Kavanagh QC (1995) s03e02 Episode Script

Blood Money

1 (Beeping) FEMALE SURGEON: Clamp.
Drain.
Dram (Hiss of compressed air) BP's holding steady.
Jammy beggar.
Looks like he's turned the corner.
More than he managed to do earlier.
(Laughs) Yes.
Shame about the motor.
- Steering column snapped on his chest.
- (Groans) (Beeping) - Hello? - David, I'm a bit pushed for time.
I'll be along as soon as I can.
Do the closure on your own.
OK? Mm-hm.
They've said they'll call down.
Please.
It's Reception again.
Any news for Mrs Meadows? Uh-huh.
OK, I'll tell her.
Everything went fine.
You'll be able to see him in a while.
(Sighs) Thank you.
Lisa, I'm really sorry.
I'm just leaving now.
Tell the kids I'll be there in ten minutes.
OK? (Beeping) (Groans) One, two, three, four, five.
One, two, three, four, five.
Any output? - No - One, two, three, four, five.
Anything? - No.
- One, two, three, four, five.
Anything? - No.
- OK.
Charge again.
360 joules.
Ready.
Stand clear.
(Beep) - And again.
Charge.
- Ready - Stand clear.
(Beep) - What happened? - One last time.
Charge.
- Ready - Stand clear.
(Beep) He died.
(Continuous beep) TANNOY: We have an open day to raise funds for our dialysis unit next Saturday.
Could you tell me where Mrs Meadows is? - Yes.
It's the lady there.
- Thank you.
- Mrs Meadows? - Yes.
I'm Hilary Jameson.
I operated on your husband.
Well, he he is going to be all right? I'm so sorry.
I'm afraid he's dead.
Dead? He had a heart attack.
(Gasps) Oh, damn you! (Sobs) When you've finished that, Gary, there's 30 quid on your desk.
Go and fetch a bottle of champagne.
It's Mr Foxcott's birthday.
30 quid! How many bottles do you want? Here, this one's Mr Aldermarten.
Which one's he again? He's a tall bloke.
Talks a bit like Prince Charles.
Oh, him! Er buckets of aftershave.
Fancies himself.
Yeah, that's him.
Mind you don't let the other governors hear you talking about him like that.
Hello.
sir.
How did you get on? Not guilty on all counts.
What did he do, bung the jury? They saw the light.
My client is a God-fearing man.
He runs the only Baptist massage parlour in Birmingham.
Don't say it's rent time again? Afraid so, sir.
Oh, something else to cheer you up.
Mr Aldermarten got the brief for the hospital in the Meadows case.
Oh, might be in with a chance, then! - (Laughs) - Helen? Tom, are you responsible for Mr Levison waiting 20 minutes in a room full of drug-pushers? He's the director of a merchant bank.
Should have felt at home, then.
Just don't let it happen again.
OK? I have to be blunt, Mrs Meadows.
There's not a lot here to found an action for negligence.
The hospital pathologist is adamant your husband died from a heart attack after the operation.
It's not uncommon.
And the coroner agreed.
I can't honestly see a judge disagreeing The coroner made his mind up before the inquest even began.
My husband had an air bubble lodged in his heart.
But it didn't show up at the postmortem, did it? Dr Clarke saw it.
Haven't you read his report? Our expert witness, and he's quite adamant.
If the surgeon had found the embolism when she operated on Mr Meadows' heart, she might have saved him.
But your expert witness didn't manage to convince the coroner, did he? I have to agree with Mrs Meadows about the inquest.
No-one has told the truth from the outset.
Not the hospital, not the sturgeon.
the pathologist What made you think the sturgeon was negligent, Mrs Meadows? I know she was.
You should have seen her face.
So, it was just an instinct? Nick's heart was fine.
He had a full insurance medical two weeks before he died.
He was obsessed with his health.
She must have made a mistake.
He was in a car crash.
Look when I arrived at the hospital, I saw Miss Jameson leaving hurriedly.
Then they told me that Nick had survived the operation.
I was waiting to go and see him.
And she came running back.
Now, I didn't know who she was at the time.
But I could see that she was upset.
Then ten minutes later she reappeared and told me that Nick was dead.
Even then I could tell that that woman felt sick with guilt.
Have you any idea what this action could cost you? Emotionally as well as financially.
Oh, money's not an issue.
Mrs Meadows understands the risks of litigation.
Are you taking this case or not? That's entirely up to you.
Well.
look I think I'd better go and look elsewhere.
Your dauntless reputation is obviously overstated.
Mrs Meadows I’ve given you my opinion.
If you really want to pursue this, I'll help you in any way I can.
I'm only asking for justice, Mr Kavanagh.
Not miracles.
Sometimes they amount to the same thing.
EALAND: I'll join you in a minute, Sarah.
She does know what she's doing, James.
Yes.
Yes, we could take them for one and a half, two million, couldn't we? It's a once-in-a-decade case, James.
It's a plum.
- Have they made you an offer? - Nickels and dimes.
Oh? I thought money wasn't the issue.
- It happened in a Byzantine church.
- Byzantine? Thank you.
How delicious.
Istanbul.
Well, Istanbul was the last The defence cuts were going to catch me out sooner or later, sol decided to jump ship and look for excitement elsewhere.
