A 90-year-old driver who killed a couple when he accidentally reversed his car into them should not be sent to jail, a judge has been urged.
Clare Haslam, 44, and Deborah Clifton, 49, of Chorlton-cum-Hardy, Manchester, died after they were hit by a car outside Withington Hospital on 7 March.
Philip Bull of Manchester said he pressed the accelerator instead of the brake in his automatic car when he dropped his wife off at the hospital.
He admitted dangerous driving charges.
Sarah Johnston, prosecuting, said CCTV captured the retired textile merchant's parking his Ford Focus in the ambulance bay outside the hospital just after 14:00 GMT.
He then got out and set up the walking frame for his wife, she said.
As Mrs Bull moved away, the defendant reversed his vehicle which suddenly accelerated as he began to turn the steering wheel to his right, said the prosecutor.
The rear of the car hit a metal bollard before it struck Ms Haslam at speed and went on to hit Ms Clifton, who was "seemingly trying to get out of the way".
Ms Haslam showed no signs of life and died shortly after at Wythenshawe Hospital. A post-mortem examination showed she suffered severe chest injuries.
Ms Clifton was later pronounced dead at Manchester Royal Infirmary and her post-mortem examination revealed she had sustained multiple fractures and a crushed liver.
Bull, of Button Lane, Wythenshawe, pleaded guilty at an earlier hearing at Manchester Crown Court to two counts of causing death by dangerous driving and was said to be "hugely remorseful".
He told the author of a pre-sentence report: "I cannot think of any way worse to come to the end of my life having now ended the lives of others."
His barrister, Richard Vardon, argued the circumstances of the case were "exceptional" and could lead the judge to impose a suspended custodial sentence.
The defendant has been carer for his wife Audrey Bull, who has had a number of health problems including Alzheimer's for more than 10 years, he said.
He said she could not be cared for at home without him.
Mr Vardon said: "The single cause of this tragedy... was the defendant misapplying his foot to the wrong pedal, and then more forcefully because he believed he was pressing the brake rather than the accelerator."
He said the unintended acceleration was "not an uncommon phenomenon" and had nothing to do with the age of the defendant, who had no medical problems at the time.
Mr Vardon said Bull was a man of "impeccably good character" who "worked all his life, served his country in the armed forces and has a good driving record".
Judge Martin Walsh said it was an "extremely difficult and sensitive sentencing exercise" and he would pass sentence on Tuesday.
Ms Haslam, 44, and 49-year-old Ms Clifton had a child and were "soulmates", their families said.