‘I could have sworn he said something, Guv – at least, about causing bother for the management.’
‘Aye, maybe – but it’s one thing destabilising the place by nicking things – topping the patients would be a bit extreme. Even I’ve ruled that one out.’
DS Leyton appears a little pained – as though he has some vested interest in his theory.
‘Thing is, Guv – it’s the surest way to stir up a media storm – patients dying because of incompetence – system failure – that kind of stuff.’
Skelgill is shaking his head.
‘Chance a murder charge to get your boss sacked, Leyton? It’d be a lot less risky to let an inmate abscond from a nature walk – hit the headlines and no one need die.’
‘Until some poor hiker refuses to share his packed lunch, Guv.’
Skelgill appears to wave away this minor complication, but in fact a bluebottle is buzzing him. He watches it fly towards the window and crack against the pane. Surprisingly unstunned, it makes more futile attempts to escape. Skelgill rises and opens the ventilation light and shepherds it out. He stands still for a few moments, perhaps considering the weather. There has been a bright dawn but already high cirrus are creating a haze and heralding the next warm front. DS Leyton clears his throat to speak.
‘But you’re not ruling out foul play, Guv?’
Skelgill turns to face him, his expression neutral.
‘Let’s see what the autopsy says.’
But DS Leyton has not yet finished mining his vein of speculation.
‘If it were, Guv – it could mean someone didn’t want him to spill the beans – that he really knew something.’
Skelgill is not open to being swayed.
‘He’d already spoken with us, Leyton – and plenty of folk saw that – it’s probably even on camera.’
‘They might have asked him what he’d said – found out it wasn’t anything too serious yet.’ (Now Skelgill has his back to Leyton and is examining his map of the Lake District that has pride of place on the wall behind his desk.) ‘He could have threatened to blackmail them.’ DS Leyton leans forwards in his chair, grimacing as his belt digs into his midriff. ‘Whatever he was – a bit loopy – he wasn’t stupid, Guv.’
Skelgill resumes his seat and inspects his cup forlornly. He adds it to his line-up of empties and then begins to insert one inside the other until he has a little tower.
‘I’ll say one thing, Leyton. It was Arthur Kerr who gave him the injection.’ Then he tosses the stack into the waste bin beside his sergeant, causing him to flinch. ‘And I did notice that when I first spoke with him about Frank Wamphray he never mentioned he was his primary nurse.’
*
‘Guv – where are you?’
Skelgill lowers his mobile and surveys his surroundings. On the shop wall in front of him is a stirring display of fishing rods, though he appears less moved by the price ticket he twiddles between the fingers of his left hand. With his right, he raises the phone.
‘In the library – in Penrith – I wanted to check out some medical point.’
DS Leyton hesitates, then inhales and speaks.
‘You might not need to, Guv – the autopsy report’s just come through – I’ve got it on the screen now.’
‘What does it say?’
‘It was a heart attack, right enough – sudden cardiac arrest caused by an excess of adrenaline in the bloodstream – that’s natural ain’t it, Guv?’
Skelgill has lowered the handset and is again staring at the array of carbon fibre shafts regimented before his eyes – but now it is clear his thoughts are focused elsewhere. DS Leyton’s plaintive squeak comes faintly from his side, like a Borrower stranded in his pocket. After a few moments he turns and strides out of the shop, and then remembers he is mid-conversation.
‘I’ll meet you out the back in five minutes, Leyton – bring us a roll and a drink from the canteen, will you.’
DS Leyton makes a sound like a strangled groan.
‘Righto, Guv – where are we going?’
Skelgill looks baffled, and does not reply immediately. Then he realises he must enlighten his sergeant and barks an abrupt “Haresfell” and terminates the call. It takes him just a couple of minutes to stride to his car, parked in a supermarket lot, and the same again to stretch the local speed limits and reach Police HQ, where he drives around to the rear of the building. As he slews to a halt DI Smart and DS Jones emerge from the staff entrance; they appear to be sharing some joke. DS Jones carries a neat designer holdall, which Skelgill recognises as her overnight luggage. They stop a few yards from his car, and he winds down the window. At this moment DS Leyton materialises, brown paper bag in hand, and ambles up to make a little group. DS Jones acknowledges him with a smile, and then turns the same upon Skelgill. DI Smart’s countenance, meanwhile, bears more of a gloating sneer.
