The body of an 88-year-old woman allegedly murdered by a hospital nurse was exhumed more than a year after her death, a court has heard.
Colin Norris is accused of murdering patients at two Leeds hospitals
Doctors at first diagnosed a stroke in the case of Bridget Bourke, of Leeds, Newcastle Crown Court heard.
Colin Norris, of Egilsay Terrace, Glasgow, is charged with murdering four elderly patients, including Mrs Bourke, at two Leeds hospitals.
Mr Norris denies the offences, which allegedly occured in 2002.
He has also pleaded not guilty to the attempted murder of the same four women and the attempted murder of 90-year-old Vera Wilby in the same year.
The court heard on Wednesday how police investigating the death of Ethel Hall, 86, from Calverley in Leeds in December 2002, decided to review the cases of Mrs Bourke; Doris Ludlam, 80, from Pudsey, and Irene Crookes, 79, from Leeds.
All three women had died earlier that year.
The jury heard the women's bodies contained large amounts of insulin which caused them to slip into comas from which they could not be revived.
Robert Smith QC, prosecuting, said: "Mrs Bourke, unlike Doris Ludlam and Irene Crookes, had been buried, not cremated.
"Following the investigation into the death of Ethel Hall, an order was obtained from the coroner for the exhumation of Mrs Bourke's body."
Mr Smith said that although Mrs Bourke had been a "frail and sick" woman, and had well-established diseases, tests carried out by two experts following the exhumation found she did not die from her original illnesses.
Following the exhumation in September 2003, a pathologist redefined her cause of death as an insulin-induced coma, he told the jury.
The prosecutor said that when another of Mr Norris' alleged victims, Mrs Crookes, was found slumped in bed, a member of staff noticed in the nurse, Mr Norris, "an attitude of detached amusement".
The medical practitioner said Mr Norris showed no urgency in trying to help revive her, Mr Smith told the court.
The trial continues.