30 November 2008
Leigh Day & Co and Mencap
have welcomed the coroner's report in the inquest of Lisa S, a learning disabled woman who died in Basildon Hospital following her admission to hospital with dehydration. Once again the importance of Mencap's 'Death by Indifference
' campaign for equal healthcare rights is highlighted by the communication failures in this case.
The case encapsulates the problems learning disabled adults face when trying to access appropriate healthcare, both in hospital and in the community. Often these problems hinge on the difficulty people such as Lisa have when trying to communicate, especially to strangers. While the Coroner found that the nursing care Lisa received did not cause her death the coroner criticised the inflexible care plan that was used by Lisa's hospital and said it was not suitable for a patient with learning disabilities. The coroner also commented that in future any division of care between nursing staff and families should be discussed and documented in a patient's medical records.
Lisa was 21 when she died. She was able to communicate by smiling and laughing when happy, or by crying when in pain. She had been cared for throughout her life in an exemplary fashion by her family who continued to provide personal care to her when she was admitted to Basildon Hospital with dehydration caused by vomiting which was a result of her suffering from Reye's Syndrome. Her episodes of vomiting continued after her admission and the decision was taken to perform a jejunostomy operation (that creates an opening in a part of the small intestine) to a to help with her feeding. Following surgery Lisa initially did well but her vomiting episodes returned and she eventually developed pneumonia and sadly she died in February 2004.
The coroner noted that medical staff did not identify toxic levels of Lisa's anti-epileptic mediation in her blood when she was admitted and that her treatment was not amended accordingly. This constituted a 'significant failure' that made a small but significant contribution to Lisa's death. Lisa's family was also concerned that worries they had about Lisa's pain and discomfort that were very obvious to them were being missed by hospital staff as Lisa was unable to communicate these to nursing staff. The care Lisa received was not tailored to meet her specific needs and was not sufficiently flexible.
Mencap supported Lisa's family throughout the inquest and is currently working with the human rights department at Leigh Day on six similar cases. If you would like to speak to someone about this type of case please contact Frances Swaine
on 020 7650 1200 for a free initial consultation.
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