Introduction

Miss Ann Cooper (known as Annie) died at her home, 68 Old Road, Hyde on Monday, 15^th February 1988 at the age of 93. Miss Cooper had been a patient of Shipman since his arrival in Hyde in 1977. He certified that the cause of her death was cerebrovascular accident.

In February 2000, following the publicity surrounding Shipman's convictions, Miss Cooper's niece, Mrs Kathleen Nield, contacted the police to express concern over her aunt's death. The police investigated the death and took a statement from Mrs Nield. An inquest into the death was opened and adjourned by the South Manchester Coroner on 18^th May 2001.

The Inquiry has taken statements from Mrs Nield and from Mrs Carol Morrison, Miss Cooper's home care worker. Miss Cooper's medical records are no longer in existence but the Inquiry has had access to Shipman's visits books for the relevant period.

This decision has been made following consideration of the papers and without an oral hearing.

Personal Background

Miss Cooper had never married. She lived most of her adult life with her sister, Miss Beatrice Cooper, who died in 1981. At the time of her death, she was living alone. Despite her age, Miss Cooper was active and capable of caring for herself. She would walk into Hyde two or three times a week to do her shopping. She kept her house in good order. She had no time for modern amenities such as the telephone or running hot water. She was very deaf and kept herself to herself. About 20 years before her death, she had been diagnosed as suffering from a stomach ulcer, but she had regained a healthy appetite and was not troubled by her ulcer at the time of her death.

Mrs Nield would see her aunt about once a month. She visited Miss Cooper on Saturday, 13^th February 1988. In the course of their conversation, it became apparent to Mrs Nield that her aunt was confused. She was speaking of her sister, Beatrice, as though she were still alive. Mrs Nield explained the mistake and Miss Cooper seemed to understand, as a tear rolled down her cheek. Mrs Nield was concerned for her aunt and visited again to have lunch with her the following day. She remained concerned.

The Day of the Death

On Monday, 15^th February 1988, at about 8.30am, Mrs Nield telephoned Shipman's surgery. She explained her concern about her aunt to the receptionist and asked if Shipman would visit. She said that her aunt was very deaf and, if Miss Cooper did not respond to the doctor's knock at the door, Shipman should go in, as the door was never locked. She said that the visit was not urgent. The problem was not acute. The intended visit appears in Shipman's visits book for that day.

At 3.30pm that afternoon, Mrs Nield telephoned the surgery and was put through to Shipman. She asked him if he had managed to visit her aunt. He replied that he had visited and had pushed the door open as instructed. Shipman said that he had found Miss Cooper standing in the kitchen, doing the washing. He had talked to her and Miss Cooper had agreed to see a specialist. At that point, Mrs Nield became a little flustered as she thought she would have to make some arrangements if her aunt was to see a specialist. She started to explain this to Shipman but he cut her short, saying something like, 'Just a minute, just a minute, she's died since then'. Mrs Nield was completely taken aback. She thanked him and put the telephone down. On reflection later, she thought Shipman had been insensitive and rude.

Mrs Nield then walked to her aunt's home. On the way, she arranged for an undertaker to remove the body. When she arrived at the house, a next door neighbour, named Ms 'Emmie' Taylor, spoke to Mrs Nield. Ms Taylor has since died and has never made a statement about Miss Cooper's death. She told Mrs Nield that she had been concerned when she saw the doctor going to Miss Cooper's house as she had never seen a doctor there before. The house was very quiet after the doctor had gone. Usually she could hear Miss Cooper moving about, as the living room floor was made of stone and the chair made a scraping noise. She was concerned, so she went to look through the window. She could see Miss Cooper lying on the bed. She had been trying to contact Mrs Nield ever since. Mrs Nield was still shocked and did not question Ms Taylor, which she now regrets.

On entering the house, Mrs Nield found her aunt lying on her back on her bed in the front living room. Miss Cooper was fully dressed in day clothes with her arms at her side. She was lying diagonally across the bed and her head was not on the pillow. It did not appear to Mrs Nield that Miss Cooper had been asleep. The room was undisturbed. The body was taken away and Shipman did not attend the house again.

