Apology after death of dementia patient

The Public Services Ombudsman has upheld a series of complaints against NHS Lothian after the death of the elderly woman at the city's Liberton Hospital.

In the wake of the findings, critics have called for independent advocates to be appointed for patients with dementia.

Ombudsman Jim Martin upheld three complaints against NHS Lothian which were lodged by the woman's husband after her death in August 2008.

He made eight separate recommendations, telling NHS Lothian to apologise to the woman's husband and ordering a review of nursing care on the ward.

The woman, identified only as Mrs C, was admitted to the ERI on 18 August after a fall and then moved to ward one at Liberton Hospital. She already had multiple health problems including dementia and asthma, and since falling four days earlier had become increasingly confused, lost her appetite and was becoming less mobile.

But even though her dementia meant she was deemed incapable of consenting to treatment, when she refused to take oral antibiotics for her pneumonia, this was not written into her records and her husband was not told.

When her condition worsened and she became distressed, her husband raised his concerns with medical staff, but instead of having her treatment reviewed, she was given the sedative haloperidol.

It was not until two days after she first refused medication that she became so agitated that a doctor recommended intravenous antibiotics to combat her worsening pneumonia. Despite the change in her treatment, she died a few hours later.

The ombudsman said: "I . . . consider that the board failed to provide appropriate treatment to Mrs C during the time that she spent in (Liberton Hospital] in the form of regular medical review, reassessment following a failure to respond to treatment and in the face of a deteriorating clinical state. Mrs C also received sedative medication without appropriate assessment."

He also criticised the hospital probe into Mrs C's death, which was led by the consultant responsible for her care, who he said would not have been sufficiently objective. He did acknowledge that ensuring that Mrs C had taken the prescribed antibiotics was unlikely to have improved her chances of survival.

The city council's Labour health spokeswoman, Councillor Lesley Hinds, said: "

It worries me that we continue to have cases like this and while the health board say 'we're going to take up the recommendations', who follows it up?"

NHS Lothian nurse director, Melanie Hornett, said: "We will formally write to Mr C, but I would like to take this opportunity to offer my sincere apologies for the distress caused and the shortcomings in the care provided.