ANOTHER DEATH FROM THIRST IN A NHS HOSPITAL

For many of the frail elderly, the doctors give them heroin (diamorphine) to knock them out and then leave them to die

A coroner investigating the death of a woman allegedly starved and deprived of fluids in hospital has been asked to hold an inquest into the death of a patient on the same ward. Relatives of Harold Speed believe that he died of dehydration, not pneumonia as his death certificate says. The 84-year-old former music teacher had been examined by the same doctor who treated Olive Nockels, who died after her drips were removed. "The whole of my husband's stay in hospital was a nightmare," Kate Speed said. "They put bronchopneumonia on the death certificate, but I believe his death was from the effects of dehydration." She has asked William Armstrong, the coroner, to examine her husband's death. Mr Speed and Mrs Nockels were patients on Kimberley ward at Norfolk and Norwich University Hospital.

Last month David Maisey, a consultant physician, astonished the inquest into Mrs Nockels's death when he said that he saw people die of dehydration "all the time - two or three times a week". The hospital has offered Mrs Speed compensation over her husband's death. "They asked me for a figure but I was afraid it was tactical and that they would then not have to answer questions. Just pay, and I would never know the truth of what happened," she said. She wants Mr Armstrong to investigate how many other complaints might have been lodged by patients' families over the withdrawal of fluid and food.

Mr Speed was admitted to hospital on October 16, 2004, after suffering a heart attack. While there he developed pulmonary oedema and was given diuretic therapy to rid him of the fluid on his lungs, and marked "nil by mouth". Mrs Speed said that when she visited her husband on October 24 his condition had deteriorated. She said that she threw "an absolute wobbly", accused the hospital of dereliction of duty and demanded to see a doctor. "His eyes were dry, sore, flat and sunken. I tried to moisten his mouth. I asked why he was so drowsy and was told it was perhaps due to the diamorphine he had been given. The doctor said he was very dry and picked up the flesh from his neck. It was like picking up a sheet. His veins were flat and there was an absence of mucous . . . these were classic signs of dehydration. I was in tears for him. There had been such a decline from the time he was admitted, but the doctor told me he could not have an intravenous drip because it would be too painful."

The hospital agreed on October 25 to give Mr Speed a subcutaneous infusion, where fluids are administered under the skin, and to lift the nil-by-mouth order. This was reversed on October 30 on the ground that he had aspirated liquid. Mr Speed died on November 2. Mrs Speed told the coroner in a statement that she saw Dr Maisey the day before her husband died. "I had a very terse conversation with Dr Maisey, who came to see my husband only when I dragged him out of reception. He did not physically examine my husband . . . he just turned my husband's softly playing radio off, returned to the foot of my husband's bed and told me Harold had had `the beginnings of a heart attack' way back on October 16, and he was going to give my husband some potassium in an IV, and went. We trusted, and he trusted, that the hospital would treat him well, instead of which there was a catalogue of error and apathy that led to his death, unless of course, there had been a decision, which I had no share in, that his life should no longer be preserved."

Mr Armstrong has adjourned his inquest into Mrs Nockels's death. Chris West, her grandson, said in a statement to the inquest: "I said I wouldn't treat my dog like that and [Dr Maisey] said it was easier for vets because they had alternative means and can `put animals to sleep'." Gillian Craig, vice-chairman of the Medical Ethics Alliance, said: "Any hospital or ward where patients are said to die of dehydration `all the time - two or three times a week' should be the subject of a police inquiry."

In his evidence to the inquest, Dr Maisey said: "The prognosis was very poor. Mrs Nockels was almost certain to die . . . within the next few weeks. To have put any food or liquid in her mouth would have led possibly to asphyxiation."

Yesterday the Norfolk and Norwich University Hospital NHS Trust denied that Mr Speed was dehydrated when he died. It had previously been said that he had been dehydrated after his five days without fluids. Andrew Stronach, a spokesman for the hospital, said: "Part of his treatment involved diuretic therapy to address his subsequent cardiac failure. This was necessary as fluid overload can trigger further cardiac failure. This did lead to moderate dehydration that was addressed by giving him fluids and suspending diuretic therapy. "He remained well hydrated and was being intravenously given fluids and antibiotics for his chest infection when he died. Dehydration did not contribute to his death. The cause of death was bronchopneumonia with cerebrovascular disease and [heart attack]."

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