Advising with empathy and experience

"Cruel" and "callous" NHS.

Katherine Murphy, Chief Executive of the Patient’s Association, has described as “cruel” and “callous” the way that the NHS handled a family’s complaint after the tragic death of three year old Sam Morrish. Sam died from septic shock in the early hours of 23 December 2010. He had fallen ill just two days previously.

Sam’s mother suspected he had flu and was concerned that he might have a chest infection.  She took her son to her GP. By the following morning, Sam’s condition had deteriorated dramatically.  A second GP appointment was made for 4.00pm.  That evening, Sam’s condition deteriorated again and the family called NHS Direct.  The family were later advised to go to an out of hours treatment centre.  A nurse there raised the alarm and Sam was rushed to A&E in an ambulance.

Once in hospital, Sam was not given the necessary antibiotics until 3 hours after they were prescribed.  He was admitted to the High Dependency Unit instead of Intensive Care. By this time, Sam’s condition was so weakened that an invasive bacterial infection had been allowed into his blood steam.  The infection took hold and Sam died in the early hours of 23 December 2010.

There were a number of concerns about the quality of the care that Sam had received during the few days of his illness.  A GP failed to check if there was any urine in the nappy that Sam was wearing.  The NHS Direct call was logged as routine when it should have been recorded as an emergency. Sam’s mum was advised to go to the out of hours treatment centre instead of being directed to A&E.

Two investigations into the tragedy were commissioned by the NHS in Devon.  A third investigation was abandoned because of a lack of confidence in its process.  Sam’s father, Scott, said: “We have strived to work with our local NHS to establish what went wrong in the hope that our tragedy might help others.  But trust in the NHS has become progressively harder as the various investigations have floundered.  Most of what we know now did not come to light through the analytical or investigative work of the NHS; it came to light despite the NHS”.

Katherine Murphy of the Patient’s Association said: “It is an absolute disgrace that a bereaved family could be so utterly let down by the whole system”.

The NHS in Devon said: “We have listened and acted upon the investigations into the circumstances surrounding the tragedy.”

A family complaint to the Health Service Ombudsman is ongoing.  The Ombudsman said its investigations are being conducted in private, but the family would have a chance to comment on a draft before publication.

Richard Wood of the CNCI team said: “Our experience is that most of those who raise concerns about NHS care do so in order to understand what has happened and to prevent such problems occurring again.  It is imperative that when the NHS investigates such issues, it does so openly, honestly and with compassion.  Any impression that the NHS is “protecting its own” simply destroys faith in the system and encourages suspicion and litigation”.

The contents of this article are intended for general information purposes only and shall not be deemed to be, or constitute legal advice. We cannot accept responsibility for any loss as a result of acts or omissions taken in respect of this article.