Dementia patient died in DGH fall

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A DEMENTIA sufferer died after falling over in hospital, an inquest has heard.

Phyllis Ovenden was spotted on the floor by a health care assistant (HCA) on the evening of January 17 and died the next day after her condition deteriorated.

An inquest into the Seaford resident’s death questioned whether her worsening condition had been flagged up urgently enough by staff nurse Josefina Dancel-Caalim to a doctor who was working that evening.

Ms Dancel-Caalim and HCA Carolyn Jones had been in charge of Mrs Ovenden, along with 10 other patients.

The 83-year-old was taken into Eastbourne DGH after suffering a fall at home. A CT scan showed she did not have any bleeding on the brain as a result.

The Vale Road resident had been monitored after the fall in hospital and was talking, said she had not hurt herself and had no obvious injury, the inquest heard.

She said she had been going to the toilet but did not activate the bell to get assistance.

Mrs Ovenden’s daughter Wendy Hobbs said her mother would have taken a fair amount of time to get to the position she was found in given her frail state.

But hours later there was concern about her blood pressure increasing.

During the evening, Dr Victoria Green, who was working elsewhere in the hospital, had been bleeped about the incident and said she would visit the patient when she could.

In total, four lots of observations were carried out on Mrs Ovenden, who had been deemed as at a high risk of falls. Ms Jones said every observation taken was reported to the staff nurse.

By 12.15am her speech was slurred and by 3.45am her breathing was unsteady and she was unresponsive. At this point the doctor was contacted again and attended straightaway.

Mrs Ovenden’s family were contacted and she passed away later that morning. The inquest heard she had bleeding in the brain and that the bleed was very fast.

Referring to when she was first bleeped Dr Green told the inquest, “I think I said I had a lot of things going on and I would come when I could but that I had pressing matters, could they keep me informed and observe the patient.”

The inquest heard Dr Green, who was looking after patients with a registrar, didn’t know that the patient’s speech was slurred.

Divisonal nurse Jacqueline Kinch, who made a report about the incident, was asked by Mr Craze if two people looking after 11 patients was sufficient.

She said it was consistent with staffing in the rest of the hospital. Bullet points of ‘lessons learnt’ from the incident had also been made, the inquest heard.

Coroner Alan Craze said he had enormous sympathy with Dr Green and she could only do her prioritising on the information she was given, adding, “It would have been better if there had been more urgency and earlier summoning.

“Having said that the only additional action would have been a CT scan and that would have shown what was going on without affecting the care and almost certainly the outcome.”

He recorded a verdict of accidental death.