Stroke treatment for elderly sepsis patient defended at inquest

Thursday 04 April 2019

Hospital staff who discovered that an elderly woman was suffering from blood poisoning only after it was too late to save her, were justified in initially treating her for the symptoms of a stroke, an inquest has heard.

The finding was presented by Hospital Consultant Dr Ajay Kumar during an inquest into the death of a 76-year-old woman in hospital, which was held yesterday.

He explained that the team’s approach was “reasonable” and “appropriate” given that the woman was presenting all the signs of a stroke when she was first seen by Emergency Department staff.

Ahead of Dr Kumar's statement, Police Coroner’s Officer Tony Forder summarised the circumstances of the woman's death in May of last year.

The inquest was told that the elderly woman had an ongoing condition which caused ulcers to her lower legs and was suffering with a wound that had become infected on her right shin.

Pictured: The inquest into the 76-year-old woman's death reached its conclusions in Morier House yesterday.

She was taken to Hospital in an ambulance on 13 May 2018 after she had a fall at her daughter’s house.

The lady was said to be slurring her speech and complaining of pain in her leg. 

These symptoms, alongside her rapid heartbeat, led the Emergency Department staff to treat her for a stroke, while also running tests to explore other possibilities. 

Pictured: The woman was taken to the Hospital by ambulance after having a fall at her daughter's house.

When the team received the results, which showed the woman was in fact suffering from a “severe infection”, they administered the relevant antibiotics and made arrangements to transfer her to the Intensive Care Unit.

Unfortunately, Police Coroner’s Officer Tony Forder told the inquest that her “condition deteriorated very quickly” and there was “no realistic opportunity to save her”. She subsequently suffered a heart attack and passed away in the Emergency Department at 21:50 that evening. 

An independent review into the treatment administered by Hospital staff conducted by Hospital Consultant Dr Ajay Kumar was read to the inquest and found that the symptoms the woman was displaying “seemed to fit best with someone who had suffered a stroke".

Dr Kumar said that the A&E Department staff took “a very logical diagnostic approach” and when they had more results available, they “acted quickly” and were “open minded” when it came to diagnosing their patient.

Pictured: An Independent Review found that A&E staff took "a very logical diagnostic approach."

The Consultant concluded that “due process was undertaken”, but that the woman had in fact died from “sepsis [which] progressed very rapidly to septic shock".

Elsewhere in the hearing, a statement from one of the 76-year-old's nurses described her as “a kind and gentle lady… who knew her own mind".

Dr Bruce Lyons, who carried out the post-mortem examination of her body, didn’t find any clots to the heart or brain consistent with a stroke but said that he deemed it “reasonable” and “appropriate” that the team would have treated her for that condition. 

Ultimately, Dr Lyons concluded that she had died due to the infection in her leg “rapidly turn[ing] to septicaemia".

Summing up the evidence heard at the inquest, Relief Coroner and Deputy Viscount Dr Martin Barrett said that she "was a very independent lady who managed her leg ulcers herself”, with the help of bandaging from Family Nursing and Home Care.

Dr Barrett also found it was “reasonable that staff focused on her irregular heartbeat and symptoms suggestive of a stroke”, but he concluded that the elderly woman had died from sepsis arising from a “complication” with her “chronic lower leg” condition.