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Sick father's painful death

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Published Date: 29 August 2009
By Kate Lahive
A DAUGHTER claims her dad was left dying in agony during his final days in a Sheffield hospital after being denied adequate pain relief.
Janet Brooks' 76-year-old father Thomas Milner was being treated for end-stage leukaemia on the palliative care ward at the Northern General Hospital, where she says he was not given enough top-up morphine to relieve his symptoms.

Mrs Brooks, 54,
said although her father's initial treatment was good he later suffered unnecessarily from not having enough medication.

She has made a series of complaints since his death in January 2006 - and Mr Milner's case has now been highlighted in a critical report by The Patients' Association.

It is demanding better care for older and vulnerable patients, claiming many are being denied dignity in NHS hospitals.

Mrs Brooks said her father - "a kind and gentle man" who lived on City Road, Sheffield - was in so much pain he was "literally pulling at the sheets with tears coming down his cheeks".

She said he was given 10 milligrams of morphine over 55 hours, which she says an independent doctor has since told her is a 'pitiful' amount for a patient with a terminal illness.

In desperation she called the family GP, and a junior doctor arrived shortly afterwards and doubled the morphine dose.

Mr Milner, a former electrician, died an hour later.

She has complained to Sheffield Teaching Hospitals which manages the city's five adult hospitals including the Northern General, and to the Healthcare Commission watchdog.

The Trust's chief nurse Hilary Scholefield said: "We have undertaken a full review of the care provided and also supported an independent review by the Healthcare Commission which found staff acted appropriately and within professional guidelines. We have shared all the conclusions of the review with Mr Milner's family."

Dr David Throssell, deputy medical director at Sheffield Teaching Hospitals NHS Foundation Trust, said: "In palliative care there needs to be a careful balance between making the patient comfortable and giving too much medication.

"Too much medication can also make patients sleepy and therefore unable to communicate their wishes or talk with their family. Later in the evening Mr Milner's condition deteriorated and, as a result, he was given appropriate additional medication."


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Page 1 of 1

  • Last Updated: 28 August 2009 1:57 PM
  • Source: Sheffield Star
  • Location: Sheffield
 
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bertiesmum,

SHEFFIELD 29/08/2009 14:03:25
I know sometimes we only hear the bad and not the good, but I really thought things had changed since my dad died in the same hospital in 1996, although there was no palliative care ward in those days. He had heart and lung failure, and the last time I saw him the day before his death, he was in pain, and very distressed, so much so that I vowed to take his sleeping pills with me when I visited the next day. That was all he wanted, some sleep, but nothing was given to help him. I'm not talking euthanasia here, just the relief of a good sleep. Ok, he may not have woken up again, but at least he would have died peacefully, as opposed to being distressed and alone, the latter despite the hospital having at least 4 contact numbers for relatives. My sister left her job to go and see him, as she had telephoned to enquire how he was, and then felt uneasy. She got there 5 mins after he died, when she could have been there for him had any of us been notified. This was in the daytime, not the middle of the night, so there can be no lack of staff excuse for not getting a call, in fact we could have been told when SHE phoned THEM. I believe it was just easier for them not to have relatives there at the time, and I will never forgive them for denying my dad the comfort of his family when he wanted it.
When my husband died from cancer, despite receiving 'adequate' care from that hospital, the minute he told me he wanted to come home, I made the necessary calls and got him home. At least there he did not have to go nearly 36 hours before his syringe driver was refilled with morphine for pain relief, and got edible food.
I find it a travesty that our politicians are defending the NHS in one breath and ignoring and desecrating the standards in another. Maybe the time has come to make ALL of them, not just Mr Mandelson, use the same services as the rest of us.
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20092009sheffield20092009,

Sheffield 29/08/2009 17:35:23
I would like to praise all the staff on the Palliatve Care Unit who I know indeed do a very good job at caring for patients. I have known several people who have been cared for here and sadly some of them lost their lives on the Unit. The nurses always showed compassion and gave their patient's dignity at all times and I find it hard to believe that the nurses treated a patient like this. Unfortunatly it sounds like this patient's family have really gone to town with letting the press know and giving the Unit a bad reputation. I hope the family feel satisfied by these and I am sure people know what the Unit is REALLY like from all the pleasant things that are said by people who have experienced it there.
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Janet Brooks,

Sheffield 29/08/2009 18:50:01
I am Janet Brooks, daughter of Tom.

The Healthcare Commission Report said that the medication 'WAS LOW IN THE CIRCUMSTANCES' and made several recommendations for the 'Trust' to implement in the future. The Hospital quote avoided this fact.

I thank the family G.P. for contacting the ward and for the Junior Doctor noting in the Medical Notes 'Tom pulling at sheets' and then giving medication.

