Fam­ily lost lov­ing fa­ther due to ‘in­ad­e­quate care’

Coro­ner rules sui­cide risk pa­tient ‘not ad­e­quately mon­i­tored’

Harefield Gazette - - NEWS - By Will Ack­er­mann will.ack­er­mann@trin­i­tymir­ror.com

HILLING­DON Hos­pi­tal has ad­mit­ted li­a­bil­ity for a pa­tient who com­mit­ted sui­cide while his nurse went on a break.

Rory Mag­ill, 44, was left unat­tended de­spite be­ing a known sui­cide risk, hav­ing gone to A&E be­cause he tried killing him­self by swal­low­ing an­tifreeze.

Hilling­don Hos­pi­tals NHS Foun­da­tion Trust, which runs the hos­pi­tal in Pield Heath