Our Reply to Andrew Cash and NHS 22/9/09

enlarge image

Dear Ladies and Gentlemen,

Re: THOMAS MILNER Case No. 6 PATIENTS ASSOCIATION REPORT 27/8/09 www.tomsanguish.com

I wrote to you all, 30/6/09, and for your reference I enclose a copy of that letter which now takes also into account comments made to the press – Telegraph 5/7/09.

As you will be aware the Patients Association Report 27/8/09 included my father’s case. This report was primarily concerned with ‘vile’ nurses as Ms. Claire Rayner commented.

There have now been numerous press articles and apparently my father’s case received a lot of press coverage! Not least to do with the fact that an NHS Department had written to my dead father in July 2009 about the ‘care’ he had received!

Having been referred back to the Hospital over this protracted matter, I now have a copy of a letter written in the name of SIR ANDREW CASH OBE dated 14/8/09. This was sent to one of my 2 M.P.’s, Mr. David Willetts. I enclose a copy of this for your reference.

In this letter the dates of the supposed set up and re-fill of my father’s syringe driver are ERRONEOUSLY noted.

I have the medical notes and these dates and times DO NOT TALLY with any of the entries!

My father started receiving morphine 5mgs. 17.00p.m. 7/1/06 on the MAU ward. Subcutaneous injections of morphine and midazolam were given throughout this evening. Morphine and midazolam was administered throughout 8/1/06 and at 2.00a.m. 9/1/06 a syringe driver was set up containing 10mgs. morphine and 10mgs. midazolam. This was done on the MAU ward.
Morphine and midazolam had been administered during a 33 Hour period prior to the set up of the syringe driver which means that my father was NOT MORPHINE NAIVE.

At 18.00p.m. 9/1/06 with the syringe driver having been in situ for 16 Hours, he was taken from his death bed on the MAU ward. He was wheeled in a wheel chair, into the open, cold January air wearing only pyjamas, to the Palliative Care Unit of the Sheffield Northern General Hospital.

It states quite clearly in the Admittance Notes for this Palliative Care ward ‘syringe driver in situ’. (It had been for 16 HOURS)!
It was also noted that he was agitated, restless and in pain and needed oranmorph and morphine prn on arrival to this ward!

Throughout the evening of 9/1/06 and early hours of 10/1/06 my father received 6 x 5 mgs. morphine and midazolam prn.
It was noted that my father was breathless, agitated, in pain and bleeding rectally.
There is NOT ANY mention of ‘9th January at 22.50hrs syringe driver commenced’ – as per Sir Andrew’s letter! Indeed by 22.50hrs the syringe driver had been in place for 20 and ½ HOURS!

The following day 10/1/06 is well documented in my original letter to you which is here enclosed.
My father NEEDED 6 x 5 mgs. (30mgs) morphine and midazolam during the first 14 hours on the Palliative Care Ward, and had had a lot of prn morphine and midazolam whilst the syringe driver was in situ on the MAU ward - 16 Hours. 30 HOURS in total!
By the time the Consultant did her round at 10.30a.m. 10/1/06 the syringe driver had been in situ for 32 HOURS. She DID NOT CALCULATE AND CONSIDER the extra amounts of prn that had been required either on the Palliative Care Ward or on the MAU ward and left the morphine syringe driver holding JUST 10mgs!

My father for the rest of that daytime shift on his penultimate day, was DENIED/NOT ALLOWED any prn/extra morphine.
He had the syringe driver holding JUST 10mgs. morphine and midazolam.

In the medical notes 17.00p.m. 10/1/06 Dandelion and Burdock is cited as being ‘enough to settle him’.

Once the night staff from the previous evening returned, and with the syringe driver having been in situ for 42 HOURS holding just 10mgs. morphine, the prn morphine and midazolam was re-commenced. The medical notes entered by this night staff 6.15a.m. 11/1/06 state ‘restlesss, agitated, in pain needed a lot of prn’.

(THERE IS NOT ANY MENTION IN THE MEDICAL NOTES THAT ‘10TH JANUARY 20.20.HRS SYRINGE DRIVER RE-FILLED.
It is written that the syringe driver was refilled 10mgs. and resited at 6.40 A.M. 10/1/06 - 14 HOURS prior to what SIR ANDREW CASH OBE HAS WRITTEN !
This was done by the night nurse at the end of her shift early on the Tuesday morning. 4 Hours prior to the Consultants round at 10.30a.m. 10/1/06).

The syringe driver WAS NOT REFILLED AGAIN UNTIL 1 HOUR PRIOR TO DEATH! Therefore from 6.40a.m. 10/1/06 until 9.30a.m. 11/1/06 there wasn’t ANY change made to the syringe driver in this 27 HOUR period. By 9.30a.m. 11/1/06 the morphine syringe driver was still holding JUST 10mgs. that had been the set up dose some 54 and 1/2 hours earlier!

11/1/06 at 9.30a.m. the syringe driver which had been in situ for 54 and 1/2 HOURS holding just 10mgs. morphine and midazolam - was Doubled. This is NOT standard Palliative Care Practice. My father died 1 hour later.

The only reason ANYBODY came to change the syringe driver on that morning was due to my call to the family G.P., which is clearly noted in the medical notes ‘call from G.P. – Tom pulling at sheets’.
In the press, the Hospital continues its lies, deception and misleading comments:

In the Yorkshire Post 26/8/09:
Hilary Scholefield, Chief Nurse at the Sheffield Teaching Hospital Trust, said ,a review had been carried out by the Trust and the Healthcare Commission about the medication given to Mr Milner and it was found staff acted "appropriately and professionally".

As you know the Healthcare Commission said that ‘the amount in the morphine syringe driver 10mgs. WAS LOW IN THE CIRCUMSTANCES'.

