Woman dies after medical mistake by replacement worker while thousands of Californian nurses locked out of their hospitals

Thousands of Californian nurses will return to work on Tuesday morning after a four-day lockout by hospital management during which a patient died having been mistakenly given a lethal drug dose by a temporary replacement carer.

Judith Ming, 66, died on Saturday morning at Alta Bates Summit medical centre in Oakland after being given what police say was a "non-prescribed dosage of medication" at lethal levels. The drug was administered by a stand-in nurse brought in from Louisiana by the company that owns the hospital, Sutter Health, following a one-day strike organised by California nurses in protest at cuts to hospital services, benefits and working conditions.

About 23,000 members of America's largest nurses' union National Nurses United went on strike last Thursday, intending to return to their positions after 24 hours. Of those, 17,000 were allowed back by the health giant Kaiser Permanente, but 6,000 nurses were locked out for a further four days by the hospital chain Sutter Health and the independent Children's hospital in Oakland.

Martha Kuhl, one of the locked-out nurses, said the union had given two weeks' notice to employers before the strike began to allow them to assemble suitably qualified replacements, "but apparently that hasn't happened". She said the lockout had been unnecessary and regrettable.

"Qualified nurses were available to work, but management prevented them from returning. So, yes, I believe that the blame for the patient's death lies with them.

"Nurses with 24 years' experience were showing up for work, but were denied entry by security guards."

The hospital is carrying out an internal investigation into the death, and is co-operating with a police inquiry. Dr Steve O'Brien, the medical centre's vice-president of medical affairs, said the death was caused by medical error.

"While medical errors do exist in health care, we are constantly investing in ways to improve patient care. This is a most unfortunate event for which we are very sorry," he said.

Sutter Health also put out a media statement that accused the union of exploiting "the tragic death of a patient to further its own bargaining purposes". It said that all of the 500 replacement nurses that were used were experienced in the areas in which they were assigned.

The union says the strike was part of worsening relations between medical staff and employers, which unions accuse of driving hospitals relentlessly in a commercial direction and imposing market-based cuts in services – even though they are described as not-for-profit institutions. The union accuses management of trying to roll back on standards of health provision, including minimum nursing numbers per patient.

In some of the medical centres involved in the strike, managers have tried to change the conditions of nurses so they would have to pay $4,000 more a year to have their children treated at the hospitals at which they work – a hike that union members say would make the services they themselves supply unavailable to their own children.

Ming was being treated for cancer and had been at Summit hospital since July. Further information about her was being kept private under Californian and federal privacy laws.

Kuhl said it was inevitable that replacement nurses were less equipped to care properly for patients. "We work together, we know the equipment and we know each other's skills and abilities. When management brought in unqualified or even qualified workers, they don't have that advantage, and that sets people up, unfortunately, to make mistakes."