As the curtains lift on the premiere episode of "Malpractice," Dr. James Ford (portrayed by Tom Hughes) warmly greets Aislene (Amy Marston) and Charlie (Stephen Thompson). Inside the Obstetrics Department of Queen Mother’s University Hospital, Dr. Sophia Hernandez (Selin Hizli) reassures a concerned patient that all is well. Meanwhile, Ed Newman (Alex Price) confides in Hannah McClean's Rosie Newman about her struggle to juggle the demands of a newborn and a toddler. Recognizing the stress, Sophia suggests a private conversation might help. Elsewhere, Precious Danso updates James about the persistent calls regarding Toni's Mental Health Act assessment, emphasizing that the team is at Toni's residence, poised to section her, but awaiting the arrival of Dr. Kate McAllister (Zoe Telford). The Approved Mental Health Professional (AMHP) warns of canceling the operation if Kate doesn't arrive promptly, despite Kate still being in her office, engrossed in tasks.
Dr. Hernandez then beckons James to conduct a straightforward review of Rosie's case. In his conversation with Kate, she reveals she's entangled in organizing a management meeting but insists on Toni's immediate sectioning due to her pregnant state and crack addiction. She proposes James's assistance, noting their need for a Toni-acquainted physician. James, who has just taken on another referral, suggests delegating the task to an SHO, but Kate persists. When James informs Sophia of his change of plans due to Toni's impending danger, she threatens to document it as a downgrade of an accepted referral, prompting James to plead otherwise and offer a later review. Sophia, unyielding, hints at escalating the matter. James decides to prioritize Toni and rushes off, amidst his buzzing phone interruptions.
During his session with Rosie, who shows no signs of self-harm or aggression, James's phone continues to buzz. Kate messages him, alerting him to the police's imminent departure. He concludes that Rosie, though sleep-deprived, poses no immediate risk. Privately, he instructs Sophia to refer Rosie to the Home Treatment Team for a comprehensive assessment the following day, suggesting a temporary lorazepam prescription to alleviate her anxiety and aid sleep, confirming she's not breastfeeding. Sophia cautions against its use in breastfeeding mothers, but James reassures her of its safety for short-term use in Rosie's case.
Sophia conveys James's recommendations to Ed and Rosie, with Rosie inquiring about lorazepam's breastfeeding safety despite Ed's reminder of her recent cessation. As James arrives at Toni's place, he finds protesters decrying the police presence. Amit Sahfi (Ash Rizi), introducing himself as the Section 12 Doctor, joins James, while Michelle Dornaway (Charlotte Mills) from the Adult Care Team attempts to coax Toni Campbell Brown (Seraphina Beh) to open the door, adding another layer of tension to the unfolding drama.
An officer looms menacingly, threatening to resort to force to gain entry. With a mighty crash, the door gives way, revealing a man wielding a knife. Swiftly, he's incapacitated with a Taser. James scoops up a frightened little girl, ushering her outside to shield her from the unfolding chaos. Inside, Toni's screams pierce the air.
Later, back at the hospital, James offers Dr. Bernadette Asamoah (portrayed by Jessica Layde) heartfelt apologies for missing the handover, recounting how Toni's assessment had turned into a harrowing ordeal. Meanwhile, another patient insists that God is the father of her unborn child. Bernadette decides to confront her delusions head-on with cold, hard facts.
As James examines Miss O'Reilly, he notices telltale signs of elevated intracranial pressure and a palpable abdominal mass. His suspicion falls on uterine cancer with metastatic brain tumors. Bernadette concurs, acknowledging the authenticity of her pelvic pain and nausea. James mentions the need to ensure Toni's section paperwork is up-to-date. Scanning his messages, he stumbles upon inquiries about his availability.
In the dead of night, Bernadette's frantic call jolts James awake, informing him of a dire situation involving a patient – Rosie Newman. James overhears Rosie's rage-filled outbursts and curses echoing through the phone. Bernadette explains that the police are exacerbating the situation. James instructs her to keep Rosie at the Accident and Emergency department until he arrives.
Rosie's aggression escalates, targeting Bernadette, who manages to retreat to the phone, pleading with James to hurry. He directs Bernadette to administer five milligrams of haloperidol intramuscularly and to contact the Approved Mental Health Professional (AMHP). James rushes to the hospital without delay.
