sheet was included. Cause of death was given as severe immune response to the presence of foreign tissue, despite satisfactory in vitro compatibility. As the compatibility rating of the donor organ was given as 84 per cent, Dunbar thought Staff Nurse Fairfax’s complaint that Amy had been given the wrong organ did not sound too convincing.
He turned to the file on Lisa Fairfax herself. In view of what had gone before, it was possible that the nurse’s claim might have stemmed from her having been deeply fond of young Amy Teasdale and correspondingly upset by her death — always an occupational hazard for staff in children’s wards. She obviously believed that the immunological reaction she had witnessed in her young charge had been caused by the child receiving an incompatible organ, but her reaction could have been inspired by grief and the inherent need to explain away an emotionally unacceptable happening.
Despite assurances from the hospital authorities that there had been no mix-up and that Amy had received an entirely compatible kidney, as shown by lab analysis, Lisa Fairfax had persisted in her claims and she and the hospital had parted company. It looked like a classic case of a nurse allowing herself to become too involved with her patient, thought Dunbar.
He closed the file. It seemed straightforward on paper, although the question of why Staff Nurse Fairfax had persisted with her allegations until Sci-Med became aware of them puzzled him. People did tend to make wild claims and accusations when they were deeply upset, but after a period they usually recovered and, in many cases, were embarrassed about things they had said under stress. Maybe he should arrange a meeting with her, to see if there was more to her than had come through in the report.
He looked to see if there was any more about her and found a one-page personnel file. It included her address and some background material, including the fact that she had worked for three years as a theatre nurse and for a further three specializing in transplant patient care. This made Dunbar think again. He had been ready to dismiss her as emotionally vulnerable, but perhaps he was wrong. You accumulated a lot of nursing experience in six years. Lisa Fairfax must have seen a lot of transplant patients come and go in that time. He decided that, in fairness, he would definitely have to arrange a meeting.
The file on Sheila Barnes’s complaint was skimpy. A young patient named Kenneth Lineham had, like Amy Teasdale, died after rejecting a transplanted kidney. The organ had been deemed highly compatible with his own tissue type but, again like Amy Teasdale, he had undergone immunological rejection of the organ after the operation. Sister Barnes, like Lisa, had maintained that there had been a mix-up somewhere along the line and he had been given the wrong organ. A preliminary investigation of her allegation failed to find any evidence of this and she had resigned in protest.
Dunbar could certainly understand why the Sci-Med computer had drawn attention to the situation. The two nurses had made almost identical claims about two different patients almost three years apart, and both were experienced transplant-unit nurses. But, it had to be said, there was a total lack of scientific evidence in both cases. The women’s assertions seemed to have been based on gut feeling and very little else.
Dunbar wondered if there had been any other cases of apparently severe immune rejection in patients receiving organs classed as perfectly compatible by lab testing. This was something he could check on the computer. He had access to the main Sci-Med computer through the IBM notebook he carried with him. All he needed was a convenient telephone line, and the hotel was equipped with telephone points for modem connection.
He logged on to the London computer through his access number and password and started asking questions about kidney-transplant records. There were plenty of them; kidney transplant had become an almost routine operation over the past few years. He had to narrow down the data available to that pertaining to unsuccessful transplants in the last two years. Asking the right questions was always the key to a successful computer search. Having access to all the data in the world was no use at all unless you knew exactly what to ask.
A lot of thought had gone into the systems design of the Sci-Med service. He further narrowed down the information to patients who had died within two days of their operation, as had Amy Teasdale and Kenneth Lineham. He then asked how many of them had been given kidneys with an 80 per cent compatible rating with regard to host tissue. The answer was none.
Dunbar stared unseeingly at the screen for a few moments. He was thinking about the result. Only two patients in the UK in the last three years had died within two days of their operation after receiving highly compatible organs, and both had been patients at Medic Ecosse. Coincidence? That couldn’t be ruled out, he supposed. Two wasn’t a large number, maybe statistically insignificant. Perhaps there were more cases just outside the 80 per cent compatibility figure. He asked the computer the same question with a less stringent figure on compatibility, reducing by first 5 then 10 per cent. The two Medic Ecosse patients were still the only ones. He then looked at cases in which the patient had died within the first month after transplant. There were ten, and without exception there had been other circumstances involved in their deaths. The two Medic Ecosse deaths remained out on their own. They were a puzzle.
FIVE
In the morning Dunbar asked at the desk about his hired car and was told that it was already in the car park. He signed the relevant documents and was given the keys to a dark blue Rover 600Si. It was just after nine. He thought he would let the office day begin before he added his presence to it. He arrived at Medic Ecosse Hospital a little before ten and made himself known at Reception. A pleasant woman in her late thirties, smartly dressed in a dark suit and pristine white blouse that successfully conveyed the impression of cool efficiency, said he was expected. If he cared to take a seat someone would be with him shortly.
The someone in question turned out to be a short, dark-haired young woman, also wearing a business suit, who introduced herself as Ingrid Landes. Her gaze was confident and direct, her handshake firm.
‘Come with me, and I’ll show you to your office, Dr Dunbar. Do you have a car?’
‘Yes.’
‘You’ll need this.’ She handed him a hospital parking permit, already inserted in a clear plastic holder for fixing to the windscreen, adding, ‘You’ve been allocated space seventeen round the back of the building. It’s clearly marked.’
‘Thank you,’ replied Dunbar, impressed by the efficient way he’d been met and welcomed. He was even more impressed when he was shown into a well-appointed office, tastefully furnished and equipped with just about everything he could possibly need, including a computer and fax machine.
‘Will this be all right?’ asked Ingrid.
‘Absolutely.’
‘Now, can I get you some coffee while you decide what you want me to do? How do you like it?’
‘Decide what I want you to do?’ he asked.
‘I’ve been assigned to you for the beginning of your stay with us, to help you settle in. But if that doesn’t meet with your approval I’m sure we could just-’
‘No, no,’ interrupted Dunbar. ‘It’s just that I didn’t expect assistance. This is a very nice surprise.’
She gave what he saw as a superior little smile and said, ‘Good. And the coffee?’
‘Black. No sugar.’
She left the room and Dunbar sat down behind the desk. He wondered about her and why she had been assigned to him. He hadn’t requested secretarial assistance. Had she been detailed to keep an eye on him, or was it just a case of creating a good impression, an apple for the inspector? Maybe he was being too suspicious. For the moment he would keep an open mind.
Ingrid returned with coffee and laid it down on the desk. The smell told him it had been made with proper ground coffee. There was only one cup.
‘You’re not having any?’ he asked.
‘I’m trying to cut down,’ said Ingrid with a smile that showed uneven teeth. ‘I was drinking too much of the stuff. It made me jittery. I’ve changed to Perrier.’
‘Then why don’t you get yourself a Perrier and then you can tell me about the hospital? After that perhaps you can show me around? I’d like to get a feel for the place.’
