Sunday 28 September 2014

John Moore-Robinson

Stafford Hospital spleen rupture patient could have lived

John Moore-Robinson John Moore-Robinson died hours after he was discharged from Stafford Hospital

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An inquest has concluded a patient who died after being discharged from hospital with an undiagnosed ruptured spleen could have been saved.
John Moore-Robinson died at home in 2006 in Leicestershire after staff at Stafford Hospital failed to notice the severity of his injuries.
Coroner Catherine Mason concluded had staff done their job properly, the 20-year-old would have survived.
His family said the hospital was "in meltdown" at the time.
Mr Moore-Robinson, from Sileby, near Leicester, was admitted to the scandal-hit hospital after a mountain bike accident on Cannock Chase.
He later collapsed at home and died in Leicester Royal Infirmary.
Stafford Hospital John Moore-Robinson was discharged from Stafford Hospital after he was diagnosed with bruised ribs
Mrs Mason found six separate shortcomings at the hospital's A&E all of which contributed to his death.
She said: "The seriousness of Mr Moore-Robinson's condition was not fully appreciated and decisions in relation to his care were made on incomplete information as a result of poor communication, poor documentation, inadequate assessment, insufficient investigation and an oversight to consider medical notes that were available."
She added that on the "balance of probabilities the loss of his life could have been prevented".
Speaking after the hearing, his sister Kelly Hainsworth said it had been a "long eight years" but they were satisfied with the facts and accepted the findings.
'In meltdown'
His father, Frank, believes other lives could have been saved if his son's death had been properly investigated at the time.
"Stafford Hospital at the time was in meltdown," he said.
"Many, many people have lost their lives, including our son John, and that we can never forgive them for. It's been a hard road but one we have had to take."
The inquest heard that a paramedic told Stafford Hospital he believed Mr Moore-Robinson's condition was potentially life-threatening.
Still vomiting
But the patient was sent home with a diagnosis of bruised ribs after an x-ray showed he had not suffered any bone fractures.
Friends described him as confused and still vomiting and they had to use a wheelchair to get him to a waiting car.
Staff told the inquest they felt "bullied" by a four-hour target for patients' length of stay in A&E.
Mrs Mason concluded that Mr Moore-Robinson was not triaged properly and a nurse failed to communicate "obvious" and relevant information which meant he was treated by a junior doctor more than an hour after his arrival at Stafford Hospital.
The hearing was the second inquest into his death after the High Court overturned the original ruling following a campaign by his family.

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Sunday 14 September 2014

wake up' during surgery

Some patients 'wake up' during surgery

Picture of the beginning of anaesthesiaSome people reported sensations of tugging and suffocation

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More than 150 people a year in the UK and Ireland report they have been conscious during surgery - despite being given general anaesthesia.
In the largest study of its kind, scientists suggests this happens in one in every 19,000 operations.
They found episodes were more likely when women were given general anaesthesia for Caesarean sections or patients were given certain drugs.
Experts say though rare, much more needs to be done to prevent such cases.

Start Quote

For the vast majority it should be reassuring that patients report awareness so infrequently”
Prof Tim CookLead researcher
'Unable to move'
Led by the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland, researchers studied three million operations over a period of one year.
More than 300 people reported they had experienced some level of awareness during surgery - some recalled experiences from years ago.
Most episodes were short-lived and occurred before surgery started or after operations were completed. But some 41% of cases resulted in long-term psychological harm.
Patients described a variety of experiences - from panic and pain to choking - though not all episodes caused concern.
The most alarming were feelings of paralysis and being unable to communicate, the researchers say.
Patient who woke in surgery: "Something must have gone wrong with the anaesthetic"
One patient, who wishes to remain anonymous, described her experiences of routine orthodontic surgery at the age of 12.
She said: "I could hear voices around me and I realised with horror that I had woken up in the middle of the operation but couldn't move a muscle.
"While they fiddled, I frantically tried to decide whether I was about to die."
'Rare but concerning'
She told researchers that for 15 years after her operation she had had nightmares of monsters leaping out to paralyse her.
And it was only after she made the connection between this and her operation that the nightmares stopped.
Each person's experience was analysed to identify factors that could make these situations more likely.
About 90% occurred when muscle-relaxant drugs - used to help paralyse muscles during surgery - were administered in combination with other drugs that normally dampen consciousness.
Picture of anaesthetist checking monitorAnaesthetists give a mixture of drugs to dampen down consciousness during surgery
Researchers believe in some of these cases patients received an inappropriate balance of medication, leaving them paralysed but still aware.
And there were several reports of awareness from women who had Caesarean sections while under general anaesthesia.
Though this type of anaesthesia is most often used in emergency situations, researchers say women should be informed of the risks.
Drug errors
They calculate up to one in 670 people who have Caesarean sections with general anaesthesia could experience some levels of awareness.
But experts argue this is partly due to the balance needed when achieving unconsciousness for the woman while still keeping the baby awake.
Other common factors include lung and heart operations and surgery on patients who are obese.
And some 17 cases were due to drug errors.
Researchers are calling for a checklist to be used at the start of operations and a nationwide approach to managing patients who have these experiences.
Prof Tim Cook, at the Royal United Hospital in Bath, who led the research, said: "For the vast majority it should be reassuring that patients report awareness so infrequently.
"However for a small number of patients this can be a highly distressing experience.
"I hope this report will ensure anaesthetists pay even greater attention to preventing episodes of awareness."

