Andrea West death: Urgent inquiry into LCP claims

Andrea West on her wedding day Andrea West went into the Priscilla Bacon Lodge for "routine" treatment

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A government minister has called for a police inquiry into the unexplained death of a mother-of-six at a hospice.

Andrea West, 35, who had cervical cancer, died last year in Norwich after going in for "routine" treatment.

Her family refused to accept cancer was the cause of death and claim she was placed on the Liverpool Care Pathway (LCP) - an end of life treatment plan.

An NHS trust denied Mrs West was on the LCP but said it took the family's concerns "very seriously".

"We take the concerns of the family very seriously and will do all we can to support them," the spokesman for Norfolk Community Health and Care NHS Trust said.

"We will also assist in any way we can during the inquest, should we be called upon."

Care Minister Norman Lamb says he will be writing to again to the police and coroner in the light of the new evidence

Tests by two independent pathologists, including one commissioned by the BBC, found significant levels of morphine in Mrs West's body - a drug which was not prescribed and was not in her hospice medical records.

Norman Lamb, North Norfolk MP and minister responsible for care services, said claims the medical notes did not "properly reflect" the treatment given would need "thorough investigation".

Heavily sedated

Liverpool Care Pathway

Geriatric generic

The pathway was developed during the late 1990s at the Royal Liverpool University Hospital, in conjunction with the Marie Curie Palliative Care Institute.

It was intended to provide uniform, high-quality, dignified care for dying patients.

Under the LCP, patients are regularly reviewed to ascertain whether medication should be stopped - and whether fluids should be withdrawn once they have ceased to be able to eat and drink.

Families have complained relatives were put on the pathway without their consent, and that death has been hastened in people who were not dying imminently.

Critics say that it is impossible for doctors to predict when death is imminent, so the decision to put a patient on the pathway is at worst self-fulfilling.

"It's an extraordinary situation and obviously very serious, and I will be writing both to the coroner and to the police to ask for absolute clarification of what steps are being taken in light of this new information," said the Liberal Democrat minister.

"Where there are allegations that the notes don't properly reflect what has been found in the body, then obviously there has to be a thorough investigation.

"The information that the BBC has now uncovered needs to be considered fully by the police."

Patients are placed on the LCP when doctors believe death is imminent. Patients and relatives should be consulted.

The government said on Monday that the LCP should be phased out in England.

Mrs West went into the Priscilla Bacon Lodge hospice, in Norwich, last September for symptom control and treatment for an infection. She died on 20 September, five days after being admitted.

Her family say the day before she died she was alert and eating well and chatting to her children.

The following day she was heavily sedated.

Her mother, Janette Green, 58, said she had a phone call telling her to go to the hospital as Mrs West had taken a turn for the worse.

Her husband, Chris West, asked Norfolk coroner William Armstrong for an autopsy and inquest, which was opened last year.

Mr Armstrong declined, saying he understood Mrs West died of cancer, but later changed his mind and instructed a pathologist who concluded cancer had killed her.

Urgent inquiry

Mr West had challenged that initial decision and commissioned a report from independent pathologist Dr Michael Jarmulowicz which concluded that, on the balance of probability, morphine and other drugs caused Mrs West's death and not cancer, and that they were given to her shortly before she died at the hospice.

Andrea West Andrea West's family say the day before she died the mother-of-six was alert and eating well

The pathologist wrote to Mr Armstrong saying: "I disagree with the cause of death given by your pathologist... the levels are consistent with a recent administration of morphine."

The BBC asked pathologist Dr John Grant for a third opinion, in which he agreed with Dr Jarmulowicz.

He wrote: "The deceased is likely to have received morphine during the time that she was an inpatient in the hospice... it is difficult to accept that the cancer in her pelvis was the immediate cause of her death."

A spokesman for Norfolk coroner's service said: "The inquest has not yet been concluded. Inquiries, including those of a scientific nature, are ongoing.

"The Coroner's Office is also awaiting contact from Mr West. This matter is sub judice and therefore any further comment at this stage would be inappropriate."

Last November, a spokesperson for Norfolk Community Health and Care NHS Trust (NCH&C) said: "We can confirm that this patient was not on the Liverpool Care Pathway while under our care."

However, in a letter to Mr West, Andrea West's GP said a hospital consultant had told him she had been on the LCP.

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