‘You’ve caught us red-handed, Skel – making a break for the big city.’ He throws his thin, bony hands up in a gesture of liberation and gazes heavenwards. ‘Civilisation!’
Skelgill cannot prevent a disapproving frown from descending upon his brow. He ignores DI Smart and stares at DS Jones.
‘How long are you away for?’
‘Just until Friday, Guv.’
Her choice of words, avoiding mention of “two nights”, and the way in which she slowly and rather surreptitiously tilts her bag from sight behind her legs, only conspire to highlight the obvious facts. Her smile dissolves beneath the weight of Skelgill’s glare, and she glances nervously at DI Smart. He has no such difficulty, and invokes a double-edged jibe.
‘Don’t fret, Skel – if you’re worried about her beauty sleep – I don’t intend to keep her out late.’
Again Skelgill declines to give DI Smart more than a cursory glance. He addresses DS Jones.
‘Keep your phone switched on – something’s just come up on the Haresfell case – I might need you in a hurry.’
DS Jones nods, though with the smallest movement possible, as if she is trying to conceal it from DI Smart beside her. Skelgill revs his engine and rocks the car on the clutch. He indicates with a jerk of the thumb that DS Leyton should climb in. Meanwhile DI Smart is leering disparagingly at the mud-encrusted shooting brake with its mackled modifications.
‘Skel, if you’re heading south I’ll race you to Tebay.’ He cackles disparagingly. ‘Give you a five-minute start, eh?’
Skelgill flicks a parting glance at DS Jones and screeches away, causing the still-open passenger door to slam and an unbelted DS Leyton to flounder and flail in an effort not to scald himself beneath Skelgill’s hot beverage.
‘Crikey, Guv – you’re not seriously racing him?’
Skelgill is scowling angrily.
‘Leyton, I’m not even going down the motorway – but let him think we did – we just need to reach the A6 turn before he sees us.’
DS Leyton nods emphatically. He is sympathetic to his boss’s sensibilities when it comes to DI Smart. ‘I thought you weren’t too fussed about DS Jones doing that Manchester jaunt, Guv – it was her that didn’t seem too keen on it.’
Skelgill does not offer an opinion either way, on either of these points of view. Instead he concentrates on the job of getting his car off the A66 and out of sight over the hump of the Eamont bridge.
13. HARESFELL
‘The concentration of epinephrine in Frank Wamphray’s blood was consistent with a dose injected for the purposes of attempted resuscitation – epinephrine being more colloquially known as adrenaline.’
Dr Peter Pettigrew is holding court in the office of Briony Boss, Director of Haresfell. He sits alongside her, while Skelgill and DS Leyton face them across the coffee table. As he adds this footnote, he turns pointedly to his senior colleague.
‘I’m perfectly aware of what epinephrine is, Doctor.’
The Director’s prickly response hints at some tension in their relationship. Indeed this is already evident from her body language. She has
seated herself well apart from Dr Peter Pettigrew, her legs crossed away and her arms folded. (Today she wears her trademark tailored skirt, while her blouse is a sleeveless affair that is partially see-through.) It must strike the detectives as salient that she refers to the man by his title, when it is clear they have a long-standing working relationship. DS Leyton perhaps recognises this tension, and its potential as an unproductive force in their discussion, and blurts out a typically self-deprecating yet intuitively diplomatic retort.
‘Colloquial’s alright by me, squire.’
Doctor Peter Pettigrew flashes him a look of surprise – though his own origins are probably quite humble, a growing weight of qualifications has brought a certain formality and sense of decorum upon his shoulders – and he is no doubt unaccustomed to being referred to as ‘squire’ by a police officer. DS Leyton makes a series of confused hand gestures by way of excusing himself, and this seems to provide the necessary stimulus for the psychiatrist to press on. He adjusts his reading glasses and bends over his notes.
