My elderly mother was admitted to Yeovil Hospital with chronic diarrhoea.
Doctor A. phoned me. He said she still had the diarrhoea and was dehydrated but was stable. He thought it was Colitis or a re-emergence of Crohn’s disease which he said he was confident could be treated. He said that they would give her antibiotics and potassium intravenously (although when I enquired about this later, I was told that she wasn’t on a drip) and would take samples. (She tested negative for Coronavirus.) He said a “clinical decision” had been taken not to resuscitate my mother in the event of a cardiac arrest although he did not expect that to happen as her heart was sound. He sounded optimistic that she would recover and if medically fit would be discharged “possibly next week.”
In telephone calls we made during that first week we were told by various staff that my mother was improving. (Because of the Coronavirus we were not allowed to visit her at this stage.) There were conversations with the Discharge team about where she might go after she had left the hospital.
I spoke with a physiotherapist, M. who said he had just walked my mother around the ward and that she was “stable”. A dementia nurse, J. informed us that my mother had been sitting in a chair and reading. She enabled me to speak to my mother on the phone – she was able to converse with me and asked questions about what was wrong with her and so on.
A nurse told me that my mother was stable, the diarrhoea had lessened and they were hopeful she would be discharged soon.
From this day on, after my mother had been in hospital for 10 days, the situation changed dramatically. When I rang and asked to speak to her, she sounded unrecognisable and very distressed and said she was in pain. She said she was constantly thirsty and hadn’t been given a drink for a long time. I became very concerned.
I asked a nurse who my mother’s consultant was and was told this was Dr S. but whenever I asked to speak to her, she was never available. (Please refer to the comment made to me by Dr G. on 10.6.20.) I was told that another doctor would contact me but they did not. I had to rely on information from nurses and ancillary staff, which now varied from day to day.
I eventually got to speak to a Doctor G. I expressed concern that the sudden unexpected deterioration in my mother’s condition was at odds with what we were previously told and that we were concerned. He told me that her consultant, Dr S. “still doesn’t know what is wrong with her.” He said that the scan didn’t show anything but added: “I will suggest she has another look to see if anything was ‘missed’…..”. I was surprised to hear this, it did not inspire confidence.
He then told me that Dr S. had decided that my mother should have a sigmoidoscopy but that it also did not reveal anything. He then told me that Dr S. “thought” that my mother had a fistula because faecal matter had been seen to enter the bladder after a catheter was fitted. However, when I spoke to another Doctor S. (male) on 9.6.20 he said that the catheter had apparently been put in the “wrong place” leading to a misdiagnosis where Dr S. thought there was a fistula but in fact there wasn’t.
When I asked why, after 17 days, Dr S. still had no clue exactly what was wrong with my mother, had not been able to administer anything to stop the diarrhoea and had not been able to do anything about the mounting pain my mother was experiencing, he told me that they had “tried steroids” but she hadn’t responded to them. There was no suggestion that they would try any alternative forms of medication. He also said that they had withdrawn the antibiotics they were giving her. At this point it became apparent that they were not going to do any more for my mother and that they were effectively letting her die. I was told that she would be moved to a “side room” and that I could now visit her from 10th June.
I visited my mother in the hospital and was alarmed by her deterioration and her excessive suffering.
I asked a nurse if I could speak with Dr S. but Doctor G. appeared instead. I asked why I couldn’t see Dr S. He said bluntly: “You can’t – basically she makes the decisions about your mother’s treatment, she tells us what’s happening and we tell you.” He also made reference to my mother’s advanced age, something which I increasingly heard from other members of staff: it seemed that they had stopped caring for her – which caused her immense suffering in the process – because she was elderly and therefore deemed not worth treating. I again expressed concern that after two and a half weeks not only did Dr S. show no willingness to engage with us, she had failed to identify the cause of my mother’s diarrhoea other than that it was “possibly Crohn’s”, had been unable to prescribe an effective treatment to alleviate the diarrhoea and was not prepared to explore alternative treatments. Because of this apparent incompetence, my mother deteriorated very quickly and had now developed secondary problems such as infections which caused painful sores on her lips and in her mouth, terrible redness due to the constant diarrhoea and could now barely talk or eat and drink.
He said nothing.
I spoke to a Doctor A. He told me that a decision had been made not to carry out further tests on my mother (which, in any case, had been inconclusive and which had only increased her suffering) and that they had withdrawn all medications. It was only at this point that I was told they had also withdrawn her blood pressure/calcium tablets, which she had depended on for years, several days previously. He said Dr S. had seen her earlier that day, that she was “waiting for more results” and that she now “thought” that there was a cancerous growth on the bowel (this subsequently proved not to be the case). He also said that Dr S. had decided upon a “shift of focus” regarding my mother’s care. My interpretation of this statement was that, after almost a month, having failed to help my mother, they were basically letting her die. There was an assurance that my mother would be made comfortable and pain-free – the reality I witnessed was the complete opposite of that.
My brother emailed Dr S. to express concern about my mother’s worsening condition and questioned Dr S’s role in this. She responded by saying that she couldn’t reply to his email (why not – unless this was to avoid her written words being used against her at a later stage?). She asked for his telephone number, this was given but he did not hear from her.
My partner visited my mother in the morning. He asked to see a doctor. A Doctor K. appeared and he tried to engage him in a discussion about the seriousness of my mother’s condition and the apparent neglect which had led to this. This doctor seemed “uncomfortable” with discussing the matter and suggested he talked to Dr S. instead. Dr S. finally appeared but said very little other than that she hadn’t been able to establish the cause of the diarrhoea (and yet Crohn’s Disease was given as a cause of death on the Death Certificate.) She said
that nothing could now be done for my mother. He was compelled to point out that she had had almost a month to discover what the problem was and had failed. If she had done her job properly – before my mother’s condition deteriorated – my mother might have been saved. The conversation was unsatisfactory.
When I visited my mother later that same day, I was astonished to be told by nursing staff that there were plans to “fast track” her into a nursing home – even though she was in terrible pain and discomfort, bed-ridden and could not eat or drink. I had been led to believe that she would die in hospital and was now told something very different.
I visited my mother in the morning, my partner visited in the afternoon. My mother was in a very bad way, could not keep anything down, had a painful stomach and was breathing rapidly. There were no staff around. I eventually found a nurse and asked them to give something to relieve her suffering. They gave her morphine, she fell asleep.
Later that evening a senior nurse (H. ) telephoned to say that my mother “probably” had around two hours to live. She asked if we lived near the hospital which I thought was odd but which resonated later on. We were at the hospital within minutes. When we entered the room a nurse was crying excessively.
My mother had died before I got there. In retrospect, we suspect she had already died when the telephone call was made. Thus I was deprived of the chance to be with my mother before she passed away.
In conclusion – I hope it is obvious from the above account that there were multiple failures at this hospital but ultimately I consider Dr S., as the consultant in charge, who made the decisions about how my mother was to be treated, to be responsible for the disastrous chain of events which led to my mother’s unexpected and preventable death. I consider what happened to be “euthanasia by neglect”.
Dr S’s apparent professional incompetence, the decisions she made and her total mis-management of my mother’s condition – as well as her poor communication skills – resulted in medical negligence which cost my mother her life. In the hands of another consultant, my mother might well have lived.
I will never get over the horror of seeing her die in so much agony.