King's Mill Hospital staff say they could not possibly have foreseen that Dorothy Cardno (67) would 'succumb to an irrational urge' and plunge from the balcony after running from the ward.

Mrs Cardno, from Mansfield, was in Ward 3 at King's Mill Hospital after suffering a suspected heart attack when, in March 2003, she slipped through a gap between the balcony and the wall and plummeted to the ground.

She had run through the ward to a fire escape door and nurses, who were alerted by the rush of cold air as the door opened, were horrified to see her lying on the ground below.

Mrs Cardno suffered devastating injuries in the fall. She now has to use a wheelchair when she leaves her home and is in constant pain.

In February this year, Judge Richard O'Rorke awarded her £230,000 damages against the Sherwood Forest Hospitals NHS Foundation Trust after ruling that the gap in the balcony was unsafe and created a risk that confused or disorientated patients might squeeze through it.

However, the NHS Trust was today granted permission to appeal against Judge O'Rorke's ruling after its counsel, Mr Robert Owen QC, said Mrs Cardno's accident was 'wholly unforeseeable' and it was 'manifestly wrong' to find the hospital in any way to blame.

The case will now go ahead for a full hearing at London's Appeal Court - and payment of Mrs Cardno's damages will be 'stayed' pending the final outcome.

Mr Owen said Mrs Cardno had been noted as 'alert, orientated and co-operative' when she arrived on the ward and her condition had been carefully monitored by medical staff on their rounds.

Her family had been 'assiduous' in visiting her - her daughter, Jenni Vardy, had said goodbye to her when visiting hours ended less than three hours before the accident.

Although her daughter had said she was 'out of sorts, irritable and distant', the QC said there was no indication to the nursing staff on duty that night that Mrs Cardno could do something entirely unexpected.

Lady Justice Smith pointed out that the 'unsafeness' of the balcony was well established and it would have been possible for any slender adult to squeeze through the gap.

However, she nevertheless granted the NHS Trust permission to challenge Judge O'Rorke's ruling at a full Appeal Court hearing, a date for which has yet to be set.

Payment of Mrs Cardno's damages and legal costs bills was "stayed" pending the outcome of the NHS Trust's appeal which, if successful, will mean the pensioner goes without a penny.