This is an odd one! When users have a name change here we actually rename their user login account, not just the Display Name like many places do. Exchange 2010 is fairly new here, so this is the first time I've noticed this problem:
The user in question had her account renamed, and then went on a leave of absence for a time. While she is out, several others have full permissions to her mailbox (including send-as) so that they can make changes to appointments she made earlier.
For appointments that she made after the name change, the permitted users can make changes without any problems. But with appointments she made before the name change, the permitted users are unable to send updates. (Sorry, I can't find the exact error message.)
My first suspect was the old email address, but that is listed as a valid SMTP alias for her account, so it should be okay. Any other thoughts as to why this happens, and how to fix it?