‘However – there is no record that any member of staff – let alone the RRT – administered such a dose.’ He looks up and glances around briefly. ‘Our stocks of epinephrine are one hundred per cent accounted for. There is no obvious indication on Frank Wamphray’s body that he received such an injection.’ (Skelgill starts, and leans forwards to speak – but the doctor continues.) ‘The only puncture mark relates to an injection of anti-psychotic medicine given by the primary nurse at eleven a.m.’ (Skelgill now visibly relaxes – this was evidently going to be his point.) ‘The syringe was disposed of according to the sharps procedure and had already been collected for destruction – but we have traced the empty vial.’ He pauses and licks his rubbery lips. Then he looks around the table, his dark eyebrows coming together like a pair of hairy caterpillars meeting head-on upon a twig. ‘We have been able to establish that the vial was contaminated with epinephrine.’
There is silence. Then the Director speaks.
‘Contaminated seems to be putting it mildly.’
It is hard to divine Briony Boss’s stance – both her voice and features are even, and her hands with fingers interlocked clasp her uppermost knee. Perhaps she sits on the fence that divides alarm from anger until she fully understands the situation: to assume responsibility or assign blame? The outcome no doubt could have serious implications for Dr Peter Pettigrew, but for the time being he plays the role of expert witness, a neutral actor in the drama.
‘How could that happen, Doctor?’
This is Skelgill, homing in on the crux.
Dr Peter Pettigrew takes off his spectacles and leans back against the sofa. His manner is unpatronising – and he seems genuinely puzzled as he begins to address the question.
‘A central dispensary prepares the patients’ prescriptions. Because of the numbers we operate on a system of a small buffer stock, two-to-three days’ supply.’ He glances briefly at Briony Boss. ‘And, by the way, we’ve quarantined all existing stocks and introduced double-checking until we get to the bottom of this mistake. Then when batches are ready we –’
‘Hold on, sir – if you don’t mind.’ Skelgill has raised a hand. ‘You say mistake – but if none of your adrenaline is missing – how could this be a mistake?’
Now Dr Peter Pettigrew does for the first time look pained, as though a more sinister alternative is not something he can contemplate – despite the obvious conclusion that can be reached from the very facts he has so far supplied.
‘It has to be a mistake, Inspector – it just doesn’t make sense otherwise.’
He looks rather imploringly at the detectives, and then at Briony Boss – but the antipathy in her expression does not bode well for him. Skelgill appears more equivocal, and presses on in a logical manner.
‘The vial you mention – it was the correct one?’
‘It was, yes. Labelled with the intended contents and Frank Wamphray’s patient number.’
‘So it had the wrong stuff in it.’
‘It appears epinephrine – adrenaline – was somehow introduced.’
‘By the dispensing chemist?’
The doctor shakes his head decisively.
‘Not knowingly – the young lady in question is dismayed – we have sent her home with a colleague.’
Skelgill makes a sweeping gesture with one hand.
‘But what I’m saying is, given you’ve not had patients dropping like flies, it was a single vial that was tampered with – not some whole batch of medicine you’ve had delivered.’
The doctor nods reluctantly, though the word tampered clearly troubles him. Briony Boss is seated directly opposite Skelgill and watches him closely. He continues.
‘So, somewhere between the medicine being made up, and the injection being given, it became contaminated. Who else could have had access to it?’
Again Dr Peter Pettigrew glances rather apprehensively at Briony Boss – but her attention remains focused upon Skelgill, and she leaves the psychiatrist to field the question himself.
‘It would have been taken to the local dispensary on the ward – we have a team responsible for the secure transfer of medicines about the hospital. There it is stored under locked conditions – both the room itself, which has a kind of service counter, and a secure chiller cabinet. Senior hospital staff like myself have keys, and other medical staff such as nurses are allowed appropriate access during their shifts. There will always be a duty manager with keys, and the duty head of the RRT – in case of an emergency.’
