‘Paramedics raised Novichok alarm but were overruled’, inquiry told

Paramedics who attended Dawn Sturgess’ partner after he fell ill, feared he was suffering from nerve agent poisoning, but were overruled by police, an inquiry heard.

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

Paramedics told the inquiry they performed life support on Ms Sturgess and used a defibrillator in case she was suffering from a drug overdose.

They initially misdiagnosed the mother-of-three with opiate-poisoning due to an overlap of symptoms.

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, the hearing was told.

A member of the critical care paramedics, Keith Coomber, told the inquiry he administered naloxone to Ms Sturgess but said he did not notice if it had any effect on her as he was busy.

He added that if Ms Sturgess had not had an opiate overdose it was “not going to do anything bad but it’ll help reverse… if it was”.

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”.

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.

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.

One of the paramedics who attended the incident, Mark Marriott, said Ms Sturgess’ skin was “very blue”, adding “that would indicate a lack of, or no, blood flow”, and that she was not breathing.

Mr Marriott said Mr Rowley told him Ms Sturgess was complaining of a headache and was going to have a bath when he heard a noise, “like she was gurgling”, so went in and found her collapsed in the bathroom.

Mr Marriott told the inquiry: “So, while doing the compressions, I said to the male partner, ‘are you the partner?’ and he replied, ‘yes’.

“I said ‘what happened?’, he replied, ‘she was complaining of a headache and she was going to have a bath, I heard a noise that sounded like she was gurgling, I went in and found her collapsed in the bathroom, she was foaming at the mouth’.

“I asked the male partner ‘when did she collapse?’ and he replied ’10 to 15 minutes ago’. He was quite flustered and he seemed a bit jittery, quite muddled in himself.”

The paramedic said at this point he thought it was a cerebral incident, possibly a stroke, and turned on a portable defibrillator.

The defibrillator however gave him a “a verbal indication of no shock indicated”, so he carried on with compressions which is when more colleagues arrived.

At one point, the defibrillator indicated she was “shockable” and it was delivered, then he could see a pulse. The critical care team then arrived and administered naloxone in case she was suffering from an opiate overdose.

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.

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’Brien 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.”