Among the aggravating features of the case identified was the fact that the errors occurred amid a "general malaise" in standards and priorities at Stafford Hospital between 2004-2007, a judge has said.
"The underlying causes of the breaches and the malaise were fundamental organisational and managerial failures, which can be traced to the very top of the organisation." Mr Justice Haddon-Cave said.
A judge sitting at Stafford Crown Court said the death of Gillian Astbury, who was not given insulin despite being diabetic, had been caused by an "effectively broken" system for hand-overs between staff and poor record-keeping.
Passing sentence on the Mid Staffordshire NHS Foundation Trust, High Court judge Mr Justice Haddon-Cave described the 66-year-old's death as tragic and wholly avoidable.
The trust which runs stafford hospital has been fined £200,000 for failures in care which led to the death of a diabetic patient in 2007.
Gillian Astbury died after nurses failed to give her insulin. Stafford Crown Court heard how there was a systematic failure in providing proper handovers between nursing shifts and proper record keeping. As a result nurses failed to give the essential medication Ms Astburyneeded.
The judge said it was a wholly avoidable and tragic death of a vulnerable patient who was admitted to hospital for care but died because of a lack of it.
Mid Staffordshire NHS Foundation Trust has also been ordered to pay £27,000 in costs.