I shouldn't bank on getting much round here.
(General conversation) So Hello, Peter.
Happy Birthday.
Oh, thank you, Helen.
Oh, how kind.
Hello, Charles.
You're settling in fine, I see.
It's such an attractive environment.
Can you devil a brief for me? I'm up to my neck.
You know about charter-parties? I've been to a few.
Well, it's a bit tricky, but it's serious money.
I'll bring you the papers.
What do you know about shipping law? It beats Bow Street Magistrates.
(Laughter) Charles! Charles, my boy.
You wouldn't look up some cases for me, would you? You see, my briefs just come in for tomorrow, and I'm in a pickle.
I'm busy, I'm afraid.
Alex is at a loose end.
But he's usually so keen.
Da-da! Oh, how's your new acolyte, Tom? Gary? Oh.
Yeah, getting the corners knocked off him.
I think he'll turn out all right.
His dad's a clerk up at Lincoln's Inn.
Actually, I sent him out to get you something.
There really was no need.
(Laughs) Hey-~ Asti spumante.
How kind.
Oh, nice one, Gary.
Plenty to go round.
(Laughing) (Phone rings) - Hilary? - Hello.
Could we have a word tomorrow morning about the Meadows case? I'm in theatre all day.
It'll have to wait.
Stop that! Sorry.
It's all right.
We've got you covered.
I'll see you at ten o'clock.
Right.
(Children laughing and splashing) Hilary's one of our best.
I hope to God we don't have to lose her.
It's not a question of that, surely? We can hardly renew her contract if she's found negligent.
And if we were to lose, there may not be an intensive-care unit for her patients, anyway.
I beg your pardon? Four-million-pound overspend already this year.
I've deliberately been putting off the tough decisions but this case could force my hand.
Why haven't you told the trustees? That's what I'm doing now.
I understand Sarah Meadows is a friend of yours.
Vaguely.
Our husbands were.
I can't believe she'd want to jeopardise lives.
I don't think she's capable of rational thought.
She's on a crusade, Colin.
I suppose I could have a word.
If you would.
Still on the hod? Get your filthy boots off my furniture! You look like a Cairo navvy.
I'm surprised you haven't put him in a tin bath in front of the fire.
Well, we can't have him skiving all through the summer, can we? There'll be enough of that at university.
If he gets the grades.
Of course he will.
You're more uptight about it than he is.
I am actually here, you know.
Have a seat.
What have I done? Exceeded my soap ration? Not this week.
It looks like we're going to trial, Hilary.
You know what that'll mean for patient care if it goes pear-shaped? Got to be watertight on this.
We'd like you to look again at your statement.
We exchange with the other side tomorrow.
Your evidence is fine.
But if there's anything else we ought to know this is your last chance.
No.
I think I did everything I could.
Don't look so worried.
We stand or fall together on this one.
ALDERMARTIN: Mr Jellicoe.
Miss Jameson.
Mr Beenier.
Jeremy Aldermarten.
Come this way, please.
After you.
He may have the edge on charm, sir, but you've got it where it counts.
Right.
80.
now.
just to make it perfectly.
Perfectly clear you assumed from the outset that the patient had died of a heart attack? Yes.
I had no reason to think otherwise.
But the plaintiffs expert says that death was caused by an air bubble.
Yes, I know.
He was at the inquest.
He says that the the right ventricle was badly swollen.
I didn't see anything like that.
Now, are you sure? Well, as far as I can be.
The heart looked fine.
No, you see, it's it's vital that you try to remember exactly what you saw.
Was the heart swollen? Yes or no? Not that I noticed.
You see.
it's imperative that that er you keep your remarks absolutely clear.
Just try to stick to "yes" and "no".
Perhaps if Miss Jameson had a moment to read Dr Clarke's report Thank you.
Think she'll be able to cope with a cross-examination? She'll be fine.
Just needs a bit of careful handling.
She needs to know her answers backwards.
Dr Cazalet, too.
Don't worry about him.
Solid as a rock.
Now, I seem to erm I don't seem to have a statement from the anaesthetist.
I'm afraid we lost him a few weeks ago.
- Heart attack.
in fact.
- Oh, dear.
One last thing.
We thought this might interest you.
Slipped through the net on disclosure.
Ealand's articled clerk must have been careless with the photocopying.
A letter from the plaintiffs solicitors to Dr Clarke.
Their expert witness.
Oh, how nice.
How fortunate.
(Chuckles) Now, you realise, of course.
This is a privileged document.
I can't possibly Lise this in evidence.
Of course, but it might give us one or two ideas.
Well l await your instructions.
(Knock at door) James Intent on ploughing on with this, are you, James? I mean it's wonderfully ironical, isn't it? What? You, the bleeding-heart liberal, being paid a fortune to attack the dear old NHS, while I defend its ramparts on a pittance.
It's not even your field.
Far messier game than crime, you know.
What are you after? Encouraging her to be a nuisance won't help.
My clients are prepared to give her £10,000 to go away.
And that's a final offer.
They offered twice that three months ago.
Da-da! Miss Jameson's personnel file.
Not strictly entitled to it.
But I thought you might need a head start.
So.
my first Crown Count trial.
"The Crown and Barrick.
Wounding with intent.
" Looks like you've had a coin with him.
Anything I should know? I expect you'll take it in your stride.
