Sir Bobby Charlton Inquest Records Accidental Death After Fall in Care Home Raises Questions in Relation to Treatment
Written by Senior Associate Solicitor, Nimish Patel.
On Wednesday 1 November, Warrington County Court recorded that England and Manchester United football legend, Sir Bobby Charlton, had sadly passed away following an admission at Macclesfield Hospital five days earlier after a fall at a care home. After the initial fall, there was a delay in referring him to a hospital before the doctors put him on an “end of life” care pathway following scans which showed an increased risk of pneumonia.
Questions Regarding the Care of Patients
When reading the accounts of the circumstances surrounding his death, a number of questions concerning his treatment highlight issues which we are finding in our cases. These generally involve the elderly and patients who have been diagnosed with advanced illnesses.
Sir Bobby Charlton had been residing in the care home where he required one to one assistance due to his advanced dementia. He had been clearly assessed as having a risk of falling due to being unsteady on his feet. To combat his fall risk he had crash mats surrounding his bed. Despite the crash matts and receiving one to one care, he fell against a windowsill and potentially a radiator. When checked over he was found to have no apparent injuries. However, a swelling was later found on his back and he went to hospital to discover after scans that he had fractured ribs and had an increased risk of pneumonia.
Read more about AWH’s care home and nursing home claims.
50,000 Cases of Dementia Missed
It has emerged that up to 50,000 dementia cases were missed while the UK was under COVID lockdown. Furthermore, around 1 in 10 new sufferers went undiagnosed, as referrals to clinics stopped. Experts have warned that the backlog could put further pressure on already overstretched hospitals.
Cases of Dementia on the Rise
Concerningly, dementia cases are already on the rise. Worldwide, there are already around 50 million people who have dementia. Nearly 60% of those with dementia live in low and middle-income countries. Every year, there are roughly 10 million new cases and those are only the diagnosed ones. The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%. Furthermore, the total number of people with dementia is projected to reach 82 million in 2030 and 152 in 2050. Much of this increase is attributable to the rising number of people who are living in low- and middle-income countries.
Supporting Families Making Negligence Claims
We are running a claim where our client was at a care home requiring care due to his dementia and he broke his hip whilst attempting to go to the toilet by himself. He passed away whilst in hospital due to his injuries less than a month later. We have had a previous claim where the wrong medication was provided by the care home to the family when they took their mother home for Christmas and this led to further infections and deterioration of her condition. We have also had other cases where the care homes have been questioned by the Care Quality Commission due to the shortage of staff to provide adequate care to them. This has been especially apparent since the Covid pandemic.
Doctors Quick to Choose End of Life Care Pathway
The other aspect to be concerned about is how quickly the doctors were willing to put him on the “end of life” care pathway.
I argued personally with a Consultant in January when my own father had Covid and pneumonia that he should not be put on the pathway and suspect that the pattern is directly linked to the lack of resources, staff shortages and increased backlogs for appointments.
We have found that since the Covid pandemic there has been a sharp increase in the speed that doctors have placed patients on the pathway. There have been numerous examples of decisions being taken by the hospital to stop taking any positive steps in treatment due to an extensive medical history or nurses leaving drinks unattended and out of reach of elderly patients so they were unable to take fluids on board.
We have one case where the family were arguing against a decision by the hospital to put their mother on the end of life care pathway for six months and we are aware of other cases where patients with advanced illnesses were told that due to their condition only palliative care was being offered rather than treating the infection which had arisen.
Poor Communication Between Hospitals and Family of Patients
In the following article Mr Stowell started a claim against a care home due to a lack of communication between the care providers and the family as to why his mother was placed on the pathway. The NICE guidelines for care of an adult who is dying from 2015 are clear that a patient nearing the end of their life should be treated with compassion, dignity and comfort. They also highlight the need to recognise when the patient’s symptoms are getting worse as well as when the symptoms are improving.
Unfortunately, once the decision is taken to put a patient onto the pathway, it has been our experience that there has been poor communication with the patient’s family and a general reluctance to take positive steps to assist the patient because they are on the pathway. This is certainly the circumstances in one case that we are currently running where nurses were alerted to issues raised by the patient’s family but they refused to investigate them further as she was on the pathway. The hospital has admitted that if a doctor had been informed then they would have undertaken a scan and she would not have passed away due to the sepsis infection.
Failings in End of Life Care
It is not our intention to say that the hospitals are refusing treatment by putting elderly or people with advanced illnesses on the pathway. However, due to questionable decision making and the speed in which healthcare professionals put someone on the end of life pathway, we are seeing increasing numbers of missed opportunities to prolong the life of a patient.
The issue post pandemic is the loss of systems and resources available at the hospital. Support systems for the family of relatives or loved ones entering the end of life pathway are not in place like they were pre-pandemic. Hospitals are no longer offering grief counselling referrals as they no longer have the same time and resources to provide adequate care the way it was envisioned in the NICE guidelines. As a result, hospitals are unable to smoothly guide patients through the process with the support they vitally need in a difficult time.
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