Upon arrival, Bernadette informs James that Rosie's behavior necessitated confinement in the Section 136 suite. James peers through the window, seeking clarity. An officer recounts receiving a call about Rosie attempting to drown her baby, describing her as distressed and combative. Ed, locked in the nursery with the baby, has taken him to A&E for a checkup. James questions the necessity of the restraints and enters the room to remove Rosie's mask and bindings. She recognizes him from a previous encounter and mentions Alfie, her baby, though she insists he doesn't exist. She converses with an imaginary figure, professing her failure and vowing to continue her efforts until "he" is dead. Spotting Bernadette, Rosie lunges at her again, prompting James to demand an additional five milligrams of haloperidol.
Later, James assures the officer that they have the situation under control and requests assistance from reception for transferring Rosie to Willow Ward. He instructs the nurse (played by Dearbhaile McKinney) to prepare a ward for Rosie before the sedatives wear off, expressing puzzlement over her sudden unpredictability, given her apparent calmness earlier.
Checking in on Ed and Alfie, James inquires about the timing of Rosie's lorazepam intake. Ed reveals he didn't witness her taking any tablets. James dashes back to find that Rosie, now in a wheelchair, has attacked Precious and fled on foot. Without hesitation, James gives chase.
He catches sight of her, her figure dashing up the stairs of the pharmaceutical building with urgent strides. As James follows suit, pounding up the stairs in pursuit, an ear-piercing alarm blares, filling the air with tension. Reaching the rooftop, James discovers Rosie perched precariously on the edge, the world beneath her seemingly oblivious to her fragile state. With gentle persuasion, he endeavors to coax her away from the brink, but Rosie, pacing back and forth, utterings of failure that resonate deeply. James proposes a retreat indoors, a sanctuary for heartfelt conversation. However, in a heart-stopping moment, Rosie loses her balance, toppling backward from the zenith of the building to crash onto the unforgiving pavement below.
Later, the echo of the tragedy lingers as James concludes his harrowing narrative to the police. In a private confrontation with Sophia, he confides that Rosie's turmoil was far more profound than he had anticipated, reminding Sophia of her earlier assessment that contradicted this gravity. He ponders aloud that perhaps Rosie's fate might have diverged had she adhered to the prescribed lorazepam. Kate's entrance interrupts this poignant exchange, Sophia's accusations raining down on James as she blames him for the unfolding calamity. Kate, sensing the timing's inappropriateness, steps in to diffuse the escalating tension, urging Sophia to depart. She then turns her attention to James, who confesses his inner turmoil, prompting her to urge him home for some much-needed rest.
Outside, Dr. George Adjei (Jordan Kouame) and Dr. Norma Callahan (Helen Behan) exit the MIU, their conversation hushed yet laden with the weight of Rosie's demise. Norma warns of the upcoming challenges, their somber discussion drawing in Ed, who recounts James's hurried demeanor and incessantly ringing phone. George notes Rosie's neglect of the lorazepam, a detail that Ed attributes to her breastfeeding anxieties. He shares how Rosie, upon returning home from the hospital, retreated straight to bed, leading him to assume she had taken the medication. Sophia clarifies the rationale behind Dr. Ford's prescription, though James has already departed. Ed then recounts a harrowing midnight encounter where Rosie, fixated on bathing Alfie under the tap, engaged in a struggle with him until she collapsed. Ed, shielding Alfie, barricaded them in the nursery, emerging only when Rosie's cries summoned the police. He laments that discharging her from the hospital was a grave mistake.
Inside, Kate inquires about Toni's welfare with Kwame Essiedu (Tobi Bakare), just as James re-enters the room. James reports Toni's refusal of her quetiapine, the information interrupted by Precious Danso (Naana Agyei-Ampadu)'s urgent announcement that Toni remains transfixed by the television, defying all entreaties to move. Sophia ponders whether Toni's presence is necessary, given Arun Mansoor's (Ace Bhatti) comprehensive briefing. James contends for an elective cesarean, citing Toni's crack use and potential complications, including placental abruption and premature delivery, exacerbated by her medications. Kate counters with Toni's uneventful natural delivery of her first child, Apple, but James persists, highlighting the lack of adequate facilities should Toni go into labor. Sophia suggests transferring her to the hospital, but James, haunted by Rosie's fate, expresses doubts. Kate ultimately agrees to keep Toni at the facility.
Outside once more, Kate subtly reminds James of the impending investigation into Rosie's death, urging him to align his accounts. She probes his failure to recognize Rosie's dire state during outpatient visits, to which he responds with a reminder of his pressing engagements.