Here you are, Charles.
I need it by Monday.
75 an hour.
All right? Great.
Am I being paranoid, Tom, or are all my cases going to Charles Beaufort? Mr Barrick, for example.
I've already had a conference with him at Brixton.
Oh, yeah, nasty piece of work, miss.
Oh, don't tell me.
They wanted a man? Something like that, yeah.
So, my three years' experience didn't come into it? Well, I think they're just giving him a try-out, you know.
Here.
How about a nice drink-driving in Cambervvell? If you think I'm up to it.
Prima Donna.
Postoperative heart failure was the most likely explanation, though, wasn't it? Hospital pathologists usually go for the obvious.
They don't have time for detail.
But your conclusion rests on er "pink froth in the artery"? Dr Salmon noted it in the initial postmortem.
He obviously didn't know what to make of it.
But with the swollen heart, it only leads to one conclusion.
Presumably.
the body was not exactly in er pristine condition by the time you saw it? It had decomposed a little.
but the heart was still quite well preserved.
I can be very precise about its dimensions.
You can see from the photographs.
You told me he had the heart of a healthy man.
Yes, it was remarkably good for his age.
And he shouldn't have died, should he? Now, I'm certain his death was caused by Miss Jameson's negligence, yes.
Well, thank you, Dr Clarke.
I think that's all I need for the moment.
See you all at court.
Mr Kavanagh You think I'm just being vindictive, don't you? If you had known my husband, you might think differently.
He was a whirlwind.
You met him and you couldn't help but be swept along.
For it all to be taken away feels like he's been murdered.
Sarah Sarah, anything you need, just call, OK? Thanks, Tim.
Pamela! I was just passing.
Well, how nice! Do some in.
Nick never suggested you get involved in the business? Oh, me, in the computer business? He wouldn't even let me stay on as his secretary after we married.
I might be able to find you something.
There's a real need for sensible school governors.
Maybe.
You mustn't get depressed, Sarah.
It tends to be unavoidable when You must have someone close you can talk to? (Clock chimes) People keep telling me how much I've got to be grateful for.
As if Nick's money were all that mattered.
- I don't know how you're coping.
- Oh Not with running a court case, as well.
Lawyers can be so manipulative.
You must be a bit of a catch for them.
Please! We've worked so hard to keep going, on such slender resources.
We can barely afford to keep our intensive-care unit open.
Your court case could send it over the edge.
I'm sure that's not what you want.
I think you've said enough.
I have to tell you as a friend.
Sarah I hate seeing you taken advantage of.
(Groans angrily) Hi.
How's it going? Oh, it's coming along.
Good.
So, tell me, Charles.
What do you make of this place? As an outsider coming in.
It has a certain Edwardian charm.
Oh, yeah.
It's full of pompous old common lawyers.
HELEN: I could be making serious money if I could just get my commercial practice properly off the ground.
I need the backup.
The problem is getting the right silks.
Kavanagh's a great advocate, but he's happiest in the Old Bailey.
BEAUFORT: Jeremy Aldermartin seems a good chap.
Oh, yeah, he's all right at what he does.
Typical Temple.
Pretty average, really.
Foxcott? He's a bit of an old fart.
Don't you think? He's going to be on the Bench soon, anyway.
- Man? - Hello, love.
(Sighs) Hi.
It's half past seven.
The A-level results came out at lunch time.
- Well, he's probably with his mates.
- Why hasn't he phoned? Well, give him a chance.
(Door opens) - Matt? Well? Matt, are you all right? Leave me alone.
(Kavanagh clears throat) Two Es and an N.
(Exhales) Come on, mate.
It's not the end of the world.
You can take them again.
You shouldn't waste your money.
You did your best.
Why don't you say what you think for once? Maybe you don't know what to say.
You've never failed at anything.
ALDERMARTEN: The ingratitude! You know, Helen was damn lucky we took her on at all.
KAVANAGH: I seem to remember you were very keen.
Ever since she's arrived in chambers, she's done nothing but sow poison.
KAVANAGH: Do what I do - steer clear.
She's been conspiring, James.
I overheard her with the new boy.
- Charles? - Yes.
She was inviting him to join some sort of clandestine ring she's organising.
A sneaky little faction to keep all the best work for themselves.
And she wasn't planning on including you? Come on I mean, that's hardly the point, James.
I mean, chambers is you know.
I mean, it's a family.
There's got to be trust.
- What do you expect me to do about it? - Well, I want you to talk to her.
You're closer to her than Peter or me.
Well, and you're the only one she doesn't regard as a toffee-nosed twit.
You said it.
TV: The picture's faded: I'm still the same Still torturing yourself with Clarke's report? I'd give it a rest.
It's all bullshit, anyway.
Maybe I did overlook something.
A ruptured lung? You would have said something.
If you thought there was anything I hadn't done? Of course! Hey.
(Beeping) - Thanks.
KAVANAGH: He died at 5:43.
She was dictating her notes before twenty past.
Dr Cazalet says that Meadows didn't arrest until half past.
But he doesn't even mention Miss Jameson being there.
Sarah Meadows was right.
She left before him.
Now, why would a surgeon leave before an operation was over? (Switches off TV) The main surgeon doesn't always open and close.
Depends how busy they are.
