My mum fell out of bed in hospital, and after a cursory check they put her back into bed on hourly checks. Four hours later she was dead.
The PM says that she died of an internal bleed following a rupture to the pleura (the outer covering of the lungs) caused by three broken ribs, badly broken, clearly, not just cracked.
Not looking for sympathy (in fact it was a quick-ish exit from what could have been longer and nastier) but I'm less than impressed that they put her back to bed without a full (including X-ray/scan) examination.
As her son I have the legal right to ask questions of the witnesses (nurses x 3, doctor x 1) who will appear. I'm not going to instruct a solicitor/counsel, yet, though I might.
Any tips, suggestions, advice? I'm receiving a copy of the PM and the witness statements.
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whats your ultimate goal? May sound daft but it determines how far and how deep you want to go
For example - the truth, or someone to blame, or a change in hospital practise, or the trust mamangement on the hook, or compensation, etc etc
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Is it going to be a Jury Inquest ?
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Sorry to hear about your loss.
"Because an inquest does not determine blame for a death, the verdict must not imply criminal liability or civil liability on the part of any person by name. Verdicts used include natural causes, accident or misadventure, industrial disease, suicide, and unlawful killing, or open verdict if evidence for any other verdict is insufficient. Coroners must not add any comment to a verdict, but can inform any appropriate person or organisation of action needed to prevent further deaths in similar circumstances.
Coroners do not have to summarise their findings, but usually do so and may also explain why a particular verdict cannot be used. If an inquest is held with a jury, the jury will decide the verdict, guided by the coroner on points of law. The inquest hearing is closed when the verdict is stated by the coroner. "
For a verdict to be reached other than 'natural causes, then the person has to die within a year and a day. If the death can be attributed to the fall in this case I would rekon on a verdict of 'accident or misadventure'.
Last edited by: Fullchat on Tue 16 Mar 10 at 19:31
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whats your ultimate goal? ...the truth, or someone to blame, or a change in hospital practise, or the trust mamangement on the hook, or compensation,
Not money.
A change in practice would be the best, so it does not happen again. Not the direct fault of the senior management, though clearly training and standard procedures are a potential issue.
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ONB- sorry to hear of this.
Can I ask: what was your mum admitted for?
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Regards Sir. All the best with this.
MD
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"Can I ask: what was your mum admitted for?"
Hard to know where to start..
She had Parkinson's and a variation of rheumatoid arthritis - and was at a guess in the last few weeks of her life had the fall not accelerated things. She also had non-Hodgkins lymphoma (often linked to autoimmune diseases such as the RA), and I think cancer of the stomach.
She'd lost loads of weight in the last few months of her life, and had been very frail for several years. She also had other non life threatening problems.
She had gone in to the hospital for a planned blood transfusion for anaemia in the early summer, gone downhill, stabilised (perhaps) been transferred to a community hospital for seven weeks, where she lost further weight, and then gone back the general hospital to attempt to get on top of the Parkinson's. She dies three weeks later.
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I would be very inclined to take advice. If a there was a "problem", it is far better to have it out than it is to let it go unremarked. If no-one does anything, then nothing will be done. Any action needed and taken may help stop a "problem" happening again.
Best wishes, BTW.
Last edited by: FotheringtonTomas on Tue 16 Mar 10 at 21:27
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The inquest will be held by the coroner sitting alone.
It is an inquisitorial hearing, not an adversarial one like a criminal court.
You are there to find out what happened, not to apportion blame.
Having said that, nothing to stop you asking questions.
Why was a bed with cot sides not used?
Did they consider nursing your mother on a low bed or even on the floor?
I expect you will be told elderly people can break their bones simply by turning over in bed and this type of injury is quite common.
If he's any good, the coroner will have read the papers properly and will be prepared to pass a few choice remarks when giving what is called a narrative verdict.
Of course, coroners work closely with the local medical profession, so you are relying on getting one who is brave enough to do the job right.
Nothing to stop you contacting the local paper in advance of the hearing.
The presence of a reporter might encourage the coroner to perform.
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ONB
Sorry to hear of your loss.
