North West Anglia NHS Foundation Trust Have Admitted That Failings In Care Led To Her Death

The family of a great-grandmother demand changes in policy and procedure after her oesophagus was punctured during a routine procedure. North West Anglia NHS Foundation Trust have admitted that failings in care led to her death.

Annabelle Jocelyn died aged 73 on September 1st last year, two days after she attended Peterborough City Hospital for the gastroscopy to investigate her symptoms of gastric reflux. Her family instructed specialist medical negligence lawyers at Irwin Mitchell following her death.

The inquest into her death held last week at Huntingdon Coroner’s Court heard a range of concerns related to her treatment, including how Mrs Jocelyn was incorrectly referred for the procedure and that three attempts were made to insert the tube despite her oxygen saturation dropping to 88% after the first attempt and blood showing after the second attempt. The procedure was eventually abandoned and Mrs Jocelyn was sent home.

Hours after the abandoned procedure, Mrs Jocelyn was admitted to the emergency department of the same hospital with swelling and pain in her neck and face. The perforation was discovered but, due to its position and her pre-existing muscular dystrophy, repair was not possible. She died shortly afterwards.

The Trust conducted an internal investigation which tragically revealed that Mrs Jocelyn’s complex medical history was not taken into account when referring her for this elective procedure. Further, Mrs Jocelyn was wrongly added to the general ‘pool’ of patients awaiting a gastroscopy, rather than referred to a specialist, and her additional risks were not documented on the referral form.

The Assistant Coroner for Cambridgeshire and Peterborough gave a narrative conclusion following the inquest, which concluded on Friday. Mrs Jocelyn’s family and specialist medical negligence lawyers at Irwin Mitchell are now urging that North West Anglia NHS Foundation Trust review their policies and procedures to ensure that this tragic episode is not repeated. Annabelle’s loved ones instructed the legal experts to help them gain answers regarding her death.

Amie Minns, the solicitor at Irwin Mitchell’s Cambridge office who is representing the family, said: 

Expert Opinion

“Our clients understandably remain devastated by their loss and the inquest has raised many heart-breaking details concerning what Mrs Jocelyn went through prior to her death.

“The issues highlighted in this case should have been avoided through proper and comprehensive care, particularly considering Mrs Jocelyn had such complex needs. This truly is a tragic case which could have and should have been avoided; Mr Jocelyn has lost his wife of 56 years as a result of needless errors.

“It is absolutely vital that lessons are learnt and further training provided where necessary. Following the evidence heard at the Inquest, it is hoped that the Trust will continue to implement the recommendations made in their own Serious Incident Report. The safety of patients should always be the fundamental priority of the NHS and the terrible issues seen here should simply never be repeated in the future.” Amie Minns - Associate Solicitor

During the inquest, a range of issues were identified during Mrs Jocelyn’s care. At the referral stage it was heard how forms were not completed properly, as well as that Mrs Jocelyn’s pre-existing conditions were not adequately considered and the risks of the procedure were not fully explained. The Trust made a full admission of liability prior to the inquest.

Annabelle Jocelyn’s husband Ted, 78, said: “Annabelle was a much-loved mother, grandmother and great-grandmother and the entire family still miss her so very much.

“We have had long-held concerns regarding the standard of care she received at Peterborough City Hospital prior to her death and the inquest has clearly highlighted how more could – and should – have been done to ensure she was looked after in a safe manner.

“The past few months have been terribly difficult and while we have taken a step towards gaining answers regarding her death, we are fully focused on ensuring that lessons have been learnt and procedures changed. Annabelle’s death could have been avoided and we want reassurances that no other families will have to face the ordeal that we have been through.”

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