A DEVASTATED daughter whose elderly mum was starved for 36 hours after a string of surgery delays has blasted the “antiquated” treatment she believes led to her death.
Mary McLaughlin was an active 73-year-old, though suffering from probable early dementia, when she was admitted to the Western General Hospital with pneumonia.
She was expected to be home within days following routine treatment with antibiotics in March last year. But her hospital stay quickly turned into a nightmare after she fell and broke her leg, necessitating an operation at the Royal Infirmary.
Her family said the fall, which left her screaming in agony, was the first in a series of “catastrophic mistakes” which would see the grandmother dead within two months.
A scathing report by the Scottish Public Services Ombudsman has now backed their claims of sub-standard care, criticising both hospitals for her “unreasonable” and “antiquated” treatment.
It found proper assessments had not been carried out and that she was needlessly subjected to repeated periods of fasting before operations that were then cancelled, leaving her “very weak”.
Daughter Mary Ford said the family were in no doubt she would “still be here” if the fall hadn’t happened.
“It might say natural causes on her death certificate, but we definitely think the fall is what killed her,” she said.
“With the strain and the stress, she just gave up in the end. I told my brother that we weren’t going to get her out because the level of care she received was horrendous from start to finish. It’s bittersweet that she’s at peace and out of pain, but she should still be here now which makes us angry.”
Mrs McLaughlin, from Leith, was admitted to the Western with pneumonia and associated confusion and hallucinations.
Later that night, nurses heard her screaming in agony and found her lying on her back in the bathroom in pitch darkness. It took eight members of staff, using a bed sheet, to manoeuvre her from the toilet floor and on to a trolley before an X-ray revealed she had broken her thigh bone.
The health board initially insisted the frail patient had fallen out of bed, but was later forced to admit Mrs McLaughlin had hurt herself on a trip to the toilet.
The investigation found a full risk assessment and care plan, that should have been carried out within 24 hours of arrival, was not done and only a “brief assessment” took place.
Medics transferred her to the ERI within hours for planned surgery, but she didn’t go under the knife until March 20 – six days later.
Surgeons cancelled her theatre slot three times, but only after periods of fasting before each planned operation.
“She was fasting for three days before she was supposed to go in for surgery and we were told there were to be no visitors. That’s what angered me the most,” said Mary, 51.
“They kept saying ‘an emergency has come in’, they’re still saying it, but I honestly believe they thought she was going to pop her clogs from pneumonia so wasn’t a priority.
“I felt as though everyone on the ward that had been taken in with breaks had been operated on – the only one that was waiting was my mum.
“She just got so fed up that her hopes kept being dashed. Every day she was being told she was going to the operating theatre and then left wondering why she was still there.
“At one point I turned around to them and said that animals in the zoo get better treatment, you wouldn’t leave an animal with no food or water like she was.
“When we did go in after they’d been cancelled, we were taking sandwiches because she was clearly hungry, she ate them all.”
She was then transferred to a high-dependency ward – to the shock of her family, who then learned a “do not resuscitate” order had been placed on her without their knowledge. This was later reversed by doctors.
After being transferred to the Royal Victoria building for a fortnight’s rehabilitation, Mrs McLaughlin was sent home with a full care package, but remained in excruciating pain.
After calling NHS 24, a doctor arrived and advised her to go back to the Royal Infirmary, but after five hours at A&E, another doctor sent her home again, and increased her carer visits from two to four per day.
On May 6, the family called NHS 24 after Mrs McLaughlin’s leg turned blue and she was rushed back to the ERI.
But the mother-of-three, grandmother-of-four and a great-grandmother to one, who had twice beaten breast cancer, died on May 8 from heart failure.
Commenting on the ombudsman’s findings, Mary said she felt some justice had been done for her “proud mum”.
“Up until she went in and had the fall, she had no home help and no carers, I was her carer. She was independent, she lived in her own house and did her own washing, ironing, her own cooking. She was a very proud woman. Mum was active and would take the dog to the park every day.
“I am still very bitter that NHS Lothian have never apologised properly, we’ve never had a letter offering a meeting from them which is why we pursued it. Our family didn’t want it happening to anyone else.”
The damning report pointed out serious flaws in assessment and care of dementia patients, pre-operative nutrition and communication with relatives, and made seven recommendations to the board.
The ombudsman concluded: “The nursing notes for the days before her operation were very sparse and showed that Mrs McLaughlin was clearly in pain. She was starved of food for 36 hours, which I found unreasonable. Current advice is that patients need only fast for six hours before surgery and my nursing adviser said that the approach adopted in Mrs McLaughlin’s case was based on antiquated practice and lacked individual care.”
Sarah Ballard Smith, deputy executive nurse director at NHS Lothian, publicly apologised and said lessons would be learned.
“I would like to publicly apologise to Mrs McLaughlin for the failings in this case and offer our sincere condolences to her and her family. We accept the report from the Ombudsman and we are taking the recommendations very seriously indeed.
“We have reviewed our practices and procedures and have begun implementing measures in relation to the assessment of patients, care planning and during consultations with patients and relatives.”
Launch of dementia care learning programme
PROFESSOR June Andrews, director of the dementia services development centre at Stirling University, today launched the world’s first dementia care learning programme for emergency care staff.
She said when frail, older people are admitted to hospital, it is vital they have a thorough assessments for potential falls.
Patients with dementia are more susceptible to falls because it often causes a decline in muscle strength, walking and balance as well as reducing reaction speeds and depth perception.
She said: “There are very simple tests that you can do that are very quick that will let you know if someone has cognitive impairment.
“There is a four-item questionnaire which is often used at the point of admission to hospital and, although that doesn’t confirm 100 per cent that there is dementia, if somebody fails that, they should assume that they have dementia until they have been properly tested.
“It doesn’t do them any harm if it turns out they do not have dementia and you have to take special care when someone has cognitive impairment.”