Possible negligence in hospital after stroke

TwilightSparkle2019

My mother suffered a stroke in December, as she was in a different area of country when it happened she needed be transferred to a hospital closer to home when more stable. I was told by this hospital my mother was also anaemic. A bed was found yet she only stayed in hospital just over a weekend, she might aswell transfered home. A week after getting discharged she took ill again with another stroke which as been devasting.

Hospital have not told us much but a nurse remarked that she be more disabled if they hadn't given her tpa drug ... She can't be any more worse than she is now to be honest. Anyway they kept saying she's drowsy and so on and it turned out she got bleeding on the brain as they scanned her. I think the tpa drug may caused this, I think possibly it was too late to give her the drug and it caused more damage than good. We've not been told much by hospital however while in hospital they also found out she has lung cancer, they said at time it not spread but because of her health after stroke she not fit to treat .

Hospital were very keen to get her discharged back home and ward applied for continuing healthcare and it was awarded... We were told she had 3 months to live but could be weeks or even days at time.... Pretty much 6months on and she still with us but is suffering incredibly. She is bed bound, can't communicate with us, incontinent, poor quality of life all round. It's been a farce since coming out hospital, staff who come round making errors, wrong refferals for help and so on.... I'm going need to complain about all that but it's nothing compared to what gone on just before.

Her discharge papers stated that she deteriorated upon arrival and they also found she had pneumonia too.... I believe this tpa/ thrombolysed drug as made things worse. I know it should only be given is stroke is ischemic and the hospital should determined the course of stroke with scan prior to drug given.... The drug is dangerous and there is a time scale that it should be given and possibly the window had gone. Something just doesn't add up....

Also the Dr prepared a do not resuscitate order yet the box is ticked that she is able to make that decision.... That she doesn't want it... She certainly wasn't at the time and now 6months on she can't even give a yes or no answer if we ask a simple question of wanting a drink etc. She wasn't able to write and can't now as she lost the use of her right hand from the 1st stroke. I don't have power of attorney and neither does anyone else so we can't make decisions for her.

I feel like she was discharged far too soon from hospital after the 1st stroke, I mean if she was fit to go home then the original hospital would have just discharged her to home address not to a local hospital.

So where do I go from here, is it worth pursuing a negligence claim?

keithdc

TwilightSparkle2019 wrote: »

My mother suffered a stroke in December, as she was in a different area of country when it happened she needed be transferred to a hospital closer to home when more stable. I was told by this hospital my mother was also anaemic. A bed was found yet she only stayed in hospital just over a weekend, she might aswell transfered home. A week after getting discharged she took ill again with another stroke which as been devasting.

Hospital have not told us much but a nurse remarked that she be more disabled if they hadn't given her tpa drug ... She can't be any more worse than she is now to be honest. Anyway they kept saying she's drowsy and so on and it turned out she got bleeding on the brain as they scanned her. I think the tpa drug may caused this, I think possibly it was too late to give her the drug and it caused more damage than good. We've not been told much by hospital however while in hospital they also found out she has lung cancer, they said at time it not spread but because of her health after stroke she not fit to treat .

Hospital were very keen to get her discharged back home and ward applied for continuing healthcare and it was awarded... We were told she had 3 months to live but could be weeks or even days at time.... Pretty much 6months on and she still with us but is suffering incredibly. She is bed bound, can't communicate with us, incontinent, poor quality of life all round. It's been a farce since coming out hospital, staff who come round making errors, wrong refferals for help and so on.... I'm going need to complain about all that but it's nothing compared to what gone on just before.

Her discharge papers stated that she deteriorated upon arrival and they also found she had pneumonia too.... I believe this tpa/ thrombolysed drug as made things worse. I know it should only be given is stroke is ischemic and the hospital should determined the course of stroke with scan prior to drug given.... The drug is dangerous and there is a time scale that it should be given and possibly the window had gone. Something just doesn't add up....

Also the Dr prepared a do not resuscitate order yet the box is ticked that she is able to make that decision.... That she doesn't want it... She certainly wasn't at the time and now 6months on she can't even give a yes or no answer if we ask a simple question of wanting a drink etc. She wasn't able to write and can't now as she lost the use of her right hand from the 1st stroke. I don't have power of attorney and neither does anyone else so we can't make decisions for her.