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social care''Cuts forcing English councils to limit social care'

'Cuts forcing English councils to limit social care'

Cyril Gillam 95-year-old Cyril Gillam no longer gets home help visits

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Almost 90% of councils in England no longer offer social care to people whose needs are ranked low to moderate, the Association of Directors of Adult Social Services (Adass) has said.
The group is warning cuts are making the care system "unsustainable".
The government says councils have been given an extra £1.1bn to help protect social care this year.
But charities say hundreds of thousands of people are struggling without help.
When someone applies for social care, their needs are determined as either critical, substantial, moderate or low.
In recent years the number of councils able to help those at the lower end of the scale has gone down as they struggle to balance their budgets.
In 2010-11, Adass says 72% of councils in England only offered help with care to adults with substantial or critical needs. The association says that figure has now risen to 89%.
Left on his own
Retired miner Cyril Gillam lives in a council bungalow in Grantham, Lincolnshire. The 95-year-old widower needs help to wash, cook and clean. He eyesight and hearing are failing and he can only walk with the help of a frame.
Until a year ago he was getting home help visits twice a day. But after breaking his leg last August and spending time in hospital, his local council provided help for a number of weeks before telling the family he was no long eligible for council care.
Keith Harrison says his 95-year-old father-in-law Cyril Gillam shouldn't be denied social care
His son-in-law Keith Harrison says: "They just dropped him like a hot potato and he was left on his own effectively. They couldn't resurrect his help."
Cyril's family challenged the decision but the council said Cyril would have to arrange and pay for his own home help visits with his £80 care allowance benefit payment.
Mr Harrison said the family contacted a number of care agencies for quotes and found the allowance would not cover the cost of the two visits a day.
Instead, a family friend calls on Mr Gillam to help him with daily tasks in return for expenses.
Cyril Gillam at homeCyril Gillam struggles to look after himself
Lincolnshire County Council says it has changed its eligibility criteria from "moderate" to "substantial" and that on his last assessment Cyril's needs were not substantial so he did not qualify for free care.
In a statement, the council said: "Mr Gillam declined any further assessment in April and we understood the family were managing with private and family care. We've not had any contact from the family since to express any concerns and no complaint has been received."
Chronic underfunding
Adass president David Pearson says: "Adult social services and local councils have done their utmost to protect services to older and vulnerable people.
"The scale of reductions in adult care spending, which amount to some £3.5 billion in the past three years, really does raise issues concerning the long-term sustainability of our services unless new money is introduced shortly."
Richard Hawkes, chairman of the Care and Support Alliance which represents 75 charities, says the care system is "in crisis".
He added: "Population changes mean more and more people need care, yet fewer and fewer people get it, as chronic underfunding has seen a year-on-year rationing of support.
"Every day, our 75 organisations hear horror stories of older and disabled people who struggle to get the support they need to simply get up, get dressed and get out of the house.
"This is also putting unbearable pressure on family carers.
"Our survey shows the public has lost confidence in the current system. It shows care, along with health, is where the public want the Government to invest more."
A Department of Health spokesperson said it had invested in social care.
"We have given an extra £1.1bn to councils to help protect social care services this year - that's on top of additional funding in recent years," he said.
"Councils are ultimately responsible for deciding how to spend their budgets but with a growing ageing population we know that we all need to work differently.
"The Care Act and our £3.8bn Better Care Fund will focus resources on helping people to live independently for as long as possible, which can save money and prevent people from needing more support."
This report will be broadcast on Sunday, 14 September 2014 on BBC Radio 5 live.
You can listen to other editions of 5 live Investigates on the BBC i-Player.
You can contact 5 live Investigates by emailing goldberg@bbc.co.uk or comment on this story on the 5 live Investigates Facebook page or viaTwitter.

