As the third chapter of "Malpractice" unfolds, Dr. Lucinda Edwards (played by Niamh Algar) awakens with a start, her desperation evident as she scrambles for her medication. George Adjei (Jordan Kouame) informs Norma Callahan (Helen Behan) that Lucinda's phone records had arrived the previous day, revealing a startling discovery: the same number that had phoned her shortly before Edith's visit also called before Alexander Taylor deliberately overdosed at the A&E. This pattern repeated itself with Camilla Woodham's overdose. George, having cross-checked with the 999 emergency call center, confirms that both overdose incidents were reported by this mysterious number. Notably absent from this grim sequence was a call before Milo's incident. George dives into uncovering any conceivable connection among these overdose patients.
Lucinda and Ramya Morgan (Priyanka Patel) meticulously review the situation with Dr. Willett, warned that Edith's father, Anthony Owusu (Brian Bovell), a former barrister, will represent the family legally. This investigation serves as a fact-finding mission to assist the coroner in pinpointing the exact cause of death. If negligence is deemed the culprit, the hospital faces potential legal repercussions from the Owusu family, and law enforcement might intervene. Conversely, if suicide is concluded, the hospital's culpability would diminish. During the hearing, Margot Owusu (Nicola Wright) is questioned about Edith's mental well-being around the time of her demise. They had no inkling of her drug use or suicidal thoughts, and no signs suggested otherwise.
Verity Roberts, the legal counsel for West Yorkshire Royal Hospital, inquires if she has any questions. Upon asking Margot about Edith's new job, she learns that Edith was thrilled about it. Margot firmly believes suicide was not in the picture. Verity then proposes playing a segment of the 999 call made on the night Edith passed. The caller, an acquaintance unknown to Margot, expresses his belief that Edith had attempted suicide. Margot recognizes neither the friend nor his voice, noting that Edith's popularity made it challenging to keep track of everyone. Verity hypothesizes that Edith concealed her drug use and suicidal ideation in her final days. However, Margot stands firm in her conviction that it was not suicide, accusing the hospital of missing a pivotal opportunity to save Edith's life.
George meticulously reviewed Alexander's paperwork, uncovering crucial details about the Guelder Clinic. During the hearing, an expert witness testified that Edith exhibited signs of opioid abuse, ultimately contributing to her demise. Elevated levels of fentanyl were detected in her bloodstream, leaving the expert uncertain whether the overdose was an accident or a deliberate act. Dr. Adeyemi concluded his questioning and stepped aside.
Next to take the witness stand was Dr. Eva Tait, portrayed by Georgina Rich, who served as Edith's addiction consultant at the Guelder Clinic between May and October 2021. Eva elaborated that Edith had a intricate history of substance misuse and harbored a strong desire to break free from it. By the time she departed the clinic, Edith was abstinent, albeit at risk of relapse, a common challenge for opiate addicts.
Eva was then inquired about Edith's suicidal tendencies. She conceded that Edith had indeed expressed them, prompting extensive work on addressing her negative thoughts and core beliefs. Lucinda swiftly followed Eva out of the courtroom, questioning why she hadn't disclosed her familiarity with Edith from the Guelder Clinic. Lucinda emphasized their presence was due to Rob prescribing fentanyl to Edith, which led to her death, but Eva countered that no concrete proof linked Rob to the fatal dose. Lucinda had assumed Rob prescribed methadone instead. Eva argued that Edith was no longer her patient at the time of her death and hadn't been seen by her for months. Rob had contacted Lucinda to ensure no one scrutinized his prescriptions, suggesting he was covering up their actions.
Lucinda inquired how Rob knew Camilla, Alexander, and the others. Eva revealed they were all undergoing treatment at the Guelder Clinic. Eva insisted she had done nothing wrong, whereas Lucinda had concealed at least three overdoses for Rob. Eva reminded Lucinda of her own addiction, hinting at the potential repercussions if the Medical Incident Unit (MIU) learned of her actions. Eva warned that Lucinda would have no choice but to stop pointing fingers if she wished to avoid further scrutiny. Suspecting Lucinda was due for a refill, Eva suggested she could have assisted her if Lucinda ceased her accusations.
