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Hospital fined for false imprisonment.

An NHS hospital has become the first to be fined for false imprisonment of a patient after refusing to allow a vulnerable woman to go home with her family.

King’s College Hospital NHS Foundation Trust kept the pensioner against her wishes for four months before sending her “to die” in an inadequately briefed nursing home.

Legal experts say the High Court judgment, which imposed “exceptional” aggravated damages on the trust, sets a precedent that significantly strengthens patients’ rights.

The patient, Christina Esegbona, was admitted to the South London hospital with heart problems, but then deteriorated as her requests to be allowed home into the care of her children - two of whom are medically qualified - were ignored.

In June 2011, doctors arranged to discharge her into a care facility two hours from her family home, deliberately informing her children too late for them to prevent it. Records show that staff also discussed calling security guards to the ward if the family intervened.

The 67-year-old, who was registered blind, died in Wilsmere House Nursing home, Harrow, nine days later from cardiac arrest having “pulled out” the tracheostomy tube that helped her breath.

Staff at King’s had seen Mrs Esegbona do the same thing two months before, yet failed properly to inform the nursing home of the risk.

Her honour, Judge Coe QC, said the patient might have avoided that fate had she been allowed home to her family.

She found the trust liable for false imprisonment for not allowing the patient home while also failing to conduct a statutory mental capacity assessment, against the advice of its own psychiatrist.

Head of King’s Chambers, Nigel Poole QC,  said he believed this is the first time an NHS hospital has been sanctioned for breaching the law in this way.

The trust was also found to be negligent for sending Mrs Esegbona to the nursing home without telling staff how closely she needed to be watched.

The Judge said the attitude of medical staff on the Lonsdale Ward had been “high-handed” and “oppressive.”

She said: “Her frustration and distress would have been significantly reduced had she better understood, and been more involved in, what was happening and if she had some hope that measures were being taken to explore the possibility of her going home, even on a trial basis.”

The court fined King’s £15,470 for false imprisonment - £150 for each day - as well as £3,500 for the pain and suffering and £5,000 aggravated damages.  

The patient’s daughter, Dr Gloria Esegbona, a senior obstetrician, told the court that the first thing her mother had said at Wilsmere House was “that she had been sent there to die.”

She and her siblings visited their mother every day of her eight-month stay at King’s College Hospital.

Despite this, the staff member responsible for arranging the Mrs Esegbona’s discharge wrote: “not to be discussed with patient’s family” in the notes.

In court, Dr Esegbona described “frantic attempts” by her family to contact the hospital once they found out about the discharge to Wilsmere House, but they could not get in touch until the transfer was underway.

The family disputes the court's finding that Mrs Esegbona removed the trachreostomy, but agree that the trust's negligent handover contributed to her death.

Many previous cases concerning deprivation of liberty issues have failed because courts decided it was not certain that omitting a capacity assessment made a practical difference.

But In Mrs Esegbona’s case, the court imposed the fine on the basis that the false imprisonment “may” have made a difference.

Charity director at Age UK, Caroline Abrahams,  said: “Ensuring that very sick older people make a good, safe transfer home, or to another setting when deemed fit to leave, is a crucial job for hospitals and one which will go much better if families are fully involved in the decision making and feel genuinely listened to.

“Hospitals are under enormous pressure and often lack sufficient staff, but they have to get this right for the sake of older people and their loved ones, since the consequences of failure can be devastating for everyone involved.”

A Trust spokesman said: “On this occasion, we felt it was in the best interests of the patient to remain in our care until a suitable care package could be identified.

“We accept that correct procedural steps were not followed for her continuing stay at the hospital. Since this happened in 2011, we have put robust procedures in place to avoid similar situations from occurring. We apologise to the family for any distress caused.”