You'd have to have a pretty good reason to make yourself scarce halfway through.
Why doesn't Cazalet mention it? This is the wicked witch, is it? Cambridge University.
First-class degree.
King's College Hospital.
Passed with honours.
Moorfield prize for surgery.
I suppose you're going to have to put a stop to this promising career.
No-one seems to have a word against her, except you.
It's not like she's committed a crime.
It's to do with money, isn't it? Matt What's your problem, Matt? Everyone says I'm going to be OK because of you, Dad.
Look at what you're doing.
Wrecking people's lives.
ALDERMARTEN: Miss Jameson - Morning, Hilary.
- Morning.
- Miss Jameson.
- Come.
She's going to drag me through the mud, isn't she? It'll be fine.
Just try to relax.
You're in safe hands.
Honestly.
Trust me.
Sarah James (Mouths) You still fancy your chances, do you, James? What's this? A last-minute offer? No.
In fact.
I've been told in no uncertain terms to box on.
Actually.
I thought you might have some news for me I can't believe your client wants to go through with this.
Oh, that's up to her, isn't it? Well, surely a man of your wit and authority can exert some influence.
Only, I mean, you're a dear friend, James, and and l mean we're not going to pull any punches.
And I'd hate to make you look an arse.
I really would.
Your Lordship will see from the statement of claim that the plaintiff alleges that Hilary Jameson and her employers.
The Southbrook Hospital Trust.
Were negligent in failing to detect an air embolism.
A simple issue.
Let's press on with the evidence, shall we, Mr Kavanagh? As Your Lordship pleases.
Where did the accident happen? Well, it it was about a mile from home.
Erm the police said that he just went too quickly round a bend and lost control.
What time did you arrive at the hospital? It was after five.
They phoned me at home.
He was in surgery by the time I got there.
What did they say about his condition? Well, I'd only been there a few minutes, and a girl from the reception called the theatre.
and they said everything was fine.
And then about ten minutes later, she came.
And she said he was dead.
Did Miss Jameson say how he died? Of a heart attack.
I knew from her manner that something wasn't right.
Anyway, his heart was fine.
Did you go and see your husband? I I didn't want to believe it.
I I just sat and cried.
I asked to see him later in the evening.
But they'd a! ready taken him away.
For postmortem? Yes.
Mrs Meadows, would you say that you and your late husband were a loving couple? Yes, very.
So, the sudden and traumatic end to over 30 years of marriage must have been very harrowing.
Yes.
At least he left you well provided for, didn't he? What's that got to do with it? It tells us that you didn't have a financial motive for prosecuting this action.
I suggest you brought this case to salve your own conscience.
My lord, this isn't the Central Criminal Court.
My client is here because she has evidence of negligence.
Try to keep to the point, Mr Aldermarten.
The point is very clear.
my lord.
Please turn to page 83 in your bundle.
Mrs Meadows.
These are the handwritten notes of Dr Salmon.
The hospital pathologist.
Made while examining your husbands body.
Do you see the heading Preliminary Observations? Erm yes.
Yes, all right.
Third line down.
"Recent scratch marks on right and left forearms and dorsal side of right hand.
Consistent with injury caused by fingernails.
" Do you know how these injuries were caused? No.
Did you fight with your husband? Is that why he was driving so recklessly when he left home? I don't know what you're talking about.
But you had been going through a rocky patch in your marriage.
hadn’t you? You'd even threatened to divorce him.
I don't see that this helps me very much.
It fundamentally affects the plaintiff's credibility.
my lord.
He was never at home.
not even at weekends.
You suspected him of having affairs.
You had had enough of it.
I don't know where you're getting this from.
ALDERMARTEN: Do you deny it? No.
And if you hadn't argued with your husband that day, he might still be alive.
You can't bear the guilt.
That's what this action is about isn't it? NO You may stand down, Mrs Meadows.
Are you all right? Doesn't any of this ever touch you, Mr Kavanagh? Or have years of dealing with people at their ugliest made you immune? You wouldn't want me breaking down in court, would you? They're right, of course.
He was a bastard.
A lousy, cheating.
Big-headed, philandering bastard.
He wanted to leave me, and I wouldn't let him go.
There, I've said it.
He was addicted to life, you see, and I was hopelessly addicted to him.
He'd been making a fool of me with other women for ten years.
And he's still doing it.
You've done the hardest part.
I think I'm only just beginning to see how people really think of me.
A silly, rich bitch.
Maybe they're right.
This is the only truly independent thing I've done in 30 years.
All the more reason not to give up.
Come on.
You can't throw in the towel after the first round.
We'll take the fight to them.
DR CLARKE".
The right ventricle of the head was grossly distended.
Almost to twice its normal size.
And the significance of the pink froth? It means air was mixing with blood in the heart, whipping it up into bubbles.
It was a sort of "airlock".
No blood could get through.
Finally, there would be a cardiac arrest.
Resuscitation would have been impossible.
And why would air get trapped in the heart, Dr Clarke? I can only assume a fragment of broken rib punctured a lung and allowed air into the bloodstream.
Did you locate such a rupture? The lungs had been quite damaged in the hospital's postmortem.
By the time I saw them, it wasn't possible to say.
And what can you conclude about the standard of Miss Jameson's treatment? The gross distension of the heart should have been obvious to her.
