Irwin Mitchell Instructed To Investigate His Care

The devastated family of a 79-year-old man who died of multi-organ failure after medical staff delayed inserting a catheter following surgery at a private Yorkshire clinic have spoken out for the first time following an inquest into his death.

James Hartley, from Addingham near Ilkley was admitted to The Yorkshire Clinic in Bingley after a referral from his GP for a routine hernia repair operation on 25^th September last year.

The 79-year-old’s surgery went smoothly, but approximately 24 hours after the operation he suffered a series of seizures and was transferred to Bradford Royal Infirmary where bloods tests showed evidence of hyponatraemia (low sodium levels), and also a cerebral oedema (swelling of the brain).

He sadly died on 1^st October from multi-organ failure due to the brain injury from water intoxication, sepsis and pneumonia.

James’ wife Angela instructed specialist medical negligence lawyers at Irwin Mitchell to investigate his care and treatment at the Yorkshire Clinic and the circumstances leading up to his death.

A two-day inquest at Bradford Coroner’s Court concluded today (25^th June) where HM Coroner’s Assistant Oliver Longstaff recorded a verdict of death by misadventure.

The court heard that there were multiple failures by Yorkshire clinic staff to record and monitor accurately or at all how much Mr Hartley was drinking throughout the day. There was also a failure to escalate the post operation urine retention to the consultant and therefore he would have been given a catheter to drain the excess fluid and his water levels would have been closely monitored throughout the night.

The Coroner heard evidence that when Mr Hartley came out of surgery at around 9:00am he was encouraged to drink fluids and the nursing staff at the Yorkshire Clinic advised him to continue to do so throughout the day. Unfortunately he developed post-operative urine retention and was unable to pass urine. He was told that he could not leave hospital until he had done so.

There was a period of around 14 hours during which Mr Hartley’s fluid balance was not monitored, despite the fact that he was encouraged to drink  copious amounts of fluids and was not able to pass urine. Medical staff at the Yorkshire Clinic did not intervene to insert a catheter until midnight on 25 September 2014.

James and Angela chose Yorkshire Clinic through the ‘Choose and Book scheme’ because of its reputation as a high quality care provider but to discover basic policies and procedures were not followed has been devastating. 

Expert Opinion

“James’ family are utterly heartbroken and are left wondering why he was not given the appropriate treatment much sooner to avoid his tragic death.

“James had been encouraged to drink copious amounts of water and yet no fluid balance charts had been started. James’ failure to pass urine and the Yorkshire Clinic’s failure to catheterise him for over 14 hours meant that his body became overloaded by fluid resulting in water intoxication.

“Although the inquest has given them some answers, we will continue to work with the family to help them as they seek to find out more about the circumstances leading up to James’ death. They want to know that lessons have been learnt to prevent similar incidents in future.”
Ross McWilliams - Partner

The family found it distressing to discover that Mr Robinson, the consultant who performed the hernia repair operation successfully, was not told that his patient was to be kept in overnight by the Yorkshire clinic. Mr Robinson said that had he been told, he would have instructed staff to insert an indwelling catheter hours earlier.

The families’ stress was compounded by the very poor investigation carried out by the Yorkshire Clinic in which key staff members were not interviewed or produced to give evidence at the inquest. The subsequently produced serious incident report stated that there would be an offer made to the family to hold a meeting and apologise for the tragic outcome but this offer never materialised.

The cause of the hyponatraemia and brain swelling was initially unknown but his official cause of death has been determined to be multi-organ failure due to brain injury from water intoxication (dilutional hyponatraemia, which is caused by excessive water intake) and sepsis from pneumonia.

Commenting after the hearing, Angela, 79, said: “Our whole family is in complete shock as to what happened to James. He was extremely fit and healthy for his age and the operation he went to have at the Yorkshire Clinic was an elective procedure and even though all surgery carries a risk, his care by medical staff after the operation was very poor.

“I would like to thank the Coroner for a thorough investigation – it has helped us get more of an understanding as to what happened to James. I now hope with the help of our legal team at Irwin Mitchell that we can find all the answers to our questions and secure justice in James’ memory.”

If you or a loved one has suffered as a result of hospital negligence, we may be able to help you claim compensation. See our Medical Negligence Guide for more information.