The Aftermath

On Tuesday, 16^th February 1988, Mrs Nield visited Shipman at the Donneybrook Surgery to collect the Medical Certificate of Cause of Death (MCCD). Shipman said that he thought he could issue a certificate. He said he thought Miss Cooper had suffered a series of small strokes, each causing deterioration. Mrs Nield was surprised as, apart from the mental confusion, she was unaware of any deterioration. Shipman made no mention of paying more than one visit to Miss Cooper on the day of her death.

Certification

Shipman completed the MCCD. Although the certificate itself has not survived, its counterfoil has been recovered. Shipman said that he had last seen Miss Cooper alive on the day of her death. He claimed to have seen the body after death and said that there would be no post-mortem examination. The cause of death was stated to be cerebrovascular accident.

Shipman also completed Form B of the cremation certificate. Until recently, Mrs Nield had not seen that form. When she saw it, she realised that some of the information was incorrect and contained inconsistencies.

First, Shipman said that he had attended Miss Cooper for three months during her final illness. Mrs Nield knows that her aunt had not required medical attention at all during that period. Shipman's visits books contain no note of any visit during that period. Miss Cooper might have suffered some deterioration in her mental processes and this could have been due to transient ischaemic attacks, but Shipman could not properly say he had treated her for them over the last three months.

Second, Shipman said that the time of death was 'Approx 2pm' and the mode of death was syncope of only seconds' duration. The cause of death was as on the MCCD. He also said that he last saw Miss Cooper alive approximately two hours before death. That would be at about midday. He said that his answers in respect of the cause and mode of death were based on his own knowledge and statements made by a neighbour and Dr Moysey. The only neighbour who seemed to have any knowledge of the death was Ms Taylor, who did not appear to have been in the house at the time of the death. It would be surprising if another neighbour had been present at the death and had not contacted Mrs Nield afterwards. Dr Moysey has no recollection of Miss Cooper's death. It would appear likely that Ms Taylor telephoned the surgery after she had seen Miss Cooper through the window, and Dr Moysey went to the house. As the door was unlocked, he could have gained entry and it is possible that Ms Taylor went inside too. However, it is hard to see how either of them could have known anything about the mode or duration of Miss Cooper's death. As Shipman later stated that no one was present at the moment of death, his entry must have been pure supposition. It is possible that Shipman visited at noon as he claims and left Miss Cooper alive and well (and about to resume her washing) and that Dr Moysey was called out at about 2pm and witnessed her death. However, if that had happened, one would have expected Shipman to explain the sequence of events to Mrs Nield either on the telephone on the day of the death or when she called at the surgery the next day. The course of events postulated by Shipman on Form B seems thoroughly implausible.

Third, Shipman said on Form B that he saw Miss Cooper's body again about four hours after death. If he did so, he must have seen it at the undertakers.

The Expert Evidence

Professor Richard Baker regarded the case as highly suspicious on account of the contents of the cremation forms.

Conclusion

The circumstances of Miss Cooper's death are highly suspicious. The death was discovered very shortly after Shipman's visit. Miss Cooper was plainly quite well when he arrived; she was doing her washing. Although the evidence is hearsay, it appears that Miss Cooper did not move about after Shipman's visit. Ms Taylor became concerned and went to look through the window. She saw Miss Cooper on the bed. I think she must then have telephoned the surgery and Dr Moysey must have come out and have declared Miss Cooper dead. Although it is possible that Miss Cooper was alive when Shipman left and then died a short time later, this seems most unlikely. It would be a most remarkable coincidence. The sequence of events gives rise to grave suspicion that Shipman killed Miss Cooper during his visit.

It appears to me that Form B is thoroughly misleading. First, if Shipman were not present at the death, he would have had no way of knowing the time of Miss Cooper's death. It is theoretically possible that Dr Moysey was present at the death but this is so unlikely that I discount it. Had that been so, I am sure Shipman would have said so on Form B and Mrs Nield would have been told. I think that Shipman's claim to know the time of death was an attempt to create the impression that the death occurred some time after his own visit. Second, Shipman's claim that he had attended Miss Cooper for three months during her last illness was plainly an attempt to create the impression that Miss Cooper's death was not sudden and unexpected, which in fact it was. I think the entries on Form B were devised to create a plausible account of the death.

I have come to the conclusion that Shipman must have killed Miss Cooper. The case bears his hallmark. I accept that, at 93, Miss Cooper was at risk of having a sudden fatal stroke but it would be a remarkable coincidence that she should have such a stroke so soon after Shipman's visit. I feel able to say that I am sure of this conclusion.