It would have been severely distressed.
If she'd acted quickly she might have saved him.
Could she have misread the symptoms in any way? Her failure even to mention the cardiac distress in her postoperative notes is quite extraordinary.
Are you implying the omissions were deliberate? To have missed or ignored those signals would have been unforgivable.
Dr Clarke your evidence is no more than emotively-worded speculation.
is it? You deliberately set out to mount an argument favourable to your client.
I try to restrict myself to facts.
Do you? All right, then.
Let's look at the facts.
You say the heart was swollen.
Yet only hours after death, the hospital pathologist could find nothing unusual about it.
Yes.
Yet that same pathologist was attentive enough to record what might to the layman seem an irrelevant detail: the presence of froth in the pulmonary artery.
DR CLARKE: He didn't put two and two together.
ALDERMARTEN: Didn't he? All right, then, would you tell the court The most common reason for the presence of froth in the blood vessels of a dead body? Well.
it can be caused as a result of bacterial activity in the early stages of decomposition Precisely.
It's caused by decomposition.
My lord, decomposition isn't the only explanation.
My learned friend is being misleading But in your report, Dr Clarke.
You note the onset of decomposition so this froth could have been found.
Whether your theory was correct or not.
Another pathologist could have reviewed exactly the same evidence and come to a completely different conclusion.
That's always a possibility.
Indeed.
And no doubt the solicitor who instructed you made it quite plain what he was looking tor? I was asked for a professional opinion.
ALDERMARTEN: One favourable to Mrs Meadows? No.
I refute that.
Do you? How interesting.
Where the blazes did you get him from? Well, he looked good on paper.
Terrific.
I thought you'd used him before.
He did all right at the inquest.
You lost the inquest.
Well, maybe this might be the moment to start talking to the other side? Well, what am I supposed to do? Appeal to the kindness of their hearts? - They're not out of the woods yet.
- Maybe I can walk on water while I'm at it! Sarah Ten out of ten, James.
You really know how to cultivate a client.
James.
A compassionate referee would step in to prevent further punishment.
You can be a smug bastard, can't you? Well yes.
The Bar Yacht Club Ball.
I can get you a half-price ticket, if you're interested.
Oh, thanks.
And if you can think of any corruptible lady solicitors who fancy a foxtrot I'll see what I can do.
Ah, miss.
Charles, is this meant to be the advice? - Yes.
- Ah.
- When you've got a moment - I'd stick to crime.
It took me three days.
Well, maybe your mind was on other things.
Miss Miss, you're six months late with the rent.
I need a cheque now.
Perhaps if you'd managed to collect some of my fees, I might be in a position to write one.
FOXCOTT.
So.
we'll call you tomorrow.
(Door slams) - Sherry James? - Yes, please.
Ms Ames seems to have developed quite a gift for upsetting people, especially Tom.
Well, she certainly speaks her mind.
We think perhaps 5 River Court isn't quite right for her, after all.
You brought her in in the first place.
- She looked good on paper.
- And in a cocktail dress.
I confess, I was swayed by rosy first impressions.
A younger, more informal chambers would suit her much better.
Somewhere with chipped mugs and pot plants.
You can't just sling someone out! Well, you were all for not letting her in.
We're a clubbable set.
One either fits in here or one doesn't.
Don't you agree? We're barristers, not Freemasons.
To be fair, she's bringing in more work than the rest of the juniors put together.
And that excuses dishonesty and scheming? She's trying to get ahead of the game.
Why not? Another thing, Peter- she considers you a bit of an old fart.
Rates you, though, James.
Then maybe it ought to be James who speaks to her? This isn't very easy.
God, it's not going to be embarrassing, is it? No.
No.
(Clears throat) I've er been asked Peter asked me to have a word with you.
Oh.
yes? It seems you've ruffled a few feathers.
Huh.
Well, if you'll tell me who these sensitive little creatures are, I can tread more carefully.
It would help if you paid your rent on time.
James, I've got no husband.
A bloody great mortgage, a kid and an ageing mother to support.
I'll pay the rent.
Look, no-one's deliberately getting at you.
You just can't afford to upset people.
You know how quickly a bad word gets round the Temple.
My- Look, I'm trying to make a successful career for myself.
So many women are in the second division of this profession.
Well, not me.
Then start doing yourself some favours.
Even if you don't like the rules, you've got to learn to play the game.
- Mrs Meadows? EALAND: What's this? Well, I haven't come to tell you you've won the pools.
I think you'd better let me see this.
What is it? It's from your husbands company.
They seem to be saying he died owing them money.
- What? - Rather a lot.
Seven million.
Hilary? I thought you'd be glad of a night off.
There's a couple of patients I want to check up on.
Nothing wrong with that, is there? They're in very capable hands.
Shouldn't you be getting back to your children? - They're with their nanny.
- I think tonight they should be with their mother.
- Hm? - She's got a hell of a tough day tomorrow.
They might be seeing a lot more of her in future.
Isn't that right? It won't come to that.
KAVANAGH: I don't think we can do anything.
We can't just let him drift.
He'll be fine in a couple of weeks.
It takes a lot of energy, being that maudlin.
Have we been negligent parents.
James? KAVANAGH: (can? see how.
Well, maybe if we'd stayed home a bit more.
