Thursday, 28 February 2013

Doctor criticised after baby dies while in care of privatised GP service

The performance of a doctor treating a seven-week-old baby boy who died while in the care of the privatised out-of-hours GP service in north London was "wholly inadequate", a coroner said on Thursday.

Dr Muttu Shantikumar assessed the newborn baby, Axel Peanberg King, in a telephone call lasting just one minute a few hours before he collapsed in his mother's arms, and later made "wholly inadequate entries on the records that were clearly at odds with the evidence", according to Dr Shirley Radcliffe, the St Pancras coroner.

Axel, previously fit and well, died last November, having contracted a routine cold which developed into a lung infection that went untreated, despite repeated calls and visits by his parents, Linda Peanberg King and Alistair King, over the course of five days to the service and their own GP. Out-of-hours GP cover is run under contract to the NHS in the north central London region by private provider Harmoni.

On the day the baby died, Shantikumar failed to ask the family the essential questions to determine how serious the case was. He downgraded Axel's priority, which had been classified as urgent by a Harmoni call handler, to routine, following his very brief telephone assessment so that the baby was only given an appointment to see a doctor face-to-face three and a half hours later.

When Peanberg King attended the Harmoni clinic, which is located alongside the NHS A&E department in north London's Whittington hospital, she was made to wait with her baby in a queue with six patients ahead of her.

An off-duty NHS paediatric nurse who happened to be sitting near them in the queue realised the gravity of his case and immediately rushed them into the NHS A&E department next door, where frantic efforts were made to resuscitate him in vain. He was declared dead when his father, who had been at home looking after the couple's older child, arrived at the hospital.

The Guardian revealed last December that staff at the Harmoni service feared delays in treating the baby may have contributed to the tragedy. It is very rare, although not unprecedented, for babies in the UK to die of pneumonia.

Recording a narrative verdict which did not apportion blame to individuals, the coroner said it was not possible to say whether intervention at an earlier stage that day would have changed the outcome. Babies that age can deteriorate very rapidly and sadly a few do die, the court heard.

The coroner also found that the consultations and assessments made by staff for the out-of-hours service over the previous few days were appropriate. Two days before he died, the baby had been seen by Dr Kuljeet Takhar, supplied to Harmoni by an agency. The parents had previously reported that Axel was having difficulty breathing, but when Takhar carried out a full examination, he found the baby's lungs were clear and the coroner accepted that at that point the diagnosis of an upper respiratory tract infection was appropriate. Takhar gave a deferred prescription for antibiotics. It was not best practice to do so in babies so young, the coroner said, but Radcliffe also noted that Takhar had told Peanberg King not to be too reassured because very young babies can change very rapidly.

The family said they were not satisfied that they had got to the truth. "We believe there are still many questions to answer about the safety of the service provided by Harmoni. We do not believe that anyone hearing all the evidence in this case could have full confidence in its services. We are now considering all our options to prevent any other children from falling through the net."

Ellen Parry, from the clinical negligence team at law firm Leigh Day, who is representing Axel's parents, said:

"Both Linda and Alistair want to know how their otherwise healthy baby, after repeated visits and calls to this privately run clinic, died from a treatable illness, a death that we believe was entirely preventable."Dr David Lee, medical director for Harmoni, said: "We would like to express our deepest and heartfelt sympathy to the Peanberg King family.

"We believe we have the right underlying systems, policies and procedures to ensure a safe and robust-out-of hours service. We will now be taking full regard of the coroner's findings.

"We know that the review of very difficult incidents such as this always identifies learning points. Our overriding priority is to ensure that this learning is acted on."

The court heard that over the period that the family were in contact with the service there were three gaps in the rota for staff to assess and see patients but Lee said that staffing levels had been safe at all times since slack was built in to allow for people being off ill or for shifts to be unfilled.


This article is courtesy of theguardian.

Friday, 15 February 2013

Widow wins NHS payout over husband's death

The widow of a "truly remarkable man" was today awarded a six-figure sum in settlement of her medical negligence claim over his death.

A judge in the High Court in London heard that solicitor Peter Wells, 59, of Epping, Essex, died in hospital from what was described as a "reversible and treatable condition".

