Metcalf Asthma UK

It was the nature of that response that surprised researchers, who assumed their presence was as a defence against noxious gases, triggering a tightening of the airways and coughing.

In fact, the mouse experiments revealed that exactly the reverse was true.

Protective response

When airway tissue from mice was treated with bitter substances, then exposed to allergens, there appeared to be a protective response.

Dr Stephen Liggett, leading the research, said: "They all opened the airway more profoundly than any known drug that we have for the treatment of asthma or chronic obstructive pulmonary disease."

In asthma, and other lung diseases, the smooth muscle lining the airway contracts, narrowing it, and drugs such as salbutamol help relax and open it, restoring normal breathing.

Dr Liggett said that an inhaler based on bitter substances such as quinine or even saccharine, which has a bitter after-taste, could "replace or enhance" current treatment.

He warned that simply eating bitter foods would not help protect from or relieve an asthma attack.

Dr Yassine Amrani, an asthma researcher at the University of Leicester, said the research was very "encouraging", potentially offering a new target for treatment.

He said future studies could focus on trying to reproduce the effect in human as well as mouse airway tissues, and making sure that the substances did not produce unwanted side effects such as inflammation.

He said: "The concept of having bitter taste receptors in the smooth muscle of the airways is a new one, and activating this receptor could offer a new way to relax them."

Leanne Metcalf, director of research at Asthma UK said that a significant number of the 5.4m asthmatics in the UK did not control their symptoms using existing drugs, and that research into new, more effective treatments, was "vital".

She said: "The effectiveness of bitter substances at overcoming the airway narrowing that causes asthma symptoms has so far only been tested in mice, however this somewhat surprising approach does make sense in terms of what we already know about the cell signalling processes involved in asthma.

"With further in-depth research, this approach could potentially pave the way for a new range of asthma treatments based on bitter substances which could either supplement or replace existing asthma treatments but if this were possible, it would be a long way into the future."

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