George informed Norma that there was no indication Lucinda knew the overdose victims. He noted that Camilla and Alexander had undergone detox at the Guelder Clinic and agreed to visit the facility the following day to explore any connections to Lucinda.
Lucinda endeavors to reach Camilla, hoping to inquire about scheduling an appointment. During the inquiry session, Matron Beth Relph, portrayed by Hannah Walter, faces questioning. Sir Anthony Owusu grills her, inquiring whether Dr. Edwards unnecessarily delayed Deith's transfer. Beth firmly denies ever uttering that Edith was merely a drug addict. Subsequently, Ramya Morgan ascends the witness stand. Anthony prompts her to recount her role in Edith's emergency department (A&E) care. Ramya reveals that she was summoned to the resuscitation area to monitor Edith. Upon Lucinda's return, Ramya assumed she would resume overseeing Edith's case. However, she discovered that Patient X required Edith's bed, prompting their transfer to the majors department together. Ramya recounts the treatment plan provided by Lucinda and notes that after administering naloxone, Edith's respiratory rate improved, prompting her return to the resuscitation area.
Anthony probes her, asking if she considered staying to observe if the improvement was sustained and querying the swiftness of naloxone's initial effects wearing off. Ramya admits her ignorance at the time, highlighting her relative newness as a qualified doctor, with only 18 months of experience. Anthony accuses Lucinda of questioning why Ramya wasn't with the overdose patient upon her return, while Ramya insists Dr. Edwards never instructed her to stay longer in case the naloxone's effects waned. Anthony challenges whether Lucinda is being truthful, and Ramya can only recount her memories, explaining that A&E's chaotic nature often presents patients with conditions unfamiliar to junior staff, necessitating reliance on senior colleagues for guidance and safety. Anthony hypothesizes that a different outcome might have unfolded if Ramya had waited just a few moments longer, ending his questions with an accusation that Ramya deserted Edith to her fate.
In a private discussion, Dr. Mike Willett, portrayed by Tristan Sturrock, laments the potential damage to the trust's reputation. Lucinda believes Ramya has implicated her unfairly. Willett advises Dr. Leo Harris (James Purefoy) to reign in his junior staff. Verity attempts to soothe tensions, suggesting there's still room for recovery, albeit contingent on Lucinda's testimony. When Lucinda takes the witness stand, she argues that assessing whether a patient attempted suicide deliberately should be left to a psychiatrist's discretion.
Edith had a history of deliberate overdoses, and past conduct often serves as a harbinger of future actions. Lucinda elaborated on her practice of flagging such instances as deliberate, ensuring that psychiatry evaluates the patient thoroughly before discharging them. As she recounted the sequence of events leading to her awareness of Edith's predicament, she preempted Sir Anthony's inquiries by narrating the backdrop. He then grilled her about Dr. Ramya Morgan's oversight of vital instructions. Lucinda clarified that the incident occurred in a real-life, high-stakes scenario, whereas Sir Anthony contended that Ramya's recall of intricate details indicated Lucinda's instructions might have lacked clarity. Lucinda insisted it was a matter of Ramya not paying attention. Reluctantly, she had entrusted Edith to Ramya's care, a decision forced upon her under the circumstances.
Sir Anthony accused Lucinda of entrusting Edith to a demonstrably incompetent doctor, implying her choice ultimately led to Edith's demise, thus branding her with gross negligence. He was reminded that he couldn't impeach a witness for criminal acts outside the scope of the present inquiry. He lambasted Lucinda for failing to exercise the requisite diligence and care in treating his daughter. The adjournment was announced for three hours' time. Lucinda attempted to convey her condolences to Sir Anthony, but he departed without acknowledging her words.
