Ambulance's drug could have saved Dawn Sturgess' life

Family HandoutParamedics initially misdiagnosed the mother-of-three's condition

Ambulance crews were carrying medication which could have saved Dawn Sturgess' life, an independent inquiry into her death was told.

Ms Sturgess, 44, was inadvertently exposed to the deadly nerve agent Novichok in Amesbury in June 2018.

Medicine DuoDote, which is an antidote to nerve agent poisoning, had been introduced on all emergency vehicles the year prior to her death.

However, paramedics initially misdiagnosed the mother-of-three with opiate-poisoning due to an overlap of symptoms, including respiratory issues and fading consciousness.

Wayne Darch, who was head of emergency operations at the South Western Ambulance Service in 2018, told the inquiry "more could have been done" to train staff on "misdiagnosis awareness".

ReutersThe inquiry heard the vial carrying the nerve agent contained "enough poison to kill thousands of people"

It is understood the nerve agent had been hidden inside a designer perfume bottle, which Ms Sturgess’ partner unknowingly gave to her.

Lead counsel Andrew O’Connor KC told the inquiry she suffered from heart failure because of the Novichok poison.

In the end, he adds, the brain injury Ms Sturgess sustained from a lack of oxygen during the initial period was the "immediate cause" of her death.

The overriding question posed by Mr O’Connor at the inquiry is: “Was the poisoning of Dawn Sturgess preventable?”

Mr Darch told the inquiry that poisoning from organophosphates, a toxic chemical compound, can come from several sources including pesticides, fertiliser, and flammable retardants.

Dawn Sturgess InquiryMr Darch said his ambulance crews often attended opiate-related overdoses and had confused the overlapping symptoms with nerve agent poisoning

He added: “A number of our clinicians will go a whole career without witnessing or attending an organophosphate or nerve agent poisoning, whether accidental or deliberate.

“We responded to the symptoms that we believed were of an opiate overdose nature. It was some hours later that it became known this was not an opiate-related incident.

“My perspective is that at the time we did the best we could with what we had available to us.”

Mr O'Connor told the inquiry that despite Mr Rowley telling paramedics that Ms Sturgess did not take drugs, the force incident manager on duty, Inspector Andy Noble, “formed the opinion that this incident was most likely owing to drugs”.

Mr O’Connor explained how police on the scene were "working from intelligence" relating to drugs previously connected to Mr Rowley- the occupant of the property.

This misdiagnosis meant the DuoDote treatment was not administered, which could have prevented Ms Sturgess' death, the inquiry heard.

By the time her partner Charlie Rowley become ill later that afternoon, paramedics raised concerns this could be nerve agent poisoning, but were effectively “overruled” by Wiltshire Police.

Dawn Sturgess InquirySkripal and his daughter were suffering from the effects of a toxic chemical, which had been left on the doorknob of his home

Just four months prior to her death, former Russian spy Sergei Skripal and his daughter Yulia Skripal had been poisoned with the same nerve agent, roughly eight miles away in Salisbury.

The pair had gone for lunch at a pub before they were both found collapsed "in a serious condition" on a shopping centre bench.

A report at the time stated ambulance staff had similarly misdiagnosed the pair, and the actual cause of their illness was not revealed until "15 hours later".

Fortunately, both made a full recovery and are currently living under protection.

Michael Mansfield KC, representing the family of Dawn Sturgess, raised the question of what provisions had been made to protect the public following this initial attack in March.

Local emergency workers appear not to have been warned to look out for the fact that symptoms between drug overdoses and nerve agent poisonings can be easily confused – meaning it was not on their immediate radar when Ms Sturgess fell ill.

Dawn Sturgess InquiryMr Mansfield said staff and the public should have been made aware after the Salisbury poisonings that there was a potential risk of further harm

Mr Mansfield also referenced an internal document sent by the Department of Health and Social Care ten days after the Salisbury poisonings, titled 'Risk of Secondary Incident'.

It contained a list of the worst-case scenarios, one of which was deemed the ‘accidental discovery of a discarded agent’ elsewhere.

However, the letter was advised "not to be forwarded further than necessary", and Mr Darch insists he never saw it.

Mr Mansfield said: “One of the problems after the Salisbury attack was a mindset, that because Novichok or nerve agent poisoning was rare or virtually unknown, that it wouldn’t happen again.”

Mr Darch said he was responding on the advice of Public Health experts at the time that the "risk was extremely low".

Dep Ch Con Paul Mills, also presenting evidence at the inquiry, was the senior Wiltshire Police officer in charge of the Novichok response.

He explained: “It was my understanding at that point in time, that this was an isolated incident.

"That Mr Skripal had been targeted and there was no more information intelligence which indicated there was a wider potential threat for a further attack.

"In hindsight, I think we should have put some advice and guidance out to staff, reaffirming their training and the types of symptoms that may present in a secondary incident," he added.

BBC reporter Dan O'Brian has been attending the inquiry at Salisbury Guildhall.

He summarised: "The big theme of this morning’s session has been about communication – or perhaps the lack of it – between different organisations involved in the response to the Salisbury and Amesbury Novichok incidents."