Dr. David Throssell, the Trust's Deputy Medical Director, has been saying in various press articles about the day before my father died (10/1/06) "When asked by a doctor, Mr Milner indicated he was not in pain and therefore the doctor agreed with the nurse that further medication was not required.

In the medical notes 9/1/06 it clearly states ‘Tom too ill to have a discussion with staff'.
In the medical notes 10/1/06 written by the Consultant 10.30a.m. ‘unlikely to be aware of surroundings’.

I have already pointed out in my previous letter to you a couple of the discrepancies written in some of the Hospital’s correspondence v. the medical notes. I have a list! And now with the GROSS errors that have been written in SIR ANDREW CASH OBE’S LETTER!!!

This letter dated 14/8/09 DOES explain that the amount of ‘as required’ medication a patient has needed in the past 24 hours should be calculated and consideration is given to the dose via the transfusion.
CAN YOU EXPLAIN TO ME WHY THIS WAS NOT DONE FOR MY FATHER?

By 2.00a.m. 10/1/06 the Syringe Driver had been in place for 24 HOURS.
When the Consultant did her round 10.30a.m. 10/1/06 it had been in place for 32 HOURS!
WHY DID SHE NOT CALCULATE AND TAKE INTO ACCOUNT THE EXTRA PRN THAT HAD BEEN REQUIRED?

My father had NEEDED 30mgs. of extra morphine in the previous 14 hours!!! Not to mention the extra morphine he had needed on the other ward!!! It was NOT the case as stated in the letter 14/8/09 that ‘not much ‘as required’ medication had been previously required’!

CAN YOU EXPLAIN WHY DR. THROSSELL IS ISSUING STATEMENTS ABOUT MY FATHER HAVING BEEN ASKED IF HE HAD A PAIN? This is trying to put the onus of lack of Terminal Medication onto my dead father.
It seems that this Dr. has not been looking at the medical notes!
i.e. ‘Tom too ill to have discussion with staff 18.00p.m 9/1/06’ and ‘unlikely to be aware of surroundings 10.30a.m. 10/1/06’.

My solicitor has advised me that there were NOT ANY pain observation charts kept for my father.

We were there the whole time. Myself, my mother and my daughter!

My father was NOT assessed on a regular basis while on the Palliative Care Ward. The ONLY time we saw ‘staff’ was when we went to the nurses station to ask for assistance. Indeed to summon help 2 hours prior to death I had to call the G.P. at 8.30a.m. 11/1/06.

Statements were not taken, as should have been the procedure under ‘professional guidelines’, once I had raised my concerns in the first instance 21/1/06.

Prior to the letter dated 14/8/09 the Hospital wrote to my other M.P. Mr. Richard Cabourn, but this letter was totally different.

There wasn’t any name to the composer of this ‘general’ letter which just had photocopies attached of the Hospital’s previous ‘deceitful and erroneous’ correspondence to me.

19/8/09 the Office of my UKIP-MEP wrote to Mr. D. Stone, the Sheffield Hospital Chairman and I enclose a copy of this letter for your reference. 27/8/09 Dr. Throssell of the Hospital emailed me to ask for more time to consider the questions posed to Mr. Stone. Up until today 22/9/09 our UKIP-MEP nor ourselves have had a reply! This matter is being treated with contempt.

21/9/09 I contacted the office of SIR ANDREW CASH OBE and nobody seems to know who wrote the letter dated 14/8/09 enclosed herein. I was told at 10.00a.m. today that Ms. Sam Fogg one of the original letter writers would call me back. It is now 5.00p.m. and I have not had a call.

This matter once again is being treated with contempt.

I am used to the fabricating of events by now. Originally when the Consultant screeched up in front of the unit just as we were leaving, 11/1/06, and ran inside leaving her car door open, I said to my mother ‘something must have happened’ not realising what!
From the libellous comments made in the medical notes post mortem, to the Hospital correspondence recalling events that contradicted entries in the medical notes, to a ‘Medical Expert’ not being prepared to answer questions about her own writings, to the personal attacks made on me and my family in the comments made on the Sheffield Star article 29/8/09 – 2 of these comments have been removed, but we have copies, they gave details of my father’s treatment that had not been in any press article and the general public’s view seems to conclude that the person who had written these entries had ‘too much insider knowledge’ - and now to Sir Andrew Cash OBE, Chief Executive of the Sheffield Teaching Hospital Trust allowing a letter go out in his name which contains such ‘MISTAKES'!!!.

I bet a lot of you in your daily lives must wonder ‘who can be trusted’!
This Hospital seems to be incapable of getting anything right!

They initially resuscitated my father 7/1/06 when there was a clear DNR order in the Medical Notes and finally wrote to the wrong G.P. post mortem to advise of death!

I have contacted some of you via email 30/8/09, 1/9/09 and 5/9/09

Ms. Christine Beasley, the Chief Nursing Officer for the Government kindly wrote 4/9/09 to say ‘sorry that your father did not receive an appropriate level of care at Sheffield’s Northern General Hospital’.
Perhaps it is now time and only decent that this Hospital apologises to myself, my 76 year old mother and the rest of Thomas Milner’s family.
I await your comments,

Yours Sincerly,
www.tomsanguish.com

Copies sent to Sir Andrew Cash OBE and:
Nigel Farage UKIP-MEP
Gordon Brown P.M.,
David Cameron Leader of the Opposition,
Nick Clegg M.P.,
Andy Burham M.P., Minister for Health
Sir Liam Donaldson, Chief Medical Officer, CMO
Dame Christine Beasley, Chief Nursing Officer, CNO
David Willetts M.P. Richard Cabourn M.P.,
Lady Finlay of Llandaff,
Lord Joffe,
Lord Turnbull

Recommend to a friend