Michael Quinn
3 Aug 2015 · Coroner Peter Bedford · Berkshire
The coroner's concerns
1. inappropriate blood glucose level
“Immediately prior to his surgery, Mr [name redacted] blood sugar level was measured at 13mmol. This was made known to the treating surgeon and anesthetist who considered it appropriate to proceed with the surgery. It is recognised that raised blood glucose levels in diabetic patients increases the potential risk of infection. In the course of the evidence at the Inquest I heard that the hospitals guidance for acceptable levels of blood glucose levels in patients undergoing spinal surgery was no more”
2. policy inconsistency
“It is clear to me that there is a great deal of confusion about what is an appropriate level for patients such as Mr [name redacted] and the optimal blood glucose level that should be achieved in patients, diabetic or otherwise, prior to surgery. While I did not find at the Inquest that Mr [name redacted] blood glucose level of 13mmol was a factor in the infection that led to his death, I am nevertheless concerned that the written policy in place at the time does not mirror that of the national guidelines and is”
3. policy review needed
“I am directing this report to you because I understand that the method adopted by Circle Hospital was based on the policy of your Trust which took the lead in these matters. In those circumstances, I would invite the Trust to review its policy to determine whether the current recommended levels are appropriate in light of other current guidelines and evidence based research.”