Family only told about pensioner's deterioration moments before she died

Thursday 09 December 2021

The family of a 76-year-old islander, who died of respiratory failure 25 hours after being taken to A&E for a fall at home, have criticised communication by the Hospital.

Pamela Winifred Rault died at the General Hospital on 30 June 2020 after a pre-existing condition, Chronic Obstructive Pulmonary Disease, was exacerbated by an infection.

Although an inquest this week concluded that Mrs Rault had received the correct care while in hospital, it did raise concerns about the quality of communication between the Hospital and her family.

Mrs Rault’s daughter, who was her primary carer, was not told her mother’s condition had rapidly deteriorated and it was only in Mrs Rault’s final minutes that her family were contacted and they were able to see her.

It was not the ending that they nor Mrs Rault would have wanted, the family said.

Hospital records which said that nurses had phoned the family were not true, Mrs Rault’s daughter told the inquest, and a list of questions sent to the hospital following her mother’s death which asked for details of the care it had given had taken far too long to be answered.

They told the inquest that they had spent a year-and-a-half “battling to see notes”.

“Our main bone of contention is the Hospital not communicating with us,” Mrs Rault’s daughter said.

The family also had concerns about Mrs Rault’s treatment in hospital. She had been admitted to A&E the previous day after suffering a fall at home which fractured her femur and pelvis. 

Despite being in pain, she left in the ambulance “in good spirits”, her daughter said, but Mrs Rault’s health declined rapidly, and she died the next afternoon.

However, doctors told the inquest that her care had been appropriate, and it was possible for a patient with serious Chronic Obstructive Pulmonary Disease to quickly deteriorate with an infection, which blood tests had indicated was present.

However, the inquest also heard that restrictions caused by the pandemic did have an impact on her care: Mrs Rault could not initially have non-invasive ventilation – something she had used successfully before – because it was considered a covid risk on a general ward.

It would have been possible in an Enhanced Care Area, but a bed was not available at first. When one did become available, and Mrs Rault was given ventilation through a non-invasive ‘Bipap’ machine, her condition was too advanced for the trial to be effective.

Questions were also raised by the family as to why records showed a five-hour gap in observations while she was on Rayner Ward. 

Although Deputy Viscount Mark Harris noted the family’s concerns over a lack of communication and when she was checked on the ward, he said these questions were beyond the remit of the inquest, which was to attribute a cause of death.

However, he requested that the Hospital provide answers to Mrs Rault’s family.

Officially recording his decision, Advocate Harris said that Mrs Rault had died in hospital from an infective exacerbation of Chronic Obstructive Pulmonary Disease following admission to hospital the previous day after a fall at home and fractured hip.