North Shore Hospital report - New Zealand Doctor

Opinion 07HDC21742[Mrs C] [Mrs C] was admitted to North Shore Hospital ECC on 25 September 2007. She had beenreferred by her GP to a General Medical Team.In ECC she was seen by the [General Medical Registrar] and treated for Congestive HeartFailure. She spent 4 hours in ECC before being transferred to ward 10. There seem to beno concerns about this phase of her care.In the early hours of September 28 th , [Mrs C] died on the ward.Concerns raised by the family about the care on ward 10 include:o Possible reaction to codeine, causing [Mrs C‘s] deterioration,o Infrequency of nursing observations,o Slowness to respond to concerns of family,o And inadequate communication re the gravity of the situation.[Mr D] [Mr D] was admitted to North Shore Hospital ECC on 20 September 2007 with complexmedical problems.He was transferred to ward 11, and all of the concerns raised by family members relate tohis care during his time on ward 11.Review of the notes suggest that [Mr D‘s] medical problem list included:o Congestive Heart Failure with pleural effusions (fluid around his lung). Persistenthypotension (low blood pressure) developed during the course of his admissionsuggesting cardiogenic shock — a condition with a very poor prognosis.o Ischaemic heart disease. A small rise in a blood test (TNI) suggests he might have hada myocardial infarction during his admission.o Chronic obstructive airways disease.o Respiratory failure.o Benzodiazepine dependence.o Severe agitation, probably contributed to by all of the above.[Mr D] died on 18 October.The concerns about his care, raised by his family, include:o Poor communication by the medical staff with the patient and the family.o Confusion between the concepts of ―active‖ versus ―palliative‖ care.o Concerns that they and the patient were ignored, including poor care to avoid bedsores, poor attention to his nutrition and needs for urination.[Mrs E] [Mrs E] was admitted to North Shore Hospital ECC on 17 October 2007. She had beenreferred by her GP directly to a General Medical Team, for assessment and treatment ofshortness of breath.On arrival, observations were recorded, an ECG was done, intravenous access wasobtained and blood samples were taken by an ECC nurse and she was triaged as Category3 (ideally should be seen within 30 minutes).April 2009 115