A grandmother who worked for the ambulance service for 25 years died when medics accidentally put a feeding tube into her lung – and failed to spot it for more than ten hours.
Maura Irwin, 77, had the nasal feeding tube misplaced into her lung after suffering a stroke, which then filled up and killed her, an inquest was told.
Maura’s daughter Kathryn Scully said her family had to watch her “slow and painful death” at Kings College Hospital as a result of the “betrayal” by NHS staff.
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Andrew Harris, a coroner, concluded: “She died from injury caused by feeding through an undetected misplaced nasogastric tube for more than ten hours.
“The failure to check the position of the tube after the second desaturation (5pm) or ensure she received timely medical assessment then contributed to her death. This was a death from unintended consequences of necessary medical treatment and subsequent omissions in care.”
Maura, who lived in New Cross, South East London, was admitted to Kings College Hospital in February 2018 after suffering a debilitating stroke. The feeding tube was wrongly misplaced into her lung two days after she was admitted, which caused her death three weeks later.
Speaking to My London, Maura’s daughter Kathryn Scully, 59, from Lincoln, said: “She had the most horrendous death because she couldn’t breathe. She couldn’t take in any oxygen. And we just had to sit there and watch her die that death.
“The conditions inside the hospital were awful. I went into visit her one day and she didn’t even have a blanket. I had to ask the nurse several times just for something as basic as that.
“It’s been horrendous for the family. It just feels as if there was no communication between staff at the hospital. I almost feel as if my mum was just written off by medics.”
Maura is survived by five children – of which Kathryn is the eldest – and six grandchildren.
Audrey worked for the NHS for 25 years, staying way beyond retirement
(Image: Kathryn Scully)
Kathryn added: “Mum was a wonderful, independent and passionate woman who was loved deeply by her family. There isn’t a day that goes by that we don’t miss her. Mum loved her job with the NHS where she worked for 25 years, staying way beyond retirement age to care for others, but she was cruelly let down by the service with the ultimate betrayal.
“Medics misplaced the nasal feeding tube into her lung resulting in food filling up her lung and drowning her. It was like watching somebody getting smothered and being powerless to stop it. As a family we had to witness her dying a slow and painful death as she could not breath properly and was in agony. No patient in the care of any medics nor family should ever have to experience such a horrendous ordeal.”
King’s College Hospital NHS Foundation Trust has apologised for Maura’s death, but Kathryn said: “As a family we are tired of the NHS saying they are sorry for our loss as those words don’t mean anything without actions.
“There were a catalogue of failings in mum’s care and we want to know that the trust made the necessary changes to make sure what happened to mum never happens to anybody else.”
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Audrey’s family say they had to watch her suffer a “slow and painful death”
(Image: Kathryn Scully)
Nicholas Leahy, a specialist medical negligence solicitor from London law firm Osbornes Law, which represents the family, said: “Maura gave 25 years of her working life to the NHS but in her time of need they failed her.
“The trust identified 18 separate actions that would be implemented after Maura’s death, but her family now need to know what has been done to make sure another person does not die in the same painful way as her. Only then will they feel that her avoidable death wasn’t in vain.
“The coroner found that feeding through the misplaced nasogastric tube together with the failure to identify this for over ten hours directly contributed to Maura’s death. The trust must work hard to ensure that the omissions in care which were identified in this case must never happen again.”
A spokesperson for King’s College Hospital NHS Foundation Trust said: “The care provided to Mrs Irwin was far below our expected standards, and we offer our heartfelt apologies to her family.
“We have learnt lessons from what happened, and implemented all of the actions arising from the investigation. We also continue to monitor our NG tube practices to minimise the likelihood of this happening to other patients.”
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