Well, what more could we have given him? When I think of what I had at his age It was different for you.
No-one had any expectations.
Yes, they did.
My dad had me marked down as a sheet-metal worker.
Precisely.
But I wonder how you would have felt if that's all you'd turned out to be.
I'm sorry.
I know you're snowed under.
It's all right.
I've had enough, anyway.
I just can't stand the thought of Jeremy crowing if I let him win.
James! A bit of bad news, I'm afraid.
Erm There's no easy way to say this.
If we lose, Sarah might have problems paying our fees.
What? Well, it seems that Nick Meadows was guaranteeing his company's debts with his personal assets.
The bank's called them in.
She's a busted flush, James.
You never had any idea? He would never discuss money with me.
Working-class pride.
It's ironic, really.
Money was the one thing I always thought I could trust him with.
God knows why! I couldn't trust him with much else.
How will you manage? Well, you never know.
Someone might even give me a job.
Do they still use shorthand? Don't worry.
I don't expect you to make promises.
Do you think he knew he was in trouble? Even if he did, I don't think he would ever let the thought of defeat enter his mind.
That's what makes a man successful.
Isn't it? 80.
Dr Salmon You were left in no doubt that a postoperative heart attack was the cause of death? None at all.
The heart was beating normally throughout the operation.
That simply would not have been the case if there had been air lodged inside it.
As a hospital pathologist, you must encounter cases like this all the time? Of course.
Sometimes several a week.
JUDGE: What was your opinion of Miss Jameson 's surgery? It looked like a first-class piece of work.
Let's look at your notes, shall we, Dr Salmon? That's the date you made them, is it, the 15th May? Yes.
The day after Mr Meadows died? As I recall.
But Mrs Meadows was unable to see the body shortly after 7pm on the evening of the 14th, because it had been taken away for postmortem.
I must have looked at the body briefly on the evening of the 14th.
And again the following morning.
So, the cause of death was not immediately obvious to you? That's not what I said.
But most hospital postmortems take less than 20 minutes.
Am I right? - Broadly speaking.
- But this one took much longer.
You looked at the body the next morning, because you were worried by the pink froth and the swollen heart.
DR SALMON: No I was just being thorough.
This was obviously a sensitive case.
You were doing what my learned friend accused Dr Clarke of doing.
You were looking for the most convenient explanation.
I think River Court rivalries are best settled before a jury.
Don't you? ALDERMARTEN: When did you first become aware that something was wrong? After closure.
The anaesthetist had just left.
He'd been called away to another patient.
Mr Meadows was doing well.
Then he suddenly arrested.
- Do you know why that was? - No.
But it's not unknown with open-heart surgery.
And there was nothing you could do? Dr Cazalet and I tried cardiac massage.
So, despite your best efforts.
You failed to revive him? - Yes.
- Thank you.
Miss Linzey.
What is your own opinion of Miss Jameson? On a personal level.
She just gets on with things.
She's a bit of a stickler around theatre, but she stands up for herself against the management.
Why should she have to do that? Well.
they're always economising.
complaining about the way we use up supplies.
How many hours had she been at work? I think she and Dr Cazalet were both on a one-in-three.
She'd definitely been on call the previous night.
So, er about 17 hours? Yes.
She must have been exhausted.
She never let it show in her work.
KAVANAGH: Presumably, she was eager to "knock off" as soon as possible? No.
She's always very meticulous.
But she was dictating her notes more than ten minutes before Mr Meadows arrested.
She only left Dr Cazalet to do the closure.
KAVANAGH: So.
for the fine! stages of the operation.
The principal surgeon wasn't present.
That wasn't a problem.
Leading counsel have been known to leave their juniors in the lurch.
They seem to getaway with it.
But Miss Jameson wasn't racing off to attend another case, was she? No.
KAVANAGH: She just didn't feel like hanging around? There was a reason she had to get home.
One of her children had chickenpox.
KAVANAGH: Chickenpox? Not exactly on a par with open-heart surgery, is it? I think that's enough excitement for the day.
Count rise.
Miss Jameson I'm sorry.
I-I was only trying to help.
Hey, Matt, it's your old man.
Matt? What are you doing? I'm going to stay with Pete for a bit.
He's got a flat up in Notting Hill.
Well, what about your college applications? You might get a place.
Yeah, right.
You were taking off without telling us? Don't make a big deal out of it, Dad.
I don't need the hassle.
- Well, what's the address of this place? - I'll give you a call.
Let's go.
(Footsteps) It wasn't my fault.
I haven't told anyone.
No-one is asking you to tell an untruth.
What exactly are you asking me to do? The point is, Miss Jameson, you can only give evidence of what you saw.
Miss Linzey had her opportunity in the witness box.
Oh, best of luck, Hilary.
The operation passed off very successfully.
I was very impressed with the quality of Miss Jameson's work.
So, why do you suppose Mr Meadows suffered a heart attack? It was hardly surprising.
The blood loss put it under enormous strain.
And what more could possibly have been done to prevent it? Nothing.
He was receiving the best treatment Southbrook Hospital was capable of giving him.
From one of its best surgeons.
ALDERMARTEN: Thank you How many operations had you attended during the day Mr Meadows died? Seven, I think.
That's a gruelling shift.
You must have cursed your luck when an emergency came in.
It was just another patient.
Another challenge.