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Sunday 31 August 2014

The five year-old boy taken from hospital by his parents while being treated for a life-threatening tumour has been found alive in Spain, shortly after his father released a video explaining their decision to flee.
Ashya King was rushed to a specialist hospital in Malaga for urgent medical treatment while his parents Brett King, 51, and Naghemeh King, 45, were detained by officers in Spain.
The family were discovered after they checked into Hostel Esperanza in Benajarafe.
Earlier, Mr King, 51, released a 10-minute video on You Tube. In the clip, Mr King lies on a bed with his son Ashya between his legs. Ashya is attached by a tube to a drip on the side of the bed.
Speaking directly to the camera, Mr King pleads with police to call of their international search, which was launched after Ashya was taken from Southampton General Hospital on Thursday.
He said he wanted Ashya to have Proton Beam therapy which is not available for the treatment of brain cancer in the UK and therefore had no choice but to take him out of the hospital.
Mr King claimed that when he told doctors he did not want Ashya to have the treatment they recommended, they were threatened with an emergency protection order, which would have prevented them from seeing their son.
“Proton beam is so much better for children with brain cancer,” he said in the clip. “It zones in on the area, whereby normal radiation passes right through his head and comes out the other side and destroys everything in his head.
“So we pleaded with them for proton beam treatment. They looked at me straight in the face and said with his cancer - which is called medulloblastoma - it would have no benefit whatsoever."
Mr King said his son's treatment seemed like "trial and error" and claimed he was told if he questioned the treatment the hospital would seek an emergency protection order.
He said: "After that I realised I can't speak to the oncologist at all, because if I actually ask anything or give any doubt I wasn't in full accord with them, they were going to get a protection order which meant in his deepest, darkest hour I wouldn't be there to look after him, and neither would my wife - they would prevent us from entering the ward.
"That's such a cruel system I decided to start looking at the proton beam myself."
He added: "We decided to try and sort it out ourselves but now we're refugees almost.

Brett King explains why he has taken Ashya out of UK
"We can't do anything. The police are after us. The things we want to do to raise the money to pay for the proton beam, they've prevented it now.
"So my son is being treated and he's doing fine. We're very happy with his progress. We're not neglecting him. He has everything he had in hospital."
On Saturday, police obtained a European arrest warrant. Officers said the warrant was obtained on the grounds of neglect but it would be used only as a last resort.
They said they “would much prefer for the parents to come forward voluntarily”.
Police had raised concerns about Ashya’s battery-operated feeding tube, which they said would have run out on Friday night. They said it could be replaced only by medical experts, leading police to warn that “time is running out” for the youngster.
But Mr King said the family had enough feeding packs and Calpol to care for their son.
“We were most disturbed today to find his face is all over the internet and newspapers and we have been labelled as kidnappers, putting his life at risk, neglect," he said.
"As you can see there's nothing wrong with him, he is very happy actually since we took him out of hospital," Mr King said.
"He has been smiling a lot more, he has very much been interacting with us."
Mr King said his son was treated by Dr Gary Nicolin, a consultant paediatric oncologist with over 25 years’ experience.
Dr Nicolin, who has worked at the hospital for the last decade, has previously worked in Canada and South Africa.
Mr King said he told doctors he would pay for the treatment himself.
Mr King said Ashya was "responding so much better" than he did in hospital.
"We couldn't take it any more - not knowing and not being able to question anything in fear that they say, 'Sorry Mr and Mrs King, emergency protection order, you're no longer allowed in the ward'," he said.
"Under that stress, our son has grade four brain tumour, we couldn't discuss or question them at all in fear that our son would be in that ward all day long by himself without his parents being able to come in.
"We couldn't be under that system any more.
"I was going to get the money to pay for the proton beam therapy but they have prevented that now because the Spanish police are involved and I can't do want I wanted to do."
Mr King urged police to call off "this ridiculous chase".
"We're not neglecting our son, he's in perfectly good health," he said.
"My son is smiling, he's happy, we're doing things as a family. We just want to be left in peace. He's very sick. I just want to get on with his treatment. I'm not coming back to England if I cannot give him the treatment I want, which is proper treatment.
"I just want positive results for my son."
According to Cancer Research UK, Proton Beam therapy is a highly-targeted type of radiotherapy that can treat hard-to-reach cancers, such as spinal tumours (chordomas), with a lower risk of damaging the surrounding tissue and causing side effects
The Kings' eldest son was caring for his siblings while his parents were held at a police station in nearby Velez-Malaga.
Mr and Mrs King were expected to be taken to Madrid on Sunday for an extradition hearing at Madrid's Central Criminal Court.
Assistant Chief Constable Chris Shead of Hampshire Constabulary said the boy's parents had been arrested at 10pm local time after Spanish police stopped the family's vehicle.
"We don't have many details on Ashya's condition at this point in time but what we do know is that he was showing no visible signs of distress," Mr Shead said.
"Ashya has now been taken to a hospital in Malaga. The parents have been arrested. They have been taken to a police station."
Spanish police were acting on a European arrest warrant requested by Hampshire Constabulary when they arrested the Kings.
When they stopped the family's Hyundai people carrier officers found Ashya and his parents inside.
Mr Shead said: "There are no winners in this situation. I've said all along that this must be a terribly distressing time for Ashya's family and I stand by that now."
He added that it was too soon to say when Ashya would come back to the UK but Southampton General Hospital have been contacted so they can liaise with the medical taking care of him in Spain.
"Ashya's brothers and sisters were not in the vehicle," Mr Shead said. "We have located them. They're all okay, they're fine. They are actually in a hotel about 10 miles away."
He also said that a team of Hampshire police officers would be going to Spain tomorrow to continue the investigation.
No one from Southampton General Hospital was available for comment. 

