Julie Morrey
24 Oct 2019 · Coroner Andrew Barkley · Stoke-on-Trent & North Staffordshire
The coroner's concerns
1. lack of communication between hospital departments
“There was a clear lack of communication between the hospital departments as to which department was responsible for the patient after she was assessed by a renal specialist and a plan made for her care and whilst she awaited a bed on the Renal Unit during which time she was looked after on the AMU. During this time she was without fluids for over 24 hours.”
2. failure to pro-actively manage condition
“There was a clear failure by nursing staff to pro-actively manage her condition due to a lack of policy, procedure and professional responsibility to the patient.”
3. no senior clinician review for 24 hours
“There was no review of the patient by a senior clinician for 24 hours following her admission and whilst she awaited a bed on the Renal Unit.”