I feel like she was discharged far too soon from hospital after the 1st stroke, I mean if she was fit to go home then the original hospital would have just discharged her to home address not to a local hospital.

So where do I go from here, is it worth pursuing a negligence claim?

This is quite difficult to follow- it would be helpful if you did a timeline as to what happened and when and remove the unncessary detail (e.g. anaemia, lung cancer, problems with carers).

Key issues seems to be:
- TPA- I'm unclear as to which stroke this was administered for.
As with any drug, it has risks and benefits. It is used in ischaemic stroke to break down clots. However, it will break down any clot so a side-effect is bleeding in the brain. On average, people will do better with TPA than not having it, providing it is given within a certain window (there are debates in the medical community as to how late it should be given). It would seem that your mother unfortunately had this side-effect- this does not mean the clinical team were negligent or made an error.
Were the risks/ benefits discussed with your mother or did the clinical team proceed based on her lacking capacity to make decisions?

- DNACPR- when was this written? It is quite possible that this was discussed when first admitted and your mother agreed that CPR was not in her best interests.

The summary is a bad outcome (whilst devastating for your family) does not equate to negligence.
Currently, you seem to be missing a lot of key information. Before jumping on the compo-train, why not arrange a meeting with your mother's consultant to discuss your concerns?

TwilightSparkle2019

They didn't want to discuss anything at hospital with us, that's why I'm really suspicious of what's happened so arranging a meeting isn't going tell us much as I've tried asking questions. They never wanted to discuss how she was over phone, it was always oh she's drowsy call back later... When I did travel a few days later as I live far away they didn't want to tell us much then.

I don't think she was ready for discharge from the 1st stroke either... I know my post complicated because I don't quite understand what's gone on. When she was in hospital they seemed rather secretive. I do know that in past she has blocked artery in neck and they did one side a while back due to tias ages back, how come nothing was looked into the cause this time? I don't think she would have consented to a DNR either. The Dr discussed a DNR with us and I said I do not know as nothing like that as been discussed.... Next thing when she is discharged there is the paper and various ticks on it. One is marked slightly through as of they made a mistake about if consent given.... They gone marked a different box.
I really sense that no one has been honest with what's gone on from the morning she went into hospital that 2nd stroke.

keithdc

TwilightSparkle2019 wrote: »

They didn't want to discuss anything at hospital with us, that's why I'm really suspicious of what's happened so arranging a meeting isn't going tell us much as I've tried asking questions. They never wanted to discuss how she was over phone, it was always oh she's drowsy call back later... When I did travel a few days later as I live far away they didn't want to tell us much then.
.

So when did you last approach the hospital and who did you approach? Consultant? Ward manager? PALS?

keithdc wrote: »

This is quite difficult to follow- it would be helpful if you did a timeline as to what happened and when and remove the unncessary detail (e.g. anaemia, lung cancer, problems with carers).

Still waiting for this!

TwilightSparkle2019

I spoke to a Dr back in January he didn't tell us much other than been bleeding on brain, that was it. I've not contacted any other dept since.

Late December she had a stroke, admitted to hospital.

Hospital wanted to transfer her to hospital near her home, waiting for bed... Transfered to hospital near home over 300 miles away on Friday... By Monday released... What was point of transferring her to hospital near home if they going release her so soon?

Out of hospital on Monday, back in by the following Tuesday so 8 days later... Then all I know is, I call up the house after school run at 8.45am she answers phone slurred, I say I'm getting an ambulance... Ambulance arrives after the region I call up request her region to send ambulance... Ambulance crew phone me up asking if they think she's had another stroke, I explain she can't use her right hand from stroke that happened last month as they not sure what symptoms they can see as they think she appears to be well. I insist they take her in as I'm sure she's had another stroke... I can tell this over phone so why can't they and they present in house? She's taken to hospital... Between Tuesday and Friday I phone up daily, sometimes twice a day asking how she is, ward clerk says drowsy each time, sometimes a nurse will speak but they don't say much. I arrive the Saturday and I see she like in a zombie state, I think the following day we told she got bleeding on brain, they say nothing more when I ask how and why they think it happened... A meeting held on the Monday with a Dr, he says she in bad way and he wants to do a DNR, during the meeting nothing is said of her condition. Approximately a week or so later she is transfered to a different hospital it's more of a rehab ward but she remains in bed. Next thing they tell us she has cancer and expect her not to live long and they ask my father if he wants to take her home... Anyway continuing healthcare is arranged and she comes home.

