A BLACKBURN toddler died when a nurse mistakenly injected him with a muscle relaxing drug which stopped his heart, a court has heard.

The jury was told that 18-month-old Jake McGeough suffered "irreparable damage" after Rose Aru gave him the drug instead of a sedative during a routine scan in July 2001.

Liverpool Crown Court also heard an emotional account from Jake's mum, Keira McGeough, who said: "Almost immediately Rose gave him the injection I saw his mouth drop open and his eyelids half close.

"His chest stopped moving and he stopped breathing.

"I began to panic but I could not get the words out to tell them Jake had stopped breathing."

Jake, of Leicester Road, Whitebirk, suffered a cardiac arrest, never regained consciousness and died at Alder Hey Children's Hospital, Liverpool, two days after the injection, which Aru was not qualified to give him.

Aru, of Wavertree, Liverpool, denies manslaughter.

Mr Peter Wright QC prosecuting, told the court, that Jake had become agitated and stressed durign a scan.

He said Rose Aru had decided to sedate Jake with the midazolam but why she had taken that decision was "inexplicable."

He added: "Rather than suspend the procedure or take other steps to calm Jake down, on this occasion nurse Rose Aru inexplicably and simply concluded that Jake needed to be sedated, notwithstanding the fact that she was not qualified or authorised to administer the prescription only drugs."

He said Aru had reached out and picked up the syringe which contained the midazolam and had shown it to Lynn Maguire, a less experienced nurse who was acting "as a spare pair of hands."

He said she had then experienced difficulty in holding Jake down and had replaced the syringe in a tray on Jake's bed while she attempted to restrain him.

She then reached out and inadvertently picked up the syringe containing the vecuronium and injected Jake with it, he said.

He said: "To administer vecuronium to a child such as Jake who was not ventilated was highly dangerous and catastrophic in consequence."

Mr Wright said almost immediately after the vecuronium was administered Jake's heart stopped.

When the error was realised a crash team was called and immediate life saving treatment was started but it was too late.

Mr Wright, said: "Jake was irreparably damaged. Once the injection of the veruronium had taken place the consequence was inevitable."

Following Jake's death, Mr Wright said Rose Aru had been distressed and expressed concern to her boss about Jake and his parents. She described the incident as "a moment of stupidity."

Mr Wright said that there was no suggestion that Rose Aru, a nurse with a "commendable" history of over 25 years experience was not familiar with nursing policies and procedures.

He said: "No-one is saying she intended to harm that boy at all but by her irresponsibility that day and by her conduct she is grossly negligent and consequently is guilty of manslaughter."

He added: "It is not suggested that on any previous occasion Rose Aru had behaved in any irregular fashion. This was wholly unexpected, wholly unanticipated and wholly irregular. It was her conduct that caused the death of Jake.

"What she did was not simply a blunder. It was contrary to established nursing procedure and practice both nationally and at Alder Hey.

"She owed Jake a duty of care. She was in breach of that duty by injecting him with the Vecuronium. That breach caused his death."

Jake had originally been taken to Queen's Park Hospital, Blackburn, on July 5 because his mum was concerned that had had become lethargic and his feet were swollen.

It was discovered that he was suffering from a serious cardiac disorder and he was transferred to the paediatric intensive care unit at Alder Hey, the court heard.

Tests revealed that the right side of Jake's heart was enlarged. Doctors were concerned that his condition may have been due to blood clots in his lungs and a scan was arranged for the following day.

Mr Wright said that the paediatric registrar at Alder Hey had taken the decision as a doctor not to attend the scan with Jake so he could spend more time caring for more dependent children on the ward.

Mr Wright said that, although he didn't attend the scan, the doctor was 'readily available' but Rose Aru had, at no point, attempted to contact him.

He added that the paediatric registrar did not think Jake required sedation and had not discussed sedation with Aru.

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

Prior to leaving she had made arrangements for Jake's transfer to the scan room including obtaining a mobile patient monitor, to monitor blood pressure, pulse and oxygen levels and had drawn up three syringes - one of a sedative called midazolam; one of the muscle relaxant, vecuronium and a syringe of sodium chloride.

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

He said that although the drugs were drawn up they had not been prescribed to Jake and no such emergency had arisen.

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