Apology over failings at Singleton hospital, Swansea
- 19 May 2014
- From the section South West Wales
A health board has apologised to the family of a patient who died following care failings at a Swansea hospital.
Peter O'Grady was not monitored properly while at Singleton Hospital and his illness worsened before his death, said a report.
Abertawe Bro Morgannwg Health Board has paid his family £500 and apologised.
Mr O'Grady's family complained to the Public Services Ombudsman for Wales after he died.
He was admitted to Singleton Hospital on 21 September, 2012, after a GP referral and was "noted to be a new diabetic who was confused, vomiting and complaining of abdominal pain and a purpuric rash" although he also suffered from other conditions.
Mr O'Grady was not properly monitored, his medical records failed to reflect his condition and chances to spot his deterioration were missed, the ombudsman's report said.
The report, which identified Mr O'Grady as "Mr Y" - said: "The ombudsman found that the failure to adequately monitor Mr Y had resulted in him becoming dehydrated which contributed to the severity of Mr Y's renal failure.
"The ombudsman also found that the medical records failed to fully reflect Mr Y's condition, and as a result opportunities to identify Mr Y's deterioration were missed."
It said the level of care had been "affected by the lack of weekend doctor reviews and the paucity of senior medical staff on the ward," adding that "nursing staff had failed to keep Mr Y warm and comfortable".
It added: "One of the basic requirements for being comfortable is to be kept warm enough.
"The failure to have sufficient blankets to keep acutely ill patients warm is wholly unacceptable."
In October 2012, Mr O'Grady was transferred to another hospital, where he died. Multiple organ failure was among the causes of death.
As well as the payment for recognising the failings in the ombudsman's report, the health board also had to pay Mr O'Grady's brother, Terry, £250 for the time spent bringing the complaint.
'Poor, poor, poor'
Terry O'Grady said he was satisfied with most of the report's findings, but added: "What can the ombudsman do?
"All they can say is for the hospital to clean their act up, which we all know they don't do."
He said his brother's treatment had been "poor, poor, poor," and the complaints procedure was "comical".
"We again offer our sincere condolences to the family and apologise for the failings identified in the patient's care," an ABM statement said.
"The findings of our internal investigation carried out in 2012 were discussed by clinical staff and appropriate actions were taken."
The statement added all staff had to attend compulsory training on fluid monitoring last year and have been reminded about the importance of record-keeping.
The ombudsman's report, issued in March, made nine recommendations, including ordering the health board to make the two payments and write an apology.