For nearly four decades, Casualty has put viewers through an emotional wringer, delivering shocking exits that stay with us long after the credits roll. While Holby’s ED has seen countless tragedies, a few deaths stand out as truly unforgettable — moments that broke our hearts and defined the show’s legacy. Here are five of the most heartbreaking losses in Casualty history.

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1. Sam Nicholls (Charlotte Salt)

When beloved paramedic Sam Nicholls was brutally stabbed by gang members in 2018, fans were devastated. Known for her compassion, bravery, and dedication, Sam’s sudden death was both shocking and gut-wrenching. Iain Dean’s grief afterwards added another layer of pain, showing just how deep their bond had been. Sam’s loss was not only a tragedy for the ED but also a reminder of the dangers NHS staff face every day.

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2. Noel Garcia (Tony Marshall)

Few deaths hit harder than Noel’s in 2021. A friendly receptionist who brought humour and warmth to Holby for over a decade, Noel was a fan favourite. His sudden death from COVID-19 during the pandemic was both painfully real and deeply symbolic, reflecting the sacrifices frontline staff made in real life. Viewers wept as the ED lost one of its most reliable and kind-hearted souls, a man who represented the everyday heroism of the NHS.

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3. Cal Knight (Richard Winsor)

The murder of Cal Knight in 2017 remains one of the most shocking Casualty moments ever. Stabbed in the car park while protecting his brother Ethan, Cal’s death was brutal and final. Fans mourned not only for Cal but also for Ethan, who was left shattered by the loss. The storyline was praised for its raw emotion and for showing how grief can transform a character — Ethan has never been the same since that night.

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4. Megan Roach (Brenda Fricker)

Megan, one of the ED’s original nurses, was a character beloved for her warmth and wisdom. Her return in later years was bittersweet, but her decision to end her life through assisted suicide in 2010 devastated viewers. It was a storyline that raised difficult questions about dignity, choice, and love, and Megan’s farewell remains one of the show’s most poignant exits. For longtime fans, it was like losing a family member.

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5. Robyn Miller (Amanda Henderson)

Robyn’s death in 2023 shocked the fanbase, not least because of her long-standing presence in Holby. A bubbly, loyal nurse with an unshakable heart, Robyn’s tragic car crash felt cruel and unexpected. For viewers who had followed her through ups and downs for a decade, her loss was like saying goodbye to an old friend. The ED has not felt the same without her.

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Why these deaths matter

What unites these storylines is not just the shock of loss, but the way they changed the ED forever. Each death reshaped the characters left behind — Iain after Sam, Ethan after Cal, Charlie after Megan, and the entire team after Noel and Robyn. These weren’t just exits; they were turning points in the life of Holby itself.

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What do you think?

Casualty has given us countless unforgettable goodbyes, but these five stand among the most heartbreaking. Which death left you most devastated? Do you think another deserves a place on the list?