Kate implores him to inform them that he conducted an exhaustive assessment and found no indications of Rosie suffering from a severe psychotic disorder. She issues a stark warning: if this incident is perceived as a result of his incompetence, they will scrutinize every facet of his life meticulously. That very night, James finds himself entangled in a dream, reliving the scene where Rosie met her fate. The memory of his conversation with her haunts him until he jolts awake from the harrowing nightmare.
The following morning, amidst the hum of daily life, James engages in conversation with Will (Joshua Lacey) and Martha (Kirsty Averton) about his ongoing house hunt. Martha mentions casually that Dad intends to visit next weekend, to which James replies he cannot make it due to his on-call duties. Later, at the Medical Emergency Unit (MIU), James discusses his handling of Rosie's case with George and Norma. He emphasizes that the couple merely sought reassurance and, at the time, Rosie exhibited no overt psychotic symptoms. He assures them that he conducted a thorough mental status examination. Jordan challenges him on why he failed to document the comprehensive details in Rosie's records. James clarifies that no positive findings warranted extensive notation, asserting that the risk of harm to herself or others was minimal. He adds that she had protective factors, notably a supportive partner.
James reveals that he instructed Sophia Hernandez to prescribe two milligrams of lorazepam immediately and another two at bedtime, and referred Rosie to the Home Treatment Team for a follow-up review the subsequent morning. Norma mentions Ed's observation about James's phone constantly ringing and going silent, to which James responds that he was on call at the time. Norma then inquires about any sense of urgency, prompting James to explain that Kate McAllister had summoned him for a Mental Health Act assessment. Although a team awaited his arrival, he insists he was not in a rush. Norma contends that Rosie ought to have been his top priority. James concedes that he would have spoken with Rosie in private had he had more time.
He describes Rosie as calm upon his arrival at the hospital, and Jordan wonders if his judgment was influenced by an earlier encounter in the outpatient room. James asserts it wasn't, believing she had consumed four milligrams of lorazepam and five milligrams of haloperidol. Norma corrects him, revealing that Rosie was actually under-sedated when he saw her in the Accident and Emergency department. James承认 he quickly returned to administer more lorazepam upon discovering her medication gap but was unaware they had attempted to move her across the ward. He admits to initiating the transfer but notes it usually doesn't take long and is a routine procedure.
James inquiries if the complaint specifically targets him, to which Norma replies that earlier detection of Rosie's symptoms could have prevented this. James stands firm, insisting that had Rosie taken the lorazepam, none of this would have transpired. He shifts the blame slightly, arguing that Sophia prescribed the medication, so if Rosie didn't take it, it reflects on Sophia. Norma, however, maintains that the care James provided fell short of the minimal standards expected.
They will delve deeply into the sequence of events that transpired on that fateful night, as well as the preceding occurrences that set the stage. Sophia, with her children in tow, heads back home and catches sight of a figure standing menacingly at the end of the street. Elsewhere, Norma and Jordan engage in a discourse about Rosie's symptoms, pondering whether she had exhibited any beforehand.
Meanwhile, James notices Bernadette and Precious in conversation with George and Norma. Bernadette pulls them aside for a private discussion regarding Rosie's ordeal at the Accident and Emergency (A&E) department. Precious reveals that James had contacted the Ward, requesting assistance to escort a patient over, but failed to mention her severe condition. She doubts that Rosie was thoroughly assessed. Bernadette shares the details of the medication Rosie had consumed, stressing that she required a comprehensive medical evaluation to eliminate any physiological causes. James had instructed her to keep Rosie at A&E until he arrived to ensure this occurred. Norma notes that James was summoned at two and arrived roughly thirty minutes later. Either the haloperidol administered wore off prematurely or had absolutely no effect.
The woman standing outside confronts Sophia, asserting that she is aware of what transpired to Rosie and坚信这一切与Sophia脱不了干系. She declares confidently that Sophia's attempts to conceal the truth will be futile, and her career will ultimately suffer the consequences. Bernadette informs Norma and George that Rosie's outburst likely occurred closer to 2:40 or 2:45. Norma expresses her belief that Dr. Ford should have been present by then, reminding them that the resident doctor on call is supposed to reach the hospital within thirty minutes. Bernadette clarifies that James arrived just before three. Norma is firmly convinced that this entire situation could have been averted, questioning why Dr. Ford was so tardy.
James steps inside and checks his messages, acknowledging that the conversation did not proceed smoothly but thankfully, they did not inquire about his whereabouts.