Mr Wells, who had just become a father, had gone to the Princess Alexandra Hospital in Harlow with respiratory failure after suffering from a persistent cough.

The case for his widow Crystal, 47, was that he was likely to have survived and made a full recovery if he had been intubated at any time prior to his death on December 9 2005.

Mr Justice Owen heard that the Princess Alexandra NHS Trust admitted liability.

Neil Sheldon, representing the trust, offered its sincere apologies to his family. The couple's son Matthew was born on March 26 2005.

The barrister said: "Mr Wells did not get the treatment he was entitled to expect. It is a matter or profound regret."

Mr Wells, who was wheelchair-bound, suffered from an inherited disorder which resulted in his bones being brittle and subject to recurrent fractures.

Despite this condition he was described as being in good health prior to November 2005, when he went to his doctor because of a persistent dry cough.

He had been in private practice as a solicitor for a number of years and was also known for his work in the community and for charity.

Mr Justice Owen told Mrs Wells: "I have read the papers and I have been immensely impressed by the tributes that were paid to your husband.

"He was rightly described as a truly remarkable man. That makes the loss that you and Matthew have experienced all the greater.

"But at least you will be able to make provision for Matthew in a way I know your husband would have wanted."

The damages figure was not disclosed in court.


This article is courtesy of The Independent.

Tuesday, 12 February 2013

'I feel utter grief and loss for the life that Milly could have': Mother of girl crippled after hospital blunder

'I feel utter grief and loss for the life that Milly could have': Mother of girl crippled after hospital blunder speaks out after court awards £10.8m medical negligence payout

The parents of a girl ‘left trapped in a body that no longer functions’ after an ‘avoidable’ hospital blunder has been awarded compensation worth £10.8 million.

Milly Evans, 11, suffered devastating injuries after medics failed to notice her heart had stopped shortly after she was born.

She now suffers from cerebral palsy, needs 24-hour care and help with all aspects of daily living.

Today a High Court judge awarded one of the highest clinical negligence payouts after ruling Lincoln County Hospital was at fault.

Speaking after the judgement, Milly’s mother Kate, 41, said: ‘Milly is a very beautiful, bright, kind and loving daughter, with a wicked sense of humour.

‘Unfortunately, she is trapped inside a body that does not function, and she is not able to do the very basic things that we all take for granted.

‘I feel utter grief and loss for the life that Milly could have had if she had she not been injured.

‘Milly is a very much-loved member of the family and we all feel privileged to have such a lovely daughter.

Mrs Evans, who lives with her husband Andy, 45, and family in Lincolnshire, added: ‘The family have been through a very difficult time. The money will never make up for the mistake that condemned Milly to a lifetime of dependency on others.

‘However, it will ensure that Milly is provided with full-time care and equipment throughout her life. We now want to build a loving and secure life for Milly in a new adapted home.

‘Milly is incredibly hard-working, adventurous and positively enjoys many activities. including sailing.

‘We are over the moon that not only will Milly be looked after financially for the rest of her life, we can now pay for the technology and modifications needed to help her achieve her full potential.’

Mr and Mrs Evans claimed that if the baby’s heart had been properly monitored on March 1 2001, the midwife would have spotted the life-threatening condition fetal distress soon after she was delivered.

After Milly’s birth at she was transferred to the neo-natal unit, where she underwent resuscitation and suffered a seizure.

They say without this failure Milly, who is confined to a wheelchair and able only to communicated through sophisticated eye-gaze equipment, could have been delivered earlier without suffering catastrophic injury.

Their counsel, Susan Rodway QC, told the judge, Sir Robert Nelson, that it was a tragic case.

She said: ‘It is yet another incident of an avoidable accident at birth which caused devastating injuries.’

Milly sat smiling in court as the judge approved a settlement involving a lump sum of £5.866 million and lifelong periodic payments rising to £204,000 a year.

He had heard that United Lincolnshire Hospital NHS Trust admitted liability in March 2010 but had contested the amount of damages until the parties recently reached agreement.

He told Mr Evans, a former squadron leader in the RAF and member of the Red Arrows display team, who was unable to continue his career because of Milly’s disabilities, that he and his 41-year-old wife, Kate, had both done a ‘fantastic’ job.

