THE NURSE accused of mistakenly killing Blackburn toddler Jake McGeough shouldn't even have attempted to give him an injection to sedate him, a court was told.

Jake, aged 18 months, of Leicester Road, Whitebirk, died on July 8, 2001, two days after wrongly being injected with a muscle-relaxing drug by Rose Aru.

She had given the toddler the drug during a routine scan at Alder Hey Children's Hospital, Liverpool, despite not having the authority to do so.

Doctor Malcolm Semple was a paediatric registrar in the hospital's paediatric intensive care unit.

He told the court it was in his professional opinion "inappropriate" for a nurse to attempt to sedate a patient without having a prescription, without consent or without the direction of a doctor.

He also said it was inappropriate to issue the drug -- vecuronium -- to a non-ventilated patient and that the paralysing effects would have been "progressive" and "irreversible".

On the morning of July 6, 2001, he had arranged for Jake to have a lung scan amid concerns that he had blood clots in his lungs. Jake had been taken to the hospital from Queens Park Hospital, Blackburn, the previous day after it was discovered the right-hand side of his heart was enlarged.

Dr Semple told Liverpool Crown Court that prior to transferring patients to other departments any possible sedation had to be planned in advance and consent sought if necessary.

He said the risks to the sufferer were "well recognised" and said "there were policies and protocols in place for sedation."

But he told the court that he did not feel it was necessary to sedate Jake on that day -- because a scan was a short and non-intrusive procedure -- and that he had never discussed sedation with Jake's nurse, Rose Aru.

The court had previously heard that Dr Semple had taken the decision not to attend the scan with Jake so he could spend more time caring for the more dependent children on the intensive care ward.

Sister Stella Rigby had been Jake's designated transport nurse, but just prior to the scan had been called away to deal with a sick child at another hospital, the court was told.

Prior to leaving she had made arrangements for Jake's transfer to the scan room including drawing up three syringes -- one of a sedative called midazolam, one of the muscle-relaxant vecuronium and a syringe of sodium chloride.

Mr Peter Wright QC, prosecuting, had told the jury that at the time of Jake's death it was standard practice to draw up the drugs when a patient was being transferred in respect of their condition so that the drugs would be "to hand" if there was an incident which required emergency treatment.

Jake went for his scan accompanied by Rose Aru, Nurse Lynn Maguire and his mum Keira. Jake had his first scan, but during the second scan had become agitated. Mr Wright said Rose had decided to sedate Jake with the midazolam even though she was not authorised or qualified to administer the prescription-only drugs.

He said she reached out to pick up the syringe, but inadvertently picked up the syringe with the vecuronium and injected Jake with it. Almost immediately his heart stopped.

The toddler did not recover consciousness and died two days later.

Under cross-examination from Mr Patrick Cosgrove QC, Dr Semple said that he had no reason to doubt Rose Aru's skills and abilities and had been "at a loss" to the cause of her "major aberration".

He agreed that it had been "wholly inappropriate" for three syringes of drugs to have been placed on Jake's bed because it meant there was an "unnecessary risk of something going wrong".

Aru, 59, of Wavertree, Liverpool, denies manslaughter.

(Proceeding)