Mr H was 77 years of age when he died at the Royal Sussex County Hospital in Brighton in December 2011.
Over the final years of his life, he suffered with Parkinson’s Disease which made him vulnerable, physically, although he remained mentally aware and fully engaged with his family to whom he was a much loved husband, father and grandfather.
In September 2010, following a fall, his right shoulder was x-rayed, at the Royal Sussex County Hospital, and reported as showing no fracture or other problems. In fact Mr H had dislocated his right shoulder in the fall. This went undiagnosed, with him remaining in great pain and personal anguish, up until 15th October 2010, when the earlier error was finally recognised. He underwent remedial surgery two days later.
In December 2011, he was admitted to the Royal Sussex County Hospital, Brighton, via ambulance, with chest pains and shortness of breath.
There followed an appalling catalogue of errors surrounding the hospital’s failure to properly assess and deal with Mr H in terms of his vulnerability to falls.
He was placed in the Catherine James Ward at the Hospital which was defective in terms of its layout, including balcony areas out of sight of the nurses’ station.
There was a failure to carry out a proper risk assessment, including completion of required documentation, Mr H was wrongly placed in the balcony section to the ward, there were inadequate staffing levels, his bed was not lowered, cot sides were not properly used and there were inadequate observations.
As a result of these and other varied failings, Mr H suffered a fall from his bed in the early hours of the morning two days after he had been admitted. He hit his head so severely that it caused a brain haemorrhage and resulted in him dying later that day.
Within protocol correspondence, the Trust and NHSLA, admitted negligence for failing to diagnose the dislocated shoulder.
They also indicated that their own expert evidence confirmed that Mr H’s care in relation to the risk of falling was not of the standard that should have been expected in an NHS hospital. Irrespective of this, however, they denied causation – that the failings made any difference.
This meant that the family had to issue legal proceedings against the Brighton and Sussex University Hospitals NHS Trust, who are responsible for the Royal Sussex County Hospital. Once the Trust’s solicitors received the proceedings the case was settled at an early stage for £27,000 plus costs.
Nick Fairweather, who had conduct of this matter, commented:-
“This case is a disgraceful but all too common example of substandard care provided to the elderly and vulnerable. It is appalling that a dislocated fracture could be missed on x-ray. Beyond this, the events leading up to Mr H’s death involved shockingly poor standards of care and were rightly condemned by our expert and by the coroner who investigated the death.
If the actual circumstances of the case, with fatal outcome, were not enough, once the family took a legal action there was delay and prevarication in admitting what had gone wrong and its consequences. This meant that public money was wasted in costs in having to issue proceedings as well as the case being prolonged for the family. I pay tribute to their determination and fortitude in ensuring that they got justice ultimately for Mr H. Their hope now, of course, is that the Trust is capable of learning from its errors in the case and improving its procedures so that another family does not have to suffer as they and Mr H have in this case.”