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MEDICS ‘THOUGHT CHEMO SIDE EFFECTS WERE ANXIETY’ INQUEST TOLD:
A 26-YEAR-OLD cancer patient died a day after beginning chemotherapy when medics mistook side effects of the treatment as anxiety, an inquest has heard.
Siaron Lowis Bonds had high grade non-Hodgkin’s adult lymphoblastic lymphoma – a type of blood cancer and had been admitted to Alaw Ward at Ysbyty Gwynedd on September 7, 1994, for cancer treatment.
But she died two days later from acute tumour lysis syndrome (ATLS) – a serious consequence of either cancer or chemotherapy – which includes symptoms of nausea, vomiting, muscle weakness, tiredness and painful joints, an inquest at Gwynedd Council’s Siambr Hywel Dda heard on Monday.
ATLS can happen when substances are released into the bloodstream faster than the kidneys can remove them as a result of the breakdown of cancer cells – either through treatment or as a result of the cancer.
Giving evidence at the hearing, her mother, Nerys Bonds, told Joanne Leese, assistant coroner for North West Wales, how her daughter’s condition had deteriorated rapidly by the morning of September 9 – a day after she started chemotherapy.
She told how her daughter, a social care worker, appeared to have become “weak and not herself” and that she was in an “awful lot of pain”.
“The difference in Siaron was unbelievable,” she said.
“I went to have a word with the doctor and I asked him what was wrong and why she was so ill.”
The consultant had replied that her daughter was “suffering from anxiety”, the court heard – which had been documented in her medical notes.
It was only hours before Ms Bond’s death that doctors discovered the seriousness of the condition, but by then, it was “too late” and she died of a cardiac arrest at 3.30pm.
“A young doctor come and told us she had passed away,” Mrs Bonds added.
“It was just unbelievable that she passed away so quickly.”
A review of Ms Bonds’ case by Health Inspectorate Wales carried out in 2008 found care given to Ms Bonds on Alaw Ward was “inadequate”.
Details of the review of her care, which were read out at the hearing, heard how a number of staff failings had contributed to her death.
They included the lack of regular blood tests after treatment had begun, a failure by staff to pick up symptoms of ATLS “due to a lack of training” and a failure to act upon symptoms of the serious condition.
The final error in Ms Bonds’ care was made by the senior medical staff, who misdiagnosed side effects of the condition for anxiety, the inquest heard.
Dr Rachel Williams, who gave evidence at Monday’s hearing told how she had been a staff doctor on duty the day before Ms Bonds died.
She said while vomiting was an expected side effect from the treatment Ms Bonds was receiving, she had appeared well.
However, she explained how her “tumour must have melted with the chemotherapy”, which would have significantly raised her levels of potassium and phosphate.
But having also given Ms Bonds a dose of potassium chloride with her drip – a routine procedure, for those who do not present symptoms of ATLS – her levels became dangerously high.
Apologising to the family, and telling how she “regretted” her decision, she told the inquest: “I don’t think it impacted on what happened to Siaron, but I know it wasn’t the right thing to do and I am sorry.”
No formal review was ever carried out following her death.
Since Ms Bonds’ death in 1994, no other patients have died as a result of ATLS on the ward and a more “robust complaints system” is now in place, the inquest was told.
The inquest continues.