Advising with empathy and experience

Apology follows tragic death.


Worcestershire Acute Hospitals Trust have issued an unreserved apology for failures in the care for a 55 year old woman from Redditch who died in November 2010 after staff at the town's Alexandra Hospital failed to monitor her glucose levels.

Margaret Pitt had lived with Type 1 diabetes for 30 years. The mother of 3 suffered an irreversible brain injury and later died.

A Coroner had earlier ruled in June 2012 that a clinician committed a gross failure in not taking a blood sugar reading for Mrs Pitt. A second nurse, who was described as a diabetes specialist, had misunderstood what to do when it was found that Mrs Pitt had low blood sugar levels and failed to give a proper hand over. Deputy Coroner Marguerite Elcock described the failings as “unacceptable”.

The case has been referred to the Nursing & Midwifery Council on behalf of the family.

Speaking of the case Kim Daniells from the CNCI Team said “Those affected by Type 1 diabetes work on a daily basis to maintain healthy blood sugar levels. The very least that a patient with diabetes can expect when being admitted to hospital is that their commitment and care is matched by the clinicians and professionals around them. A patient with diabetes may carry out more than a thousand blood tests to monitor blood glucose levels in any year. Each test takes just a few seconds. For medical staff to have failed  to monitor blood sugar levels and then failed to treat low blood sugar levels is shocking and appalling. The consequences in this case have been tragic and devastating".