Wife And Daughters Instruct Medical Negligence Lawyers To Support Them Through Inquest Process

The grieving family of a Wigan man who died after he was administered 10 times his prescribed dose of medication at a care home have spoken out following an inquest into his death.

David Fitton, from Wigan, had dementia and had been prescribed medication for this condition.

He lived at home supported by his wife Jennifer and family. During 2019 he went to Belong care home in Wigan for a week of respite care when Jennifer underwent knee surgery.

Three days into his stay, David was administered 10 times his prescribed dose of medication. He was taken to hospital by ambulance, assessed and discharged later the same day.  However, he was re-admitted the following day with difficulty swallowing, involuntary spasms and speech problems.  The swallowing difficulties led to a diagnosis of aspiration pneumonia, which happens when food or liquid is breathed into the airways or lungs instead of being swallowed.

David died approximately 10 weeks later, aged 76.  A post-mortem examination report found his cause of death was aspiration pneumonia caused by dysphagia (swallowing problems) of an unknown cause, and it also noted his dementia.

The staff member who had administered the medication received disciplinary action and underwent re-training.

Following her husband’s death, Jennifer, 72, and her daughters Jayne and Louise, 44 and 46, instructed medical negligence experts at Irwin Mitchell to investigate his care under Belong and to support the family through the inquest process.

An inquest into David’s death took place at Bolton Coroners Court in September.  A narrative conclusion was given by the coroner, which detailed that David died as a result of aspiration pneumonia and sepsis caused by dysphagia (of an unknown cause).

The family are now joining their legal team and the coroner in calling for lessons to be learned and changes to be made.

Expert Opinion

“Three years on, David’s family, particularly his wife Jennifer, are still struggling to come to terms with losing him so tragically.

Following his death, Jennifer, Jayne and Louise expressed concerns over the care provided to him. While the inquest and listening to the circumstances surrounding David’s death have been very painful for the family, they have been determined to understand what happened to David and to do everything within their control to ensure the same mistakes are not made again.

We’ll continue to support David’s loved ones at this distressing time.”
Ayse Ince - Senior Associate Solicitor

David, a former engineering manager, went to Belong with Jennifer, Louise and Jayne for one week of respite care on 16 June, 2019.  The inquest heard Jennifer, who was undergoing knee surgery the following day, provided carers with a note of David’s medication, including his dosage.

Almost four hours after the overdose had been administered on 19 June, David’s daughter Jayne was first informed of the error and an ambulance was called. Jayne arrived at Belong and David was taken to hospital early that afternoon.  Although the family still had concerns about his condition, he was discharged at 5pm and returned to the family home with Jayne, but he continued to deteriorate through the night.

At around 6am on 20 June, David was taken back to A&E.  He was in a semi-conscious state, unable to walk or talk with involuntary muscle spasms and issues with swallowing.

David didn’t recover from these symptoms.  He continued to deteriorate over the following ten weeks, with various complications, and sadly died on 30 August.

Importantly, during the inquest, the Coroner stated that she had various concerns and intends to write three letters to address these concerns; one to the Care Quality Commission (CQC), one to Belong and one to the Medicines and Healthcare Products Regulatory Agency.

She explained that within the letter to the CQC, she would ask that it remind care homes of the impact of appropriate safety checks when administering drugs to residents.

The letter to Belong will be a letter of concern addressed to the CEO. She intends to remind them of the importance of keeping up-to-date records, as it was confirmed during the evidence heard at the inquest that the care staff failed to do this for David.

Finally, in the letter to the Medicines and Healthcare Products Regulatory Agency, she intends to highlight the issue regarding the importance of having syringes with accurate and clear markings and further, the benefit of using a two-person safety netting system when administering drugs.

At the time of his death, David had been married to Jennifer for 45 years.  They shared their two daughters and five grandchildren.

David’s two daughters, Louise and Jayne have said: “Mum was dad’s main carer, but we helped out as much as we could. When we took him to Belong, we thought he was in the best place possible.  It was a huge shock when we got the phone call to say he had been given an overdose.

“Dad was in hospital for ten weeks after that, and it was devastating to see him suffer and deteriorate and know there was nothing we could do to help.

“It’s been three years since we lost him, but we feel like time has stood still for us as a family as we had so many concerns and questions over what happened.  Mum, in particular, has found the pain and grief unbearable.

“Whilst the inquest has been incredibly difficult as we’ve had to relive everything again, at least we have some answers now.

“We know that nothing will ever bring dad back to us.  However, it’s extremely important to us that nobody else is given the wrong dosage of medication and we hope that where appropriate care homes improve their systems and controls. In particular we would like to see a two-person checking system introduced – in the same way that hospitals do - as we feel that had this been in place at Belong in June 2019 this would not have happened to dad.

“We also call on them to make sure their staff are given the right training in the hope that it will help prevent other families from going through what we have.  It’s equally as important to us that such measures and changes will protect staff and carers from being in the terrible position of finding that they have made an error and the consequences of that error.  

"We accept that this was a human error and we hope that change will support staff to do their jobs safely in the future.”

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