"Concerns about the care of vulnerable patients"

About: University Hospital (Coventry) / General surgery

(as a relative),

I witnessed a staff nurse trying to push a plastic syringe ( no needle) into the pateints mouth so that some medication could be squirted in. The pt was resisting and the nurse said "Come on ,come on, she's clenching her teeth." The pt did not want the medication because it made her sick and the pt had been vomitting all afternoon, the vomit bowls were there containing bile stained vomit. The pts daughter tried to intervene to no avail. The pt was forced to swallow the contents of three syringes which exeeded the prescribed dose knowing it would make the pt even more ill.

Immediately prior to this event the staff nurse had asked the daughter about the pts gall bladder, recognising the stained vomit and appearing to understand that the pt was having gall bladder "attacks" due to obstruction.

These attacks cause severe pain and nausea.

The pt died two weeks later having become skeletal in appearance, being unable to eat or drink and continually forced to take diet and medicaton which did not suit her and caused vomiting and also threatened if she did not comply. The extent of the vomitting was never acurately reported in the notes and the consultant said it was insignificant. The dietician who prescribed the medication and diet had been told twice about the gall bladder problem by the pt and daughter but the dietician denied all knowledge of this and said she was never made aware of the vomitting.

The daughters concerns made to all staff and the dietician and the consultant were never heeded or recorded in the notes . The pt died in agonising pain two weeks later from "old age" and the daughter could get no more information about the exact cause of death. There had been more incidents in the 3 week admission and the daughter, having worked in health and social care for 30 years as a registered practitioner made complaints to the hospital, Nusring and Midwifery Council and Health Professions Council. She wondered if the pt had suffered a ruptured gall bladder as a result of the fatty diet and she found out that the pt had tricuspid insufficieny affecting liver function and causing circulatory collapse in her legs. The pt was refused oxygen when gasping for breath and there is much more.

The daughter contacted the coroner a few weeks later after reading the notes and gradually piecing together all the events surrounding the death of the patient. The daughter had contacted everyone she could think of including PALS while the pt was in hospital, and to this day does not know how pts can be rescued from such circumstances and guaranteed help to die without pain and indignity.

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Response from Daniel Ibeziako, Communications Manager, Communications, University Hospitals Coventry and Warwickshire NHS Trust

We thank you for taking the time to provide us with your feedback. We take every email and comment about the service and care we provide to our patients very seriously. When we receive comments that provide insight into a standard of care that we do not see as typical in our Trust we will always do our best to investigate. In some instances this can lead to change in the way things are done at the Trust. In this case we have carried out an extensive investigation to try and ascertain the details. We have sat down with our PALS team and looked at each notification they have received over the last two months. We have also worked with our Complaints team to try and find further details. In both instances we have drawn a blank.

Your post raises a number of very serious allegations both on the staff who treated the patient and the quality of care that the patient received. Both fall below the standard that the Trust has set for ensuring all patients are treated with dignity and compassion.

However there is very little information contained in the posting that might help us identify things further such as a ward or timeframe when the incident occurred. We would welcome the opportunity to speak with you at length and I ask that you contact myself directly on 02476 967605 so that we can carry a full and frank investigation into each area of concern.

Jill Foster

Chief Nursing Officer

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