Advising with empathy and experience

Dialysis patient left without treatment in hospital.

A seriously ill patient needing daily home kidney dialysis was left for three days without treatment, despite being in hospital.

Andrew Wilson, 51, was under the care of the renal unit at Kent and Canterbury Hospital. He died from sepsis 11 days later.

Assistant coroner, Alan Blunsdon, said that, although the lack of kidney treatment did not contribute to his death, questions had to be asked as to why he was left with no dialysis for three days.

But Mr Blunsdon demanded action from East Kent Hospitals Trust, which is responsible for Kent and Canterbury Hospital. He said: “The evidence revealed matters of concern. In my opinion there is a risk that future deaths will occur unless action is taken.”

Mr Wilson, who developed chronic kidney disease and later cardio-renal failure in February 2015, was receiving peritonial dialysis at home every night, outsourced by the Kent and Canterbury Hospital’s renal unit to a private organisation with specially trained staff.

He was admitted to Maidstone Hospital on July 20, 2015, suffering from blurred vision, severe abdominal pain, an inability to pass urine, and was diagnosed with sepsis.

But no one at the hospital, or any satellite renal unit in Kent, could provide the dialysis and for the next three nights Mr Wilson went without the treatment.

According to the NHS website, when a patient does not have peritonial dialysis, waste products can build up to dangerous levels in the body as the kidneys do not function properly, causing unpleasant symptoms which, if untreated, can be fatal.

Mr Blunsdon added: “The explanation provided by the East Kent Hospitals Trust for the absence of dialysis is that there is insufficient trained clinical staff available to provide peritoneal dialysis treatment at hospitals outside the renal unit at Canterbury.

“The outsourced staff would not be permitted to provide treatment within the hospital.”

Mr Wilson, who lived in Maidstone, was eventually transferred to the Kent and Canterbury on July 23, 2015, and dialysis was given. He died from sepsis on July 31.

Mr Blunsdon said while the lack of dialysis did not cause his death, the absence of any arrangements to provide the treatment at hospitals other than the renal unit at Canterbury, was a serious concern.

He added that clinicians at Maidstone Hospital were unaware that they had to arrange the dialysis or transport the equipment from the patient’s home to the hospital.

A spokeswoman for East Kent Hospitals said their treatment would not have been carried out at the hospital due to risk of infection.

She said: “Peritoneal dialysis is suitable for only a very small group of patients with chronic but stable kidney disease dialysing at home. It would not be good practice to provide this service for any patient in hospital because the procedure means the risk of infection is too great.

“Therefore, alternative treatments are offered for hospital patients on established peritoneal dialysis should their kidney function deteriorate but this was never required by Mr Wilson.

“In this case, the trust would have supported Mr Wilson using haemodialysis or haemofiltration if his kidney function was deteriorating.  There was never any omission in his care.

“The low numbers of patients on peritoneal dialysis in Kent means there is a limited number of staff who can maintain their clinical training in peritoneal dialysis.”