However the Medication given was by doubling the amount already in the syringe driver/drip to 20mgs over 24 hours from the pitifully low 10mgs. Doubling the doseage is not standard palliative care practice.
Gradual titration (infusion) is the norm.

My dad died 1 hour later in my arms.

God help us all and shame on them.
4

Jenny S,

Sheffield 29/08/2009 18:51:46
What a nasty comment by 20092009sheffield200920009. Looks suspiciously like someone who works on the ward has made the comment otherwise why not just say your experience was a good one, instead of attacking a grieving family?
My best friend is a nurse who works at the Northern Gen, not on that ward, but who says there are a lot of nursing staff she can't understand why are nurses because they don't seem to have a caring bone in their body.
Having seen my mother die of cancer, thankfully not at the Northern General, I really feel for this family and hope the staff who treated this poor man are hanging their heads in shame and have been removed from the ward.
These cases need to be highlighted and acted upon.
5

,

29/08/2009 19:01:42
Comment Removed By Administrator
Reason: Editor's discretion
6

20092009sheffield20092009,

Sheffield 29/08/2009 19:04:20
This upsets me as my memories of my relative are from his last days on the ward and I have happy memories there isnt anything that made it bad at that ward they were so nice and people like you are telling the whole world how awful you think it is....I am entitled to say that it wasnt bad and that I cannot believe what happend am I not?
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Sharron1,

Rotherham 29/08/2009 19:42:10
As with any story of neglect regarding the NHS everyone has there own opinions and stories to tell - we currently have an investigation pending with the above unit with the help of the Carers Federation - as people say not everyone wants money that won't bring my mum back we just want answers to questions like why my mum was left fourteen days without anyone realising she had not opened her bowels and why she died wearing another patients nightie and why a DNAR form was in place without telling us - how can things ever change though when you speak to the hospital and they say WE DON'T BLAME PEOPLE - how can things improve - I would say when my mum was in hospital it was a 50/50 spilt of good/bad nurses/doctors I have nothing to gain from telling my story I just want to know why mum was let down and all our evidence is backed up by written documents in the hospitals own file. I know there will be families and patients who have nothing but praise for the unit unfortunately we drew the short straw this time.
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yorkshireguy,

sheffield 29/08/2009 19:47:43
20092009sheffield20092009,Part of a nurses job is to inform the doctor of the patients condition and if they failed to inform the doctor that the patient was in so much pain then they have failed in there duty.
I am not saying that the staff on the palliative care ward are bad nurses because I know for a fact that is not true however in this case it seems that they have failed.
So why is this so hard for you to accept.
9

Janet Brooks,

Sheffield 29/08/2009 19:52:02
A syringe driver (nhs term pump) was set up at 2.00a.m. 9.1.06. giving 10mgs. morphine over 24 hours.
The base or starting point for this method of terminal sedation infusion.

At 18.00p.m. (6 o'clock p.m.)- 14 hours later and after having been transferred to the Palliative Care Ward, the syringe driver still in place, it was noted that my father was agitated and in pain and was PRESCRIBED top up morphine (nhs term prn).
He had 6 x 5mgs. top ups until 8.10a.m. 10/8.06.

The Consultant did a ward round at 10.30a.m. 10/1/06 Standard palliative care practice should have been that the amount of top up morphine given i.e. 30mgs. should have been taken into account and the syringe driver should have been increased from it's base level. It wasn't.

The staff that came on duty in the afternoon refused to give him is prescribed top up medication as had previously been done when we went to the nurses station - which was about every two hours as the top up wore off.

In the medical notes this nurse wrote 'wife giving mouthcare - dandelion and burdock - I explained that this intervention was enough and he did not need any prn'.

When he had the top up morphine he was settled and held our hands - it must have given him an 'all well's with the world' feeling. However as the top ups wore off, he got very agitated, twisting and turning. He was frightened as to where life's journey was taking him.

On change of staff the caring night nurse saw what state my father had been left in. The afternoon staff had also failed to see to his toiletry needs.

In the medical notes timed 6.15a.m.11.1.09 this night nurse wrote ' Tom in pain, agitated and restless needed a lot or prn - request Dr's review medication.

The notes continue entered at 9.00a.m. when the Junior Doctor prompted by the family G.P. came and doubled the dose in the syringe driver to 20mgs. over 24 hours.
(Doubling the dose in syringe drivers is not standard palliative care practice).

My father
10

20092009sheffield20092009,

29/08/2009 19:59:40
Janet I feel for you but you just keep posting messages copy and pasting what the articles say. I wanted to know how talking to the press will help your situation?

Also, if the nurses REFUSED to give him this PRN you are talking about then why havent they been struck off? They obviously havent and would have been if they had done somethnig that serious. That is truely awful if a nurse refused a patient pain relief it it was presecribed for them, but no nurses have been sacked the investigations have ruled that they acted professionally and this means nobody has been sacked so what they did was not legally wrong then?
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