‘The love and devotion you have shown to Milly with her problems has been enormous,’ he added.

Paul Rees QC, for the trust, paid tribute to the family and offered them an unreserved apology for the events surrounding Milly’s birth.

Mr Rees added: ‘No amount of fine words can put right that wrong. I know that and everyone in court knows that. But they are entitled to hear in open court that apology.’

The family’s lawyers, Access Legal from Shoosmiths, said that the money would ensure that Milly had a positive life experience as far as possible given her condition.

She would now be able to have a specially-adapted home, with hoists and a hydrotherapy pool, which would be big enough for her to access all rooms.

Partner Denise Stephens said: ‘Milly is an amazing girl, with a beautiful smile and a sense of humour.

‘She requires round-the-clock care and attention, and will do so for the rest of her life.

‘It was crucial, therefore, that we were able to secure a compensation award of this size to provide for Milly’s needs.’

Sylvia Knight, director of nursing and patient services at United Lincolnshire Hospitals NHS Trust, said: ‘I offer my unreserved apologies on behalf of the Trust, for the tragic incident in 2001 that has affected the life of Milly and her family.

'Since this incident, we have made many changes to our practice that will help ensure this does not happen again.

‘Families attending the maternity unit can be reassured that our teams will deliver high quality, safe and attentive care during their stay.’

This article is courtesy of the Daily Mail.

Monday, 11 February 2013

Ambulance service mistakes resulted in up to four deaths in Australia

Ambulance mistakes in Western Australia have resulted in up to four deaths with one fatality confirmed as being caused by an internal error.

St John Ambulance chief executive Tony Ahern revealed to The Sunday Times last night that five deaths required investigation for potentially fatal errors in the past year.

At least one death was the result of a mistake. It is understood it was a medication error.

SJA was cleared of wrongdoing in another death, but the other three investigations are pending.

For the first time St John Ambulance has revealed the number of sentinel events on its records.

A sentinel event refers to a "catastrophic outcome" for a patient through a medical error.

SJA was forced to collecting data on these events in October last year after a government inquiry into the ambulance service.

Mr Ahern said the potentially fatal errors related to ambulance response times, "clinical protocols" and handling of medication.

Changes ordered as a direct result of the deaths include a review of medications, aspects of paramedic training and ambulance guidelines.

It comes as the latest figures show that ambulance response times in WA are the slowest they have been in a decade.

More than 10 per cent of emergency calls are not responded to in the required 15 minutes.

And more than 20 per cent of non-urgent calls are not responded to within the required 60 minutes.

Mr Ahern said confidentiality prevented him from releasing specific details of the five deaths.

"We are unable to release any information which could in any way identify, or potentially identify, the individuals involved or details regarding the investigation," he said.

SJA has hired an independent firm, KPMG, to undertake an audit and review of the company's management of sentinel events.

A wide-ranging government inquiry into SJA was ordered last year after revelations that SJA mistakes caused four patient deaths, including one case where a 000 case was completely deleted.

The inquiry found that there was a crippling shortage of paramedics and phone operators in the state's ambulance service.

Mr Ahern said SJA was on track to meet ambitious employment targets.

For example, 118 paramedics had been recruited in the past year above the target of 93.

The Sunday Times understands that SJA is looking at introducing a system to fast-track training of nurses who want to be paramedics.

Last financial year, 200,000 ambulance patients were treated in WA.

Mr Ahern said the management of sentinel events was overseen by the SJA's clinical quality improvement committee.

It consists of representatives from the Health Department and the Health Consumers Council.

This article is courtesy of News.com.au.

Wednesday, 6 February 2013

Woman left fighting for life after gastric bypass surgery went wrong is awarded £35,000 compensation

A woman who was left fighting for her life after gastric bypass surgery went wrong has been awarded £35,000.

Rachel Benefer, 28, from Cleethorpes, North East Lincolnshire, spent two weeks in intensive care and needed two emergency operations after a surgeon failed to properly close a small incision.

She asked to have the gastric bypass operation after her weight increased to more than 19 stone, despite repeated attempts at dieting.

Miss Benefer's keyhole surgery to bypass part of her stomach was carried out on the NHS at Hull and East Riding Classic Hospital in 2007.

