A 58-year-old woman suffering from Alzheimer’s died at Ystrad Mynach Hospital after staff ignored signs of Deep Vein Thrombosis (DVT), according to an official report.
The woman’s family had asked for a doctor to examine before her death, only to be told by hospital staff that no doctors were available on the weekend.
The Public Services Ombudsman for Wales has now upheld several complaints made by the family of the woman, known only as Mrs F, against the hospital.
Aneurin Bevan Health Board, which runs the hospital, has apologised.
Mrs F was admitted to the hospital for assessment due to a deterioration in her mental health and her daughter, known as Mrs Q in the official report, complained about the standard of care during her mother’s admission which, she claimed, led to a more rapid deterioration in her mental and physical condition and ultimately, contributed to her death.
According to the Ombudsman’s report, Mrs F, who was admitted to hospital in December 2008, was “physically fit and well”. She passed away in February 2009 after her family became concerned about her condition on a weekend and had asked for her to see a doctor.
Public Services Ombudsman Peter Tyndall upheld the majority of the complaint which also included allegations that staff neglected Mrs F’s personal hygiene.
He said: “I found that the hospital’s procedures for the earlier detection of DVT in a patient displaying potential symptoms were lacking. I also found that the staff failed to act in an appropriate manner and contact a doctor for a medical opinion following a deterioration in Mrs F’s condition.
“The hospital also failed to seek or provide adequate reasons why access to a doctor over the weekend period was not available. I found that in general, the overall record keeping for the period of Mrs F’s admission was extremely poor. This had led to inadequacies in the response provided to the family during the internal complaints process and also in the proposed Action Plan implemented by Aneurin Bevan Health Board (the Health Board) to address the family’s concerns.
“Finally, I found that the standard of care and treatment provided to Mrs F during her admission fell below a reasonable standard. There was no evidence that Mrs F’s personal hygiene or nutritional needs were being met or that the care plans were implemented.”
The report said: “While I am unable to conclude that had such an examination been carried out this could have changed the tragic outcome of Mrs F’s death… it may at least have led to an earlier detection or suspicion of DVT, which in turn may or may not have led to an earlier referral to a physician and possibly the prevention of Mrs F’s heart attack.”
It added: “The care and treatment provided to Mrs F during her admission fell below a reasonable standard.”
A statement from Aneurin Bevan Health Board said: “We would like to repeat our sincere apologies to the family of the patient at the centre of the ombudsman’s report and for the failings that were identified.
“We aim to provide care of the highest standard, and we fully accept that the standard of care in this case fell below what could reasonably have been expected.
“Dignity and respect for all patients is very important, and since 2009 a number of actions have been taken to address the shortcomings identified in this case.”
Mr Tyndell recommended several improvement in his report including that staff improved their awareness of DVT and that adequate medical cover was available on weekends and out-of-hours.
I do not want to, and am not qualified to comment on an individual case. But I was shocked to read the new Ystrad Mynach Hospital does not have a full Accident and Emergency Service. So why have we lost The Miners, our local hospital, when we still have to go over the hill to the the Heath for A and E treatment?.
I agree with John Owen's concerns, the situation is worse than not having an A & E department. I was talking to staff at the Miners hospital about a family member who has to be transferred for an operation. I said that "It is a pity that the operation can no longer be done at the Miners." I was then told that the Ystrad Mynach hospital will also not be able to perform operations of this kind.
I am beginning to suspect that the residents of Caerffili have been hoodwinked into thinking that the new hospital is a modern replacement for the service once provided at the Miners. It is not, many patients will still have to travel to Gwent.
I cannot believe this is classed as a hospital !
My 29year old daughter was turned way after suffering what we thought was a stroke.I had to take her to Prince Charles ! It turned out she had carbon monoxide poising!
My 75 year old brother who has copd hurt his back and had to go to Prince Charles.Then he fractured his spine and had to travel to llantrisant hospital 25 miles away .
What exactly Do they cater for at this ystrad place,cos it certainly is not for Local residents
.I agree with the above comment we have been HOODWINKED.I expect they are keeping their so called ensuite bedrooms for PRIVATE PATIENTS !
Just for the sake of clarity, the hospital referred to in this story is the old Ystrad Mynach Hospital and not Ysbyty Ystrad Fawr.
The article might be about the old hospital in Ystrad Mynach but these people are right we have been hoodwinked in to believing we were having a local A&E and not knowing they were only getting a local minor assessment centre for lumps,bumps, scratches and a hospital where they place the old aged until they can find them a nursing home to put them in. A lot of money spent and not a place to go in you have an accident, because they will send you to the Royal Gwent.