Skelgill looks pointedly at DS Leyton, who suddenly realises he ought to be taking notes, and with a jolt begins to scribble frantically. Skelgill waits for a few moments in order for him to catch up.
‘That’s beginning to sound like a lot of folk.’
The doctor inhales somewhat heavily.
‘In the entire hospital it could be as many as thirty people – but in the vast majority of instances there would be two or more qualified professionals present.’
Skelgill looks doubtingly. Being qualified would not seem to lift suspicion.
‘Under normal circumstances, who would handle the vial?’
‘Once it was transferred to the ward area, only the local dispenser – and in the case of an injection she would hand it directly to the nursing team. Naturally I have spoken personally to the staff involved, and none of them noticed anything unusual about the packaging – they are of course trained to report the slightest fault and take no risks.’
Skelgill now affects a more casual air.
‘Doctor, what are your views about the medicine having been administered by injection instead of the more normal method?’
Both Dr Peter Pettigrew and Briony Boss show some reaction to this question – just small movements, perhaps a nervous twitch in the case of the doctor, and a heightened alertness about the Director’s demeanour.
‘He would not have died if he had taken it orally.’
There is a moment’s silence. It seems the doctor needs to be prompted in order to elaborate.
‘Why not?’
‘Because epinephrine rapidly degrades in the gastro-intestinal tract and is not absorbed at all – it must be injected directly into the bloodstream.’
More silence prevails while the detectives, at least, strive to understand the possible implications of this striking fact. The corollary if Frank Wamphray had not been feeling ill – or at least had not feigned illness – is that he would still be alive.
‘Who would know that?’
Skelgill looks like he is hoping for a condensed list of names, but he is to be disappointed.
‘All clinical staff from a nurse upwards, Inspector – it is a basic property of the compound – that is why the EpiPen injects.’
Skelgill ponders. Then, as he speaks, he looks at each of the senior managers in turn.
‘Are you aware of anyone who might have held some sort of grudge against Frank Wamphray?’
They shake their h
eads in unison, and Dr Peter Pettigrew looks to his superior – but again she seems content to let him answer.
‘Frankly – if I may use that term, Inspector – he was probably the most popular patient on the ward – a one-man entertainment committee. It’s hard to imagine anyone would wish harm upon him.’
Skelgill nods.
‘And the nurse who gave the injection – how has he reacted to what has happened?’
Dr Peter Pettigrew leans forwards and rests his forearms on his thighs. He seems more purposeful now.
‘His name is Arthur Kerr – I understand you may have spoken to him as part of your other investigation. He is one of our more experienced nurses – and a tough character – there isn’t much he has not had to deal with. He is upset, but I would say he does not want to show it. Naturally he is disturbed that he has unwittingly administered what has proved to be a fatal dose.’
‘Unwittingly.’ Skelgill says this rather severely – but it is clear to all that he has good reason to make such a remark. ‘If you were looking for a culprit, wouldn’t he be the first person you’d turn to – from a practical angle?’
The Director remains impassive, but Doctor Peter Pettigrew if anything rows back from this prospect, and sits upright and folds his arms. It seems he is still unwilling to contemplate the idea that there could be a ‘culprit’ in this incident, let alone point the finger at a particular individual. Rather than agree with Skelgill’s hypothesis, he stalls with a question of his own.
‘But what makes you say that, Inspector? The medicine was available for the best part of two days – albeit under lock and key.’
Skelgill shrugs rather nonchalantly.
‘I’m just going by the fact that the poison – let’s call it that, for the sake of argument – as you say, wouldn’t have worked unless it was injected. That was an on-the-spot decision – made by Arthur Kerr.’
No one offers to dispute this rationale, so Skelgill continues.
‘Unless you discover that all of the vials earmarked for Frank Wamphray are contaminated in the same way – just waiting for the possibility of an injection – doesn’t it suggest that the adrenaline was added immediately prior to injection?’
Detective Inspector Skelgill Boxset 2 Page 36
