Patients’ lives may be at risk’
THE family of a man who died when a hospital feeding tube was incorrectly inserted through one of his lungs believe further lives could be at risk if lessons have not been learnt from his death. Peter Cameron, 76, of Old Weston, had been in and out of hos
THE family of a man who died when a hospital feeding tube was incorrectly inserted through one of his lungs believe further lives could be at risk if lessons have not been learnt from his death.
Peter Cameron, 76, of Old Weston, had been in and out of hospital with respiratory problems for weeks. But he died at Hinchingbrooke Hospital on June 26 after a naso-gastric feeding tube misdirected liquid food - intended for his stomach - into his chest cavity.
Mr Cameron's brother-in-law Clive Walley, speaking on behalf of Mr Cameron's widow Heather and son John, claims the results of an inquest into the death did not go far enough and the same mistakes could happen again at another hospital.
Following the inquest in November, HM Coroner David Morris delivered his decision into Mr Cameron's death last Wednesday.
In a narrative verdict, Mr Morris criticised the monitoring of Mr Cameron by staff at the hospital, stating that it "might have been better" in the run-up to his death.
However, Mr Walley said: "We are not happy that the coroner failed to make plain that there was clear evidence that the correct procedures were not followed.
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"In essence, if the hospital is right, and the correct procedures were followed, then no patient at Hinchingbrooke, or indeed nationally, is safe."
Mr Walley also called for the coroner to report the case so that naso-gastric tube feeding procedures would be urgently examined by the Department of Health and the National Patient Safety Agency (NPSA).
Mr Morris had said that he may not report the matter as Hinchingbrooke Hospital had already written a report to the NPSA and this might be enough.
In his verdict, Mr Morris said that he believed the evidence from hospital staff but was "surprised" at their failure to spot that the tube was in the incorrect position as Mr Cameron's health deteriorated.
Mr Morris said that he believed the nurse who checked whether the tube was in the correct position may have been rushed, and added: "In this case it seems unlikely that the initial damage [after feeding commenced] could have been undone.
"The treatment of Mr Cameron during his final 48 hours might have been better monitored than it appears to have been."
In a statement, Hinchingbrooke Hospital said that lessons had been learned from the case.
The hospital says it has since changed its procedures regarding naso-gastric tube insertion with patients now routinely x-rayed and radiographers trained in spotting incorrectly inserted tubes.
The hospital has also written a report to the NPSA - which offers hospitals guidelines for carrying out medical procedures - regarding the incident.
A spokesman for the NPSA said: "All reports received are considered when procedural guidelines are reviewed.