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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