Shetland NHS apology over stroke victim’s care

A health board has been criticised after a paralysed stroke patient was not fed or given fluids for 20 hours. She was also sent home from hospital to the wrong address in a taxi, which caused her “considerable distress” as she was unable to speak.

The Scottish Public Services Ombudsman asked Shetland NHS Board to apologise to the woman’s husband, identified as Mr C, for a string of failings relating to her care.

It also asked the Scottish Ambulance Service (SAS) to apologise to Mr C for a delay in taking her to hospital to have her feeding tube unblocked. An SAS spokesman said: “We have apologised to the patient.”

The woman, identified as Mrs C, was left paralysed and unable to speak or swallow by a severe stroke in 2004, and had to be fed through a feeding tube. At around midnight on June 28 2006 staff at the care home in Shetland where she lived discovered the feeding tube was blocked and in the morning she was referred to the Gilbert Bain Hospital in Shetland.

She was admitted to accident and emergency at 5pm and was returned to her care home at around 7.30pm. Mr C said that by that stage his wife was becoming dehydrated as she had been given no food or water for 20 hours.

The hospital consultant who acts as adviser to the Ombudsman said there was no reason why she should not have received alternative methods of hydration, if necessary by intravenous (IV) drip, if not nutrition. He said that the fact that this was not considered suggests a “poor assessment” by staff at the time of her admission to A&E.

The Chief Executive of Shetland Health Board said that A&E staff have now been reminded of the importance of keeping records of these aspects of patient care and the department will also be included in the health board’s next audit of record keeping.

Mr C also complained that on July 12 2006, when Mrs C’s feeding tube had to be unblocked in hospital again, she was sent home from hospital to the wrong address. The Ombudsman said: “It must have been frightening for an elderly person, unable to move or speak, to be taken to the wrong place.”

The health board’s chief executive said that she would put measures in place to minimise the possibility of a discharged patient being taken to the wrong address in future.