Hospital Trust Admits Delays In Diagnosing Life-Threatening Conditions After Family Ask Medical Negligence Lawyers To Investigate
A husband is calling for lessons to be learned after his wife died as a result of a perforated bowel diagnosed nine hours after she was admitted to hospital.
Jane Mason was admitted to Peterborough City Hospital on 21 March, 2021, complaining of severe abdominal pain and struggling to pass urine. She was assessed and deemed to be at low risk of having sepsis despite showing two red flag symptoms for the condition which sees the body attack itself in response to an infection.
Medics initially suspected the mum-of-four and grandmother-of-six had a water infection and inflamed pancreas.
Just over four hours after her admission, Jane, a retired nursery nurse, of Oundle, near Peterborough, was reviewed by a consultant who believed she may have constipation and ordered a bladder scan.
Delay in informing consultant about scan result which showed perforated bowel
However, there was then a four-hour delay in informing the consultant of the bladder scan result which showed Jane had a perforated bowel, an NHS investigation report found.
Emergency surgery was required to repair her bowel. However, Jane, who had developed sepsis, continued to deteriorate. She died aged 73 the following day.
Jane's husband Andrew asks medical negligence lawyers to help establish answers
Following Jane’s death her husband of 46 years Andrew, instructed specialist medical negligence lawyers at Irwin Mitchell to investigate his wife’s care under North West Anglia NHS Foundation Trust, which runs Peterborough City Hospital.
Andrew, aged 74, has now joined his legal team in calling for lessons to be learned and warning of the dangers of sepsis.
Hospital Trust admits liability for death of Oundle woman Jane
It comes after the Hospital Trust admitted liability for Jane’s death days ahead of an inquest. The Trust admitted delays in diagnosing Jane's perforated bowel and sepsis on 21 March, 2021. It accepted that this contributed to her death.
An inquest has concluded that “delays in diagnosing and treating sepsis and a bowel perforation probably contributed more than minimally to her death”.
Expert Opinion
“The last couple of years and coming to terms with Jane’s death have been traumatic for the family.
“Worrying failings have been admitted by the Trust regarding delays in recognising Jane’s perforated bowel and sepsis which contributed to her death.
“While nothing can make up for their loss, we’re pleased that we’ve at least been able to provide her family with the answers they deserve.
“Sepsis is an incredibly dangerous condition which can have devastating consequences. We join Andrew in urging everyone to be aware of the signs of sepsis. Early detection and treatment are key to beating it.” Amie Minns
Medical negligence: Jane and Andrew Mason's story
Jane started being sick and complaining of intense stomach pain on the morning of 21 March, 2021. Andrew called 111 around lunchtime and a first responder and paramedics were dispatched.
Jane who was unable to pass urine despite wanting to and was shivering, was taken to hospital by ambulance, arriving just before 2pm.
An investigation report by North West Anglia NHS Foundation Trust found that a nurse concluded Jane was at low risk of sepsis despite having a low temperature and low blood pressure – red flag symptoms of the condition.
Following a further review at around 3.45pm a working diagnosis that Jane had a water infection and pancreatitis was made.
During a review at around 6.15pm, a consultant recommended Jane, who continued to be in severe pain, undergo a bladder scan. They suspected she may have constipation.
Jane had the scan at around 7pm. However, the consultant was not informed of the results for four hours, the report added.
Jane was diagnosed with a perforated bowel and underwent emergency surgery in the early hours of 22 March.
However, her condition continued to deteriorate. She died just before midday on 23 March.
Investigation findings
The investigation report found the root cause of Jane’s death was that a perforated bowel was not considered as a working diagnosis until nine hours after admission. The four-hour delay in senior review of the bladder scan may have delayed the diagnosis.
The Record of Inquest outlined that, despite several "red flags" for possible infection, Jane was recorded at "low risk" of sepsis and no specific treatment was initiated. The bladder scan was not analysed until several hours later, meaning that alternative causes for Jane’s condition were not considered.
Andrew pays tribute to wonderful, kind and caring wife
Andrew, a former agricultural salesman, said: “Jane was a wonderful woman; she was calm, kind and caring. We had a very happy marriage and were looking forward to spending the rest of our retirement together.
“Jane was very fit for her age; we were always walking and eating healthily. We kept ourselves active by going on walks every day, no matter what the weather, and looking after our grandchildren.
“When Jane started complaining of being sick, in pain and being shivery I knew something was wrong as she never complained or exaggerated things.
“Twice during the time she was in hospital I was told by doctors that she was fit for her age. To this day we as a family all struggle to understand how Jane seemingly deteriorated so drastically.
“A few days earlier we had been out walking together and I couldn’t comprehend that she had suddenly gone.
“Jane was my best friend and life without her will never the be the same for any of us. There’s not a day goes by where we don’t think about her.
Family's sepsis warning after Jane's death
“I know the surgical and intensive care teams did everything they could for Jane and I can’t thank them enough. However, it remains difficult to accept the treatment Jane received in the A&E department where she was left for hours in pain with her condition deteriorating.
“Our family have been through a tremendous amount of pain over the last two-and-a half years. It remains difficult not to think Jane’s death shouldn’t have happened and how she should still be with us.
“If by raising awareness about the dangers of sepsis I can save someone else or another family from going through this then that would be some comfort.”
The signs of sepsis
Signs of sepsis include slurred speech, confusion, extreme shivering and muscle pain, passing no urine in a day, severe breathlessness and mottled or discoloured skin.
Find out more about our expertise in supporting patients and families affected by care issues at our dedicated medical negligence section. Alternatively, to speak to an expert contact us or call 0370 1500 100.
For more information about sepsis visit the UK Sepsis Trust's website.