Monday 25 August 2014

Doctors at a hospital in north-west London have begun treating a Briton who contracted Ebola in Sierra Leone.

Ebola: British man begins treatment in London hospital
British aid volunteer William Pooley, who worked with The Shepherd's Hospice to provide palliative care in Sierra LeoneWilliam Pooley, seen here, worked as a volunteer for The Shepherd's Hospice in Sierra Leone before he moved to serve on an Ebola treatment ward
Doctors at a hospital in north-west London have begun treating a Briton who contracted Ebola in Sierra Leone.
William Pooley, a 29-year-old volunteer nurse, was described by a charity he worked for as a "hero".
Mr Pooley was flown to RAF Northolt in a specially equipped military aircraft on Sunday and taken under police escort to Hampstead's Royal Free Hospital.
He volunteered to go to care for victims of the Ebola outbreak which has killed almost 1,500 people.
His is the first confirmed case of a Briton contracting the virus during the current outbreak.
Tropical disease specialist David Mabey: Patient poses no risk to others
'Remarkable man'
Mr Pooley, believed to be from near Woodbridge in Suffolk, was flown out of Sierra Leone's main airport in Lungi, in a RAF C-17 transport aircraft.
He will be treated in a specialist isolation unit for patients with highly infectious disease, the only one of its kind in Europe.
A special tent ensures medical staff can interact with the patient but are separated by plastic and rubber.
Mr Pooley had worked as a volunteer providing palliative care at The Shepherd's Hospice in Sierra Leone from March until July.
He then requested to be relocated to the Kenema Government Hospital to serve on the Ebola treatment ward, after he heard reports that patients were being abandoned when health workers died from the virus.
Gabriel Madiye, the executive director of The Shepherd's Hospice, said Mr Pooley had been aware of the risks, but was determined to work there.
"We consider him a hero," he said. "Somebody who is sacrificing to provide care in very difficult circumstances - when our own health workers are running away."
Co-worker Gabriel Madiye tells 5 live: "We consider him a hero"
There is no cure for Ebola but with treatment of the symptoms, and proper hydration, patients have a chance of survival.
Prof Jonathan Ball, a virologist at Nottingham University, said there would be immediate testing to ensure all organs were functioning.
"He really is in the best place and will have the best possible care," he said.
line
At the scene
A specialist isolation ward has been set up at the hospital in London
Jon Ironmonger, BBC News
Whisked into the Royal Free Hospital late on Sunday night under police escort was a man whose noisy arrival was quickly replaced by the everyday comings and goings of a rainy bank holiday morning.
Inside the building a rare drama is unfolding - the meticulous treatment of the first British person infected by the Ebola outbreak.
The volunteer nurse is being treated in an isolation unit which is the only one of its kind in Europe, and more sophisticated than any facility in west Africa.
Doctors will interact with him behind the plastic of an airtight tent to avoid the risk of contamination.
They will attend to his symptoms, particularly dehydration, but Ebola has no proven cure, so the main battle is down to him and his body's ability to fight the virus.
line
Last week, two Americans who had contracted the disease in Liberia made a recovery and were discharged from hospital after being given an experimental drug called ZMapp in the US.
Officials in Liberia also said three medical staff have shown signs of improvement after taking the drug.
The US manufacturer of ZMapp has said supplies of the drug are exhausted, but the Department of Health said it was working to source any remaining doses.
Department of Health deputy chief medical officer Prof John Watson has said the risk of Ebola to the UK remains "very low".
Health officials insist the risk to the UK from Ebola remains "very low"
The World Health Organization has estimated 2,615 people in west Africa have been infected with Ebola since March.
Health officials have reported the first cases outside west Africa, in the Democratic Republic of Congo.
The virus is spread between humans through direct contact with infected bodily fluids. It is one of the world's deadliest diseases, potentially with a mortality rate of 90%. However, the current outbreak has a fatality rate of 55%.
line
Ebola Virus Disease (EVD)
A fruit bat is pictured in 2010 at the Amneville zoo in France. Fruit bats are believed to be a major carrier of the Ebola virus but do not show symptoms
  • Symptoms include high fever, bleeding and central nervous system damage
  • Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
  • Incubation period is two to 21 days
  • There is no vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

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