"Cat in Hell" is the 105th episode of Casualty and the series premiere of the 8th series. It was preceded by "Boiling Point" and followed by "Riders on the Storm". The episode was directed by Matthew Evans and written by Susan Wilkins. This episode also sees the arrivals of Mark Calder, Karen Goodliffe, Adele Beckford and Ken Hodges.
After the hospital fire last series, Holby City's A&E department is up and running with Surgical Manager Mark Calder already announcing cutbacks. Back from a holiday in Istanbul, Charlie belatedly welcomes Clinical Nurse Specialist Ken Hodges to the team, whose recent appointment has upset Ash who had also applied for the post. New SHO Karen Goodliffe is slow to fit in and annoys Josh with her moody attitude. Charlie asks new nurse Adele Beckford to join his team full time, and Duffy is now happily married to Andrew.
Driving a stolen car, teenagers George and Ed, with George's younger brother Danny are chased by police. George tries to beat the level crossing but stalls the car in the path of an oncoming train. The train smashes into the car, and there are many people trapped and injured in the wreckage. Duffy and Mike are called out to help. Joyriders George and Ed die at the scene, Danny is brought in but also dies in CRASH. Among the injured includes ticket inspector, Roy, with a severed hand. Rival politicians, Stella and Jeremy, who trapped together – the team find it hard to move one without harming the other – Stella, whose legs are trapped asks for no pain relief and to try and save Jeremy, but his injuries are to severe and he dies.
Two widowers, Bernard and Marion become friends after receiving minor injuries. And 17 year old, Daisy, who got on the train, after her estranged father didn't show up to meet her is trapped in the wreckage – when she is brought out – her father is there to greet her and apologises for being late.
In A&E, Karen also treats a student, Steve, who has been testing arthritis drugs for money and comes in with hemotemesis. Karen, furious with the drug company for not supervising him, suggests he takes legal action – angering Mike who warns her not to be too impulsive and hotheaded.