Woman dies after bowel obstruction

A 65-year-old woman who had bowel surgery after cancer treatment, suffered a bowel obstruction and later died of respiratory failure.

Nelson Marlborough District Health Board have been criticised for failing to take steps to treat the woman as her condition deteriorated. In a decision released on Monday, Health and Disability Commissioner Anthony Hill found the health board missed opportunities to implement appropriate treatment and escalate the woman’s care.

The woman, referred to in the report as Mrs B, underwent bowel surgery at a public hospital in 2014. She had rectal cancer and had undergone an eight-week course of chemotherapy and radiation, followed by an eight-week break to allow the tumour to shrink. She was expected to have a good chance of recovery.

The report found shortly after her surgery, the woman had a high white cell count and started to show signs of a bowel obstruction. Her condition deteriorated and four days after her surgery, she was diagnosed with acute respiratory distress and was transferred to intensive care. She died later that day.

Hill said there was a lack of timely investigation into her persistently high white cell count. He also found medical staff failed to consider inserting a nasogastric tube before the woman was transferred to the intensive care unit.

‘‘Given the woman’s known problems, it appears that inserting a nasogastric tube should have been considered at this time to treat the issues stemming from her [bowel obstruction] and respiratory distress, and I am concerned that this did not occur,’’ Hill said.

He was also critical about the care she received in the ICU. There had been a delay in calling the consultant anaesthetist and that invasive ventilation should have been implemented sooner.

Hill recommended the DHB apologise to the woman’s family and implement new guidelines for patients who require abdominal decompression and drainage, both of which it had done.