So.
you went along to theatre with the same enthusiasm and energy you had at 9am, did you? We were in good spirits, yes.
Miss Jameson was full of the joys of spring.
too, was she? I've got the message, thank you.
DR CAZALET.
It was the end of a long day.
So, there you were, in theatre.
Faced with an unconscious, middle-aged man, who'd already lost six pints of blood.
- Were you very worried about his survival? - Of course.
The situation couldn't have been more stressful, could it? The two of you.
dog-tired.
Facing a man about to expire, needing a highly dangerous operation on his main artery.
We didn't have much time to reflect.
What was your role during the operation? I was just a second pair of hands.
I did what Miss Jameson asked me to.
You were able to see the heart clearly throughout? Yes.
Did either of you notice anything unusual about it? No.
Miss Jameson was perfectly happy with the patients progress.
KAVANAGH: But the man's heart was swelling up like a balloon.
It must have been very difficult to overlook that.
It appeared normal to me.
So, as far as you were concerned, everything went swimmingly, did it? Or maybe you were in such a hurry that you turned a blind eye? Miss Jameson couldn't get out of the door fast enough.
She didn't exactly leave me in the lurch.
I am perfectly capable of closing an incision.
Yes, but you shouldn't have had to, should you? I am sure she wouldn't have left if she thought there was a risk of something going wrong.
As it turned out, she made a fatal miscalculation, didn't she? That's something you'll have to ask her.
ALDERMARTEN: Apart from the torn aorta, were you aware of any other injuries sustained by Mr Meadows? He had several fractured ribs, but I didn't see any rupture to the lung or any sign of an embolism.
When I left theatre.
His heart was performing very well.
Thank you.
When you set to work on Mr Meadows, you had already been at work for 17 hours, and done seven or eight operations.
Wasn't it irresponsible of you to operate in that condition? Exhaustion becomes a way of life.
Especially for a single parent.
So, you had no misgivings about your ability to act competently? I didn't have time to have misgivings about anything.
The patient was bleeding to death.
You automatically assumed that his main problem was loss of blood? He was in shock.
We were squeezing blood into him as fast as it would go.
The truth is.
You put everything down to that tear, and when things still weren't right after you'd fixed it.
You just crossed your fingers and hoped for the best.
- Nonsense.
- All you cared about was clocking off.
I left him in a perfectly satisfactory condition.
A grossly distended heart was satisfactory? I'm telling you the truth! The blood loss alone nearly killed him.
If there had been that much air in his heart.
He'd have been dead before we saw him.
We've been over this ground before, Mr Kavanagh.
Sister Linzey says that you've had a few run-ins with the management about their economising.
Yes.
When we run low on the basics, I'm expected to account for every last item.
Waste not, want not.
Waste not or look out for your job.
I'm afraid money was often considered more important than the treatment.
Does everybody kick up a fuss like you? No.
Open your file, Miss Jameson.
Can you find your operation notes there? Yes.
So, who was with Mr Meadows in his final minutes in theatre, after you'd left? Just Dr Cazalet and Sister Linzey.
Then another doctor came to help with the resuscitation.
And from what you have told us, once air gets into the blood, death is virtually instantaneous.
More or less.
Well, then, let's see how it might have got there, shall we? We'll start with the basics.
At the end of the operation there were five tubes going into Mr Meadows' body: two drips into the arm.
A CVP fine into his neck.
Measuring the pressure in his veins.
A urinary catheter and a chest drain? Yes.
So, if a large bubble of air was to get into the bloodstream at this stage, it must have been via one of those tubes? If you accept that was the cause of death, yes.
Air couldn't have got in through the catheter, because that's connected to the bladder, isn't it? Yes.
And the chest drain is merely there to stop fluid building up.
It doesn't go into the bloodstream? No.
What about the CVP line? Did you check that? There was nothing wrong with it.
The records will show it was working normally.
That just leaves the two drips.
Did you check them after Mr Meadows died? No, I had no reason to.
Because it's not something a surgeon usually concerns herself with? It's nurses' work? Mostly, yes.
So, if either of them was faulty, and somehow letting in air.
You wouldn't have known? The chances of that are so remote Was the bag changed at all while Mr Meadows was in theatre? Yes a fresh bag was connected a few minutes before I left.
- So it wouldn't have been changed again? - No.
I remember seeing it still about a third full when I came back to theatre.
So, you are sure that the saline drip was working normally? - Yes.
- Then that just leaves the blood drip.
doesn't it? Was that set up in the same way? Yes, virtually identical.
And when was the last time the blood bag was changed? About the same time as the saline.
He'd gone through a lot of blood, hadn't he? He'd lost more than six pints.
Yes.
How long does one of these blood bags take to empty? His levels were nearly back to normal by that time.
He'd stopped bleeding.
So the flow rate was quite low.
Maybe about 20 minutes.
Can you remember how much was in the blood bag when you came back to theatre? Didn't you have to account for every last bag? Must be very expensive stuff.
blood.
Please try your best, Miss Jameson.
It had been disconnected.
I assume it must have been empty.
Assume? I think it had been put on the floor with the other empty bags.
If your timings are right.
It should have been about a third full, like the saline.
What happened with that bag, Miss Jameson? What happened to all that blood? I don't know.
I wasn't there.
