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Coroner raises concerns after death of dementia patient Edward James
A DEMENTIA patient died after a suffering a 3cm cut to his head - prompting a coroner to raise concerns about the procedures on a mental health ward.
Though a nurse noticed Edward James had the cut on his forehead, the Bucks coroner expressed his surprise that a doctor was not informed sooner.
An inquest heard a doctor was only brought in the next morning, when the 78-year-old had deteriorated and become non-responsive.
Mr James, from High Wycombe, died in hospital several days after the incident, with a post-mortem suggesting the blow to the head was one of the factors involved.
Following an investigation Oxford Health NHS Foundation Trust has changed the procedures surrounding head injuries.
The incident happened on the John Hampden mental health unit in Aylesbury, where Mr James had been admitted after becoming ‘violent and difficult to manage’ at home, High Wycombe Law Courts heard last Tuesday.
The cut was noticed by Indirah Simon, a staff nurse on the Cromwell Ward, on September 10 last year, though she said Mr James remained "upright and alert".
It was thought the injury could have been caused by the pensioner banging his head against a door, and nurses starting at 7.30am the next morning were told about the incident.
But by about 9.30am, staff nurse Priscillah Mukairah noticed Mr James had become non-responsive and a doctor was called.
The retired carpenter, of Warwick Road, was transferred to another ward within Stoke Mandeville Hospital, but died of a brain hemorrhage several days later.
A pathologist said the hemorrhage was caused by the fall and Mr James's vascular dementia, with pneumonia and a heart attack said to be associated factors.
Coroner Richard Hulett said: "I’m a little bit surprised that there wasn’t a pre-existing awareness of the danger of any sort of quite small head blow to people who have a combination of significant age and dementia.
"There is without doubt a blow to the head which is alarming and dangerous in terms of old people with dementia."
Ward manager Denise Ingalls said: "What we’ve done now is we’ve made the staff know any form of head injury is immediately escalated to the nurse in charge of the shift, to either the ward doctor, or the doctor on call."
Mr Hulett recorded a verdict of misadventure.
Mr James’s daughter, Martine, told the Bucks Free Press afterwards: "It would be nice to think elderly people got better care but there’s not the money in the system to provide it. They need more money in the NHS."
Oxford Health NHS Foundation Trust, which runs the John Hampden Unit, said in statement: "This incident has been taken very seriously by the trust and an investigation into Mr James’s death was undertaken.
"At the time of Mr James’s death all staff on duty followed the policies and procedures that were in place at the time.
"However, [as] a result of this investigation it was agreed that if a patient sustains any injury to the head whilst on the ward it should be reported to either the nurse in charge or the duty doctor as standard protocol.
"On behalf of the trust we would like to offer our sincerest sympathies to the family of Mr James."
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