Northern Ireland's most senior coroner today raised the possibility that evidence to be presented at the inquest of a young mum could have consequences for the safety of the convictions of serial killer Harold Shipman.
John Leckey made the warning at the preliminary hearing into the death of 28-year-old Janet Patricia Brown who died just hours after having her third child at Antrim Area Hospital.
Mrs Brown died while feeding her baby son, who was born by Caesarian section, in September 2006.
According to a pathologist's report, the mother from Lisalbanagh Road in Magherafelt, died from ‘morphine intoxication' which means she had too much of the drug.
Today's hearing, held at the Coroner's Court in Belfast, was told that Mr Leckey had received a report from an expert at the Indiana School of Medicine in the US which he said presented him with “a number of problems”.
The report gives Mrs Brown's cause of death as exhaustion, which the coroner said is not possible, and discounts morphine toxicity.
Mr Leckey explained to the hearing that his medical officer, Dr Gillian Clark, had examined transcripts of the public inquiry held by Dame Janet Smith into the killings of Dr Shipman. Its final report was published in 2005.
Shipman, who has since taken his own life in prison, was convicted of killing 15 of his patients but Dame Janet later ruled he was linked to a total of around 250 deaths.
Dr Clark told today's hearing that 15 of Shipman's victims died from morphine toxicity.
She said Day 20 of the inquiry heard from a Home Office forensic toxicologist called Julie Marie Evans who said that morphine levels found in any victim after death could never have been higher than before.
Ms Evans also said that the body is incapable of manufacturing morphine after death.
A barrister representing the Northern Health and Social Care Trust, which has responsibility for the Antrim Area Hospital, said that its expert investigations into what happens morphine in the body after death suggest that levels can change through enzyme processes.
Mr Leckey said he was surprised that there would be any dispute of evidence given to the Shipman Inquiry.
“I can't think of any higher profile investigation,” he said. “If there had been any issue, this is something that surely would have been teased out?”
Mr Leckey asked if he should he contacting Dame Janet about the Brown inquest evidence.
“We all know that Dr Shipman was vilified on a worldwide basis,” he said, raising the potential for a “dreadful miscarriage of justice” on the basis of morphine evidence. “"I'm not exaggerating the significance of this,” he added.
He asked three barristers, representing Mrs Brown's family, the Northern Trust and midwives involved in the case, if the evidence should be brought to the attention of Dame Janet.
They each agreed it should.
Mr Leckey said he still intended to proceed with a full inquest into Mrs Brown's death on March 30 as planned.