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Factual hearing begins into DNR Orders placed on Janet Tracey

Factual hearing begins in the High Court into the circumstances surrounding the placing of two Do Not resuscitate Orders on the medical records of Janet Tracey.

Janet and David Tracey

4 November 2012

Despite having been diagnosed with terminal Cancer only weeks before, Janet Tracey, a Grandmother of seven and devoted wife to David and Mum to four daughters, left home to get a joint of Beef for Sunday lunch in February 2011.

Her daughter, Alison Noeland, had travelled from her home in Norway to her parent’s home in Ware, Hertfordshire following her mother’s diagnosis. Janet was keen that the family enjoyed a traditional Sunday roast all together.

It was with this in mind that Janet left on 19 February 2011 to drive to Harlow to collect the food.

Another of Janet’s daughters, Kate Masters explains: “Society’s perception of the Cancer sufferer is often mistaken, seeing them as frail and unable to cope.

“Despite the diagnosis Mum still wanted to soak up the joys of life and she was still very capable and very much at the centre of our family."

Within a couple of miles of leaving home Janet Tracey was hit head on by another car. She was taken by Ambulance to the QE2 hospital in Welwyn with a neck fracture broken ribs and broken clavicle and transferred later the same day to Addenbrooke's hospital in Cambridge.

Mrs Noeland explained: “We got the news that Mum had been involved in an accident and we rushed to The QE2 hospital in Welwyn, the staff were wonderful and looked after Mum in A & E whilst looking for a bed in a neurological unit as they did not have the facilities to deal with her neck break.

“We were then told she was to be moved to Addenbrookes, where they had a specialist team to deal with her injuries. We were pleased that mum was to be transferred to such a highly regarded hospital."

However, it was whilst she was at Addenbrookes, on Sunday 27 February, that Janet’s husband David alleges that a DNR Order was placed on his wife’s records without her knowledge and without her consent. However the Trust wholly dispute this.

When Mrs Tracey found out a DNR order had been placed on her file the family claim she was distressed and she asked for it to be removed, which it was.

However, on Saturday 5th March, a second DNR order was included in Mrs Tracey’s notes, which also included the phrase: "The patient does not want to discuss resuscitation". It continued that three of the four daughters had agreed to it. Both these claims the family disputes.

The family maintains that Janet made her wishes clear and that any future discussions should only happen with her husband present. No such discussions took place and the family alleges that they neither consented to it themselves nor had Janet's permission to make that decision on her behalf.

During this time Janet wrote a series of notes as her voice became weaker. In them she expressed concern about the care she was being given, writing in uncharacteristic capital letters: ‘ SHE WOULDN’T GIVE ME ANYTHING’ and ‘WHERE HAS MY PAIN RELIEF GONE’.

The Court will hear that these distressing notes were written whilst medical notes state she was in a semi comatose state, another claim the family dispute.

Janet died on 7 March 2011.

The High Court will tomorrow (Monday 5 November) begin a factual hearing into the circumstances surrounding the imposition of these two disputed Do Not Resuscitate (DNR) orders on Mrs Tracey.

The factual hearing will see witnesses being called, including the doctors involved, and cross-examined due to major factual discrepancies between the family of Janet Tracey and the staff from Cambridge University Hospitals NHS Foundation Trust.

The Court will also hear from colleagues from the care home where Janet worked as Manager. They will explain how Janet was fully involved in providing end of life care and was therefore experienced about what it entailed.

The Court must decide who is to be believed before considering the wider legal position on DNR orders in the full judicial review in February 2013.

Merry Varney the lawyer from law firm Leigh Day & Co representing the Tracey family said: “This case underlines the importance of a transparent, accessible and consistent policy regarding a patient’s right to know when a decision not to resuscitate them is made and to know how their views are taken into account and where necessary, how to challenge a decision they disagree with.

“The family’s claims that Janet was not informed of either decision are supported by notes in her medical records and the very existence of this factual dispute that the Court will determine, supports the need for patients and their families to be fully informed of the decision making process for DNR orders.”

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