Seeking solace, Lucinda ventured to the pharmacy, procuring a bottle of Night Soothe and one-a-night. She was cautioned against consuming them concurrently, as both contained diphenhydramine. Ignoring the warning, she commenced ingestion immediately upon leaving. Meanwhile, Beth Relph returned to work, engaging in conversation with Oscar Beattie (Scott Chambers), who was immersed in an audit. Beth denied any medication wastage, but Oscar remained skeptical, citing the example of a patient Ramya saw alongside Lucinda, who inadvertently received 40 MG instead of the prescribed 10 MG. Beth dismissed it as another of Ramya's errors, reminding Oscar of the importance of administering only the needed dosage.
George visited the Guelder Clinic to uncover any ties between Lucinda Edwards and the overdose cases. Lucinda had neither worked there nor received referrals. He inquired about accessing the patients' records. Apart from Edith Owusu, the other patients had been attended by doctors different from Eva Tait, who was on maternity leave for six months. These patients were discharged drug-free and didn't require follow-ups. George was unsure, given their relapse and subsequent overdoses. The receptionist assured him that no complaints had ever been lodged against the Guelder Clinic.
John Delaney-Clark (Bill Blackwood) expressed his inability to determine whether Edith's overdose was deliberate or accidental. He deemed it unacceptable for an A&E doctor to rely on a senior's instructions for managing an opioid overdose, suggesting deficiencies in the junior doctors' training within the Royal Hospital's A&E department.
He will pen a report advocating for the trust to scrutinize its medical education program thoroughly. Inside the bathroom, Lucinda inquiries of Norma if she has finally found solace. The blame for Edith's demise does not rest on her shoulders, and she fervently hopes Norma has let go of the incident. Norma gently reminds her that matters of culpability don't resolve so neatly. As Lucinda exits the bathroom, her gaze falls upon Anthony Owusu, tears streaming down his face as he stands beside his wife. Ramya tells Oscar he narrowly escaped a perilous situation. Despite always putting her best foot forward, she laments that her efforts often go unrecognized and unappreciated. She suggests he should have opted to reuse last year's audit, as others had done. Beth cuts in, reprimanding Ramya for her multitude of errors. When Oscar mentions the dosage mix-up, Ramya reveals that Lucinda instructed her to procure 40mg, despite her reservations at the time. Oscar reassures her that Beth's wrath will eventually pass.
Norma and George scrutinize the evidence and deliberate on the patients' overdose. Norma recalls Lucinda stating she altered Edith's code to deliberate to guarantee a psychiatric evaluation. She theorizes that Lucinda might have wanted to conceal the accidental nature of the incident, fearing scrutiny into its causes. They surmise that the drugs might hold the crucial clue. Edith's parents reveal that she had ceased purchasing drugs from the streets, implying another source. They visit her parents to inquire about the drugs and where Edith might have acquired them.
At home, Lucinda engages in playful antics with Abi (Liberty Miller). A message pops up from Camilla Woodham (Lucy Martin), informing her that she has exhausted her medication supply. Lucinda returns the call, adeptly posing as Rob's successor before arranging a meeting at Southern Square. Tom (Lorne MacFadyen) willingly volunteers to watch over Abi, freeing Lucinda to depart. Anthony hands George and Norma the key to Edith's apartment. While searching the premises, Camilla informs Lucinda that she was prescribed 50 fentanyl patches, supposed to last a month according to Rob's prescription. Lucinda hands her a week's worth and inquiries about her payment method to Rob. Camilla responds that she pays the pharmacy as usual. George discovers a疑似处方纸上赫然写着Lucinda的名字。
Meanwhile, Tom finds Abi unconscious, clutching a pill packet. In a panic, he tries calling Lucinda, who doesn't answer. Tom rushes his daughter to the hospital, informing Leo that he suspects she ingested diazepam. He confesses to having a prescription for the medication due to a shoulder injury. He repeatedly tries calling Lucinda, who is trailing Camilla. Lucinda confronts the pharmacist and requests to speak with his manager, revealing her knowledge of Camilla's hush money. She insists that her intent is solely to meet with them and cause no trouble. Lucinda finally notices Tom's missed calls, realizing the gravity of the situation. The pharmacist informs her that the manager awaits in the back. Lucinda panics and flees the scene. As she dashes away, the manager emerges from the pharmacy.
