I am writing to you regarding my father Michael Rathbone, currently being treated on Ward 60 at Hull Royal Infirmary.
I wish the following sequence of events to be investigated by the most appropriate Hospital Managers, and having outlined the situation in an objective manner as is possible, I have posed a serious of questions to which I would appreciate direct, concise and forensic replies. I have written to the Right Honourable Alan Johnson MP of whom my father is a constituent. He wishes to be appraised of your response. In addition I have instructed my Solicitor to act in my families best interest though naturally I do not expect it to come to that, provided we see evidence of goodwill, and a clear plan of action on behalf of the Hospital both to serve my father’s best interest and to ensure lessons are learnt.
For the record all medical notes and files are intact and on Ward 60 as of Thursday 25th November.
As the record will show my father was admitted to the Hospital earlier this month with chronic constipation. He was placed on Ward 70.
An abscess developed which required drainage in surgery, which was completed in the second week of the month. Information from Ward 70 was hard to garner and in addition when I pointed out my father has severe mental health issues and requested a visit from Psychological Medicine as he had shut down, I was told this was not appropriate. These sentiments were conveyed in a dismissive and thoughtless manner. Each time I requested information regarding my father’s condition I received confused and contradictory information from the staff on 70.
Matters deteriorated and resulted in my father going to HDU on 05/11. However my father was then sent to Ward 6 in anticipation of further surgery. Once again incomplete and contradictory information was given.
On Tuesday 16th the Consultant asked to see me. He was of the opinion that my father was not in fit shape to be subjected to surgery and had himself expressed no wish to undergo an operation. I concurred based on what I was being told. I asked about his mental health issues and their impact on this decision. The response was vague. I asked about his anti psychotic medication and was told he was “written up for it”. I assumed that this meant it was being administered. However further investigation proved this not to be the case, hence my father’s total lack of communication.
On 15th November I was informed that the staff were of the opinion my father had reached the end of the line and was close to death. Thus I agreed to his placement on the “Liverpool Pathway to Dying”.
The aim was to make my father comfortable and allow him to slip away. I prepared myself, refused my own admission to Ward 12 for life saving treatment for anti GAD associated cerebella ataxia, informed my family and waited with my Dad for the inevitable as I had promised him he would not die alone.
All nutrition, hydration and all medication for psychosis were withdrawn. Only mouth care and general hygiene were continued. No routine checks were carried out, and I was alone with Dad for hours on end with no one coming into the room.
By day four I was very concerned that he was suffering and on day six I requested he be hydrated. It was stated categorically by the nurse in charge on Saturday 20th at approximately mid day that any hydration was against the Pathway. However the document for professional clearly states that, “blanket withdrawal of hydration is morally indefensible”. My research also indicated the terrible and catastrophic suffering to a patient who is conscious would undergo if denied hydration for such a long period. On Sunday I met with the registrar and hydration was restored and given that there was no infection still present and that my father was still cognitively clear full interventions were re instated.
Needless to say I, as my Dad’s sole relative and my family have been through indescribable trauma over these last days, but more importantly my father has been put through the most appalling ordeal so naturally I expect the following issues to be directly addressed in the manner I outlined above. My work currently involves dealing with Labour Leader Ed Miliband’s day to day mailbag, and I have read some heart rending narratives, but reading back and reflecting on the above, none include such terrible suffering being inflicted on an individual as has been visited on my Dad.
1. What did the CT Scan on admission show? How much damage was there to the bowel?
2. For what reason were the mental health team not involved at the earliest possible opportunity?
3. On 15th November what did the Consultant opinion that my father was actually dying of? To what extent did “Quality of Life” come into the equation?
4. Why were my Dad’s anti psychotic drugs not given? If not by mouth why not through the tube as soon as possible?
5. Why was no written information supplied to me about the Pathway?
6. Why, given the protocol was hydration completely withdrawn? Was this to hasten death?
7. Why, on day six were we denied re hydration? This pro longed and exacerbated my Dad’s suffering. This is considered “morally indefensible” by the protocol.
8. Why were no observations undertaken for the six days he was on the Pathway? According to the Protocol was no MDT Review conducted. This is meant to happen every three day, discreet from the Ward round.
9. To what extent has my Dad been damaged by de hydration, such as effects on kidney and liver function? Has this precluded any further surgical intervention?