Heather Bills inquest: nurse haunted by patient's smile before suspicious death
A nurse has recalled noticing burns victim Heather Bills smile for the first time in her care, just hours before her suspicious death.
Auckland woman Bills died in 2013 while in the care of Middlemore Hospital, having survived an explosive fire at her Ōrākei home six weeks earlier.
Neighbours rescued the 64-year-old from the blaze and she was admitted to hospital with serious burns.
Six weeks later, however, she was dead: The mother suffered an irreversible brain injury caused by a large dose of insulin.
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The person who administered the insulin dose to Bills remains a mystery.
Police have three suspects in their own investigation, all of whom worked in Bills' care.
Registered nurse Harmeet Sokhi gave evidence to the coroner's inquiry at the Auckland District Court on Tuesday and recalled seeing Bills smile for the first time - a matter of hours before her suspicious death.
She told the inquest she is "still shaken" by the events that led to Bills death in 2013 as she burst into tears at one point.
On the night Bills died, Sokhi was her primary care nurse, working a night shift from 7pm until 7am.
Sokhi described Bills as a "quiet person" who refused to take phone calls from family.
"She would not get engaged in any conversation. She would only say 'yes' or 'no' answers with her eyes closed," Sokhi said.
When she began her shift on December 26, Sokhi went to Bills' room to check on her and discovered medical machines in her room were beeping.
However, registered nurse Sharon Connors, who had been assigned to keep an eye on Bills because of her mental state, seemed "oblivious" to the beeping, Sokhi said.
"The beeps were loud enough to be heard from the corridor outside her room.
"There was no way that anybody could miss the beeps inside her room."
Bills, too, did not seem fazed by the beeping, Sokhi said.
"It also seemed a little odd that Heather did not react to the beeps – as normally patients get irritated by the constant beeping – but Heather didn't show any irritation, she wasn't concerned," she said.
"When I was talking to Heather, she opened her eyes and smiled. It was the first time I had seen Heather smiling since I had cared for her."
The beeping was coming from various equipment, such as a humidifier machine and IV fluid pump, which needed to be attended to.
Sokhi estimated the machines had been beeping for two to three minutes, because the beeps are designed to gradually increase in volume.
Later that night, Bill's condition began to deteriorate as she became hypoglycemic due to the mystery insulin dose.
Sokhi described the stress of having to assist with Bills while also checking other patients on the ward.
"I am still shaken by this event," she said, bursting into tears.
"I have tried my best to record all that happened that night, but to be honest I cannot be 100 per cent sure that I can remember everything, as so much happened then, and so much time has passed since then."
'IT COULD HAVE SAVED HER LIFE'
Later on Tuesday, Bills' daughter Michelle Maher questioned Sokhi about her evidence.
When Bills' condition was deteriorating about 1.40am on December 27, Sokhi said she tested the patient's blood sugar level with a glucometer and the reading came back 6.4 mmol/L - a normal reading.
But a blood test also done on Bills around that time found her blood sugar was dangerously low, meaning the reading Sokhi got on the glucometer must have been an error, Maher said.
Glucometers in the burns unit were able to retain past readings, and the machines recovered as evidence did not contain the reading Sokhi claimed to have seen, she added.
"What do you think caused the error in the blood glucose reading?" Maher asked.
"The handheld glucometers, [it] could be several reasons," said Sokhi.
"One, because it was an emergency I could not have cleaned her hand or finger properly, so that could be the error there."
"You took a bedside blood glucose reading of my mum," said Maher.
"It has been confirmed it could have saved her life - I'm sorry," Sokhi said as she fought back tears.
"Why can we not find a glucometer reading with a 6.4 reading on it?," Maher asked.
"I cannot explain this to you, sorry," replied Sokhi. "I do understand that three glucometers have been taken for checking. There were four or five glucometers on the ward."
"It seems absurd to me the glucometers don't have this reading," said Maher. "We do not have a 6.4 reading anywhere. Can you help me?"
The coroner intervened, telling Maher that Sokhi could not longer assist with her line of questioning.