The operation initially appeared to be successful but the failure of the surgeon to properly close an incision led to the patient developing a hernia, which obstructed her small bowel and caused the stomach bypass to break down.

Miss Benefer developed acute peritonitis - an inflammation of the lining of the abdomen wall - and needed two further emergency operations to reduce the hernia and repair the original surgery.

She spent a total of five weeks in hospital, including 11 days on a ventilator, and also had to undergo a tracheotomy.

Miss Benefer sued Hull and East Yorkshire Hospitals NHS Trust for compensation and was awarded a £35,000 out-of-court settlement.

Danielle Barney, medical negligence specialist with the Bridge McFarland law firm, said: "Our client later required further surgery to repair the hernia and she has been left with unsightly and distressing scars on her abdomen.

"She has also suffered flashbacks and mild depression.

"This was a very painful experience for her and one that left her unable to work for a time and with an increased risk of serious long-term health problems.

"The case highlights once again that a failure by medical staff to follow accepted procedures during even routine surgery can have devastating effects.

"I am delighted that Rachel will now have some compensation to help her put this very traumatic experience behind her."
This article is courtesy of The Independent.

Monday, 4 February 2013

Woman left fighting for life after gastric bypass surgery went wrong is awarded £35,000 compensation

A woman who was left fighting for her life after gastric bypass surgery went wrong has been awarded £35,000.

Rachel Benefer, 28, from Cleethorpes, North East Lincolnshire, spent two weeks in intensive care and needed two emergency operations after a surgeon failed to properly close a small incision.

She asked to have the gastric bypass operation after her weight increased to more than 19 stone, despite repeated attempts at dieting.

Miss Benefer's keyhole surgery to bypass part of her stomach was carried out on the NHS at Hull and East Riding Classic Hospital in 2007.

The operation initially appeared to be successful but the failure of the surgeon to properly close an incision led to the patient developing a hernia, which obstructed her small bowel and caused the stomach bypass to break down.

Miss Benefer developed acute peritonitis - an inflammation of the lining of the abdomen wall - and needed two further emergency operations to reduce the hernia and repair the original surgery.

She spent a total of five weeks in hospital, including 11 days on a ventilator, and also had to undergo a tracheotomy.

Miss Benefer sued Hull and East Yorkshire Hospitals NHS Trust for compensation and was awarded a £35,000 out-of-court settlement.

Danielle Barney, medical negligence specialist with the Bridge McFarland law firm, said: "Our client later required further surgery to repair the hernia and she has been left with unsightly and distressing scars on her abdomen.

"She has also suffered flashbacks and mild depression.

"This was a very painful experience for her and one that left her unable to work for a time and with an increased risk of serious long-term health problems.

"The case highlights once again that a failure by medical staff to follow accepted procedures during even routine surgery can have devastating effects.

"I am delighted that Rachel will now have some compensation to help her put this very traumatic experience behind her." 


This article is courtesy of The Independent.

Tuesday, 15 January 2013

OAP broke hips after ambulance error

An investigation is under way after a 93-year-old woman broke her hips after she was dropped off by an ambulance crew at the wrong house.

The woman was taken to an empty house in Dinas Powys, south Wales, after visiting a day centre.

By the time the crew returned, the pensioner was found lying in the garden with broken hips.

The woman, who is normally cared for by her daughter at their home in Penarth, is in hospital.

A statement released by the Welsh Ambulance Services NHS Trust and Cardiff and the Vale NHS Trust said they regretted the incident and apologised for any distress caused.

"A formal investigation has already been launched and will be finalised shortly," it said.

"Both organisations are reviewing the procedures for the discharge of older patients requiring ambulance transport in the light of this incident."

The family of the woman has asked to remain anonymous, but her daughter told BBC Radio Wales's Good Morning Wales programme that her mother must have been "nearly frantic".

She said: "For some inexplicable reason, they left her in the wrong house, completely alone. She must have been nearly frantic.

"When they came to me and I realised she wasn't on the ambulance, they realised what had happened and said they would go back for her. But it turns out they delivered all the remaining patients to their homes before going back to Dinas Powys, which was about an hour-and-a-half later."


This article is courtesy of the Mail Online.