KAVANAGH: Well there can't be many possibilities.
One bag and two people.
It might have been faulty.
Maybe Sister Linzey made a mistake.
I'm sure that's easily done when you're tired.
NO He was your patient.
He was ultimately your responsibility.
You must have demanded an explanation.
And what did they say? Nothing.
You were happy with that, were you? You were prepared to risk taking the blame for a slapdash nurses mistake.
It wasn't her fault! I should have been there.
How did Nicholas Meadows die, Miss Jameson? It wasn't just a heart attack, was it? One of your colleagues was to blame.
I didn't see.
I wasn't there.
But you're the only one who will tell us, aren't you? What is more important to you, Miss Jameson? A human life or your professional loyalties? Be very careful about your answer.
It's easy for them.
They don't have a man's death on their conscience.
We had been told not to waste blood.
Supplies were running low.
I didn't know what happened until last night.
Sister Linzey told me.
Dr Cazalet was in a hurry.
He was probably exhausted.
The last of the blood was hard to squeeze in.
As the bag empties, it collapses.
There's no air inside.
So the blood just runs around your fingers.
What did Dr Cazalet do.
According to Sister Linzey? He injected a syringe of air into the top of the bag, so he could force the last of the blood through.
It was crazy.
For the sake of a few drops.
I'm sure he wasn't meaning to.
He must have accidentally squeezed air into the line.
Miss Jameson did you volunteer this information to your superiors? Yes, I did.
Last night.
I was told not to say anything.
JUDGE: With regard to the first defendant.
Miss Hilary Jameson.
I am satisfied that she discharged her duty of care to the best of her professional abilities.
Despite the quite unacceptable workload imposed upon her.
I therefore find the allegation of negligence against her not proven.
However.
I find the second defendant.
The Southbrook Hospital Trust.
Liable for the gross and shameful negligence of their employee.
Dr Cazalet.
Whose actions undoubtedly caused Mr Meadows' death.
Perhaps, if others had shown the necessary moral courage, the truth could have emerged sooner.
What have you to say about damages, Mr Kavanagh? - I want to talk to you.
- Can't it wait? Your Lordship will see from the particulars of loss that the value of the dependency (Whispers) Mrs Meadows would like a word with you.
If Your Lordship could give me a moment.
Very well.
Sarah, you don't realise what you're doing.
He'll hit the roof.
As the winner, I think I'm entitled to do as I like, Tim.
I don't think you and I have ever seen this case in quite the same way.
I have made a preliminary calculation.
Shall we see if we agree? My lord, my client has just instructed me that she does not wish to pursue the claim for damages.
Only her costs.
JUDGE: This count does not exist to settle personal scores.
It is here to compensate for damage.
This almost amounts to an abuse of process.
I'm sorry.
I don't know much about the law, my lord, but I do think that both sides have damaged each other enough.
You will receive a measure of damages.
Even if they are only for one penny.
Give it to charity.
if you wish.
You will agree to an order for costs, Mr Aldermarten? At the legal-aid rate, my lord.
Count rise.
Excuse me.
I hope you can live with it.
You probably can.
If only he'd had the guts to speak up at the time.
Unforgivable.
Yes.
I had to put the hospital first.
You must understand that.
I couldn't gamble with people's lives.
You were quite prepared to sacrifice me "Sorry" would have been something.
- Thank you.
- Goodbye, Sarah.
James.
Ah Oh, I'm sorry! (Laughs) I never believed I'm not sure how I'm meant to react.
I just want to say how very sorry I am.
Maybe if I'd stayed, he might have No, you weren't to know.
Miss Jameson.
They will have you back at the hospital? It feels like the right time for a fresh start.
She's right.
It does.
But what? What about a doughnut across the road, for a kickoff? That sounds tempting.
but I'm not sure that I can afford to eat out.
That was an expensive gesture you made in there.
I hope you won't regret it.
Oh, it was never really about money.
That won't bring Nick back.
It was the principle.
My treat, then.
Oh! (Laughs) Ah, see the conquering hero comes! Lapsang Souchong, James? Do I detect a whiff of sour grapes? No, James, that's the tea.
It's foreign.
We still haven't resolved our little problem with Ms Ames.
No, she cut me dead this morning.
Didn't even give me the time of day.
Perhaps she was preoccupied.
She is a working mother.
If only she brought her maternal qualities into chambers.
Oh, do you mean breast-feeding in the clerks' office? I just wish she was a little more amenable.
I Good afternoon, gentlemen.
Fascinating case in the Court of Appeal yesterday.
Yes, extraordinary.
Jeremy, I have a favour to ask you.
Oh? One of my solicitors is looking for a first-class silk to appear in a three-week case in the companies' court.
I hope you don't mind - I said you might be available.
You see, he really doesn't want to have to settle for second-best.
Yes.
Yes, of course, of course.
I'd be absolutely delighted.
Oh, good.
Peter, was there something you wanted to ask? Yes, there was one matter.
No, no, no.
It wasn't that important, was it, Peter? (Frostily) No, I suppose not.
There's no need to go out of our way to create bad feeling.
KAVANAGH: That's What I admire about you.
Jeremy.
Your infinite capacity for forgiveness.
Well, I do like to think, as a senior man in chambers, one can rise above petty point-scoring.
Don't you agree, James?
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