After long experience of hospitals with my late mother - who, like myself, suffered badly from RA and the effects of its drugs - I'd go slightly further.
If an unattended patient of limited mobility falls out of a hospital bed; then a presumption of negligence should be made unless proved otherwise.
Throughout the many months that she spent in hospitals; the nursing staff were almost paranoid about cot sides - even raising them when they were only moving round to the other side of the bed.
To simply return your mother to bed after a serious fall, without calling for the duty houseman [if that's still their title] and a full examination, smacks of an attempted cover-up.
Have the hospital indicated to you that they view this as a serious failure of care? Did they hold an internal inquiry?
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I too am sorry to hear of your loss.
I remember too well my father's final hours. Old and frail, in hospital with pneumonia, in a coma and clearly dying. Fortunately a friend in the medical profession (actually a vet!) had warned me that following Shipman they are very reluctant to use morphine lest it hasten (which it will inevitably) death and the medics are then sued. We therefore specifically asked whether he could have morphine and the nurse's response was "it might kill him, we don't generally use it." ["it might kill him" are you really expecting him to survive as the consultant doesn't] The consultant was more sensible and I have no doubt that morphine did its job.
If you feel your mother was generally badly looked after in hospital, then I can see why you might like to kick up a fuss. On the other hand, one might wonder whether an elderly relative's life had, in fact, been improved, and be thankful.
I do think we often treat elderly dogs more kindly than elderly humans, but that's another matter.
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Sorry to hear of your loss. Its possibly (I'm out of date on RIDDOR) reportable to HSE. Has the incident been investigated? Has it even been reported?
Last edited by: NortonES2 on Wed 17 Mar 10 at 10:57
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I think you should seek legal advice.
If through the inquest you save AN Other patient from a fall and possible neglect after the fall then it will be a worthwhile for both you and the others that fall and are potentially ignored.
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Its ok saying you need legal advice, you probably do, BUT no-one is going to do it for free, and unless you sue them there is no other method to recover your costs.
Ideally you need to force an inquiry of some level.
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Some similarities here; might be of some help in terms of the outcome:
news.bbc.co.uk/1/hi/england/sussex/8563470.stm
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Focus - VMT for the link. Now checking the Rule 43 reports by coroners to see if earlier inquests have made similar recommendations.
A challenge. Not great reading the PM report that my mother's brain weighed xxxx grams. Glad I didn't see her body before burial.
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..Its ok saying you need legal advice, you probably do, BUT no-one is going to do it for free...
Very few solicitors have any idea how an inquest works - I know, I've seen them perform.
A solicitor can also annoy the coroner who can see the grieving family being fleeced for 'advice' they do not need.
The coroner will have already decided if the OP's mother has been badly treated or not.
I've also been to inquests where the coroner will draw on his experience of a particular hospital.
So he might say something like: 'This court has dealt with several inquests from the Blogs Royal Infirmary in the last few months and it has to be said in each case the standard of care...etc, etc.'
In terms of rattling a few cages, the coroner is the OP's friend, and his services are free - at point of delivery.
...Now checking the Rule 43 reports by coroners to see if earlier inquests have made similar recommendations...
ONB,
Why bother? You are only interested in the inquest into the death of your mother.
I get the impression elderly people falling out of bed is quite common, so any coroner worth his salt will be well on top of the background.
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Slight thread drift. Some patients, considered to be at risk of falling out of bed are sometimes put in a VERY low bed with a thick rubber gymnastics type mat on each side. This is at least partly because the PC brigade have managed to get some PCTs to take the view that cot sided beds are a form of inappropraite or illegal "Restraint".
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...put in a VERY low bed...
Some hospitals refuse to use those because they are bad for the backs of the nurses.
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I too am sorry to hear of your poor mother's last illness onb. But it sounds to me as if you are right when you say she was dying anyway and somehow managed to shorten what might indeed have been a longer nasty process.
It is my impression that end-of life decisions are often taken in hospitals by rule of thumb by quite lowly nursing staff. But I think in your position I might want to know why such injuries were not even investigated. Of course small bones can become very fragile in old ill people. I'm sorry.
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Inquests - anyone with experience of them? - Zero