When she comes home I read through discharge papers, it says she admitted to hospital but deteriorated upon arrival, it doesn't state why, it also says she had pneumonia too... I don't know if she had this infection priory be discharged from previous stroke. Paperwork is patchy and as I said before no one seems to want to discuss anything at hospital when she was in hospital, they tell us very little like they wanting to hide something.

keithdc

TwilightSparkle2019 wrote: »

I spoke to a Dr back in January he didn't tell us much other than been bleeding on brain, that was it. I've not contacted any other dept since.
.

This may be why they have not been answering your questions!

TwilightSparkle2019

I've asked while at hospital and they didn't want to know... Because I believe they hiding info.

There still issues now with rest of services, mistake after mistake, it's still ongoing. No one communicates

Toothsmith

It's not very clear what you feel is negligent? The administration of the TPA?

Your Mum is clearly a very sick lady. It's not clear whether she was considered to be in good health before that first stroke, or whether she was aware of other medical conditions - but it's clear that after the first stroke, a lot of other serious medical issues she had, came to light.

It's easily possible that the hospital can't answer your questions because they don't know the answers - not because they're covering anything up. With a lady as poorly as your Mum, is it really the correct thing to do to run loads of tests that won't benefit the patient, just so they can answer a relative's questions?

Why are you so resistant to the DNR request? I know it is a terrible time, particularly if your Mum seemed outwardly pretty healthy before the first stroke. Would you really want medical staff doing what they have to do to resuscitate her though, if her body did just give up in the coming weeks? With the risks of injury or further brain damage even if they were successful?

I am pretty sure the hospitals your Mum has been in have done whatever they could for her.

It's obviously a very upsetting and traumatic time for the family. Pursuing a case for negligence will not help that trauma and upset. Concentrate on making your Mum as comfortable as you can for the time she has left.

Robin9

Toothsmith wrote: »

..........................

Why are you so resistant to the DNR request? .......................

It's obviously a very upsetting and traumatic time for the family. Pursuing a case for negligence will not help that trauma and upset. Concentrate on making your Mum as comfortable as you can for the time she has left.

Seeing your mum dying - for that's what it is - is very upsetting. One part of you doesn't want to let go and the other prays for a peaceful end.

I had to sign a DNR for my dad.

elsien

What is your issue with the DNAR?
That it shouldn't be there, that it's against mum's wishes, that it's unlawful due to capacity issues?

If there is no prospect of CPR bringing the person back, then the medical team will not attempt it regardless of the person's wishes, and they/their family just need to be informed of that.
If your mum is physically frail, has a cancer diagnosis and has a very poor prognosis (plus the doctors do seem to have discussed it with you at one point) then on the balance of benefits/burdens, would your mum really want to be put through the pain and trauma to end up probably worse than she is now? The bottom lone is that it is always going to be a clinical decision.
Having said that, if you feel it says consent was given when mum wasn't able to consent, then make a complaint. It won't change anything for your mum, but may ensure the responsible consultant follows a lawful process in future. However this is unlikely to get you anywhere in a negligence claim.

With regards to the other issues, hospitals prefer not to give information over the phone if you phone in, because of confidentiality and you can't prove who you are. That's not them being secretive, that's normal procedure.
What do you want to gain from a negligence claim, answers or financial redress? If answers and information are your priority, I would suggest you write to the trust with your concerns as a starting point. You have too little information to go on to get the lawyers involved at present. In my opinion, anyway.
It's no use going in, finding a random member of staff, and asking questions. They concentrate on current patients and won't have much of a clue about past ones, nor the time or inclination to look up notes. All your questions and communications should be in writing either via PALS or a formal complaint.

TwilightSparkle2019

I'm going write in.

I don't expect they to say much over the phone but in person I do and I asked questions but barely told anything . Part of the dnr is not filled out, there boxes that are missing info about consulting with others plus dates crossed through.

I think I'm going have to write in and complain...