Published:
3:24 PM October 7, 2022
A man died after surgery to remove a stent which had been left in place almost 18 months longer than it should have been, an east London coroner found.
Graham White died in hospital last August after the surgery to take out an “antegrade ureteric stent”, according to a prevention of future deaths report.
The report follows an inquest into Graham’s death, overseen by acting senior coroner Graeme Irvine.
Mr Irvine, who penned the report, has sent the document to Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) and included a list of concerns relating to the case.
The report said the stent was inserted in November 2019 to treat Graham, 72, for a kidney stone.
In his narrative conclusion to the inquest, Mr Irvine said: “The stent was inserted in November 2019 and should have been removed after three
months.
“The stent deteriorated causing a urinary tract infection and a right perinephric abscess.
“On multiple occasions in a 20-month period the deterioration of the stent was observed but no action was taken to remove it.
“Mr White’s death was contributed to by neglect.”
Mr Irvine has written to BHRUT, which runs Queen’s Hospital in Romford and King George Hospital in Goodmayes, telling it to take action to prevent future deaths.
Among his concerns was that the trust did not have a register of patients fitted with stents “that would facilitate monitoring and recall of patients”.
He also said that, at the time of the inquest, BHRUT could not assess whether it had patients with stents fitted before May this year at risk of similar deterioration.
Mr Irvine added: “The trust did not successfully identify and escalate this death through its governance procedures as a serious incident for investigation until the issue was raised by the coroner.”
Matthew Trainer, BHRUT chief executive, said: “Graham White didn’t receive the high level of care he was entitled to when he came to our hospital, and we are extremely sorry for this.
“We have since introduced an electronic register to track patients who are due to have a stent removed. We are also reviewing patients who had a stent inserted in the last three years.”
https://www.romfordrecorder.co.uk/news/health/graham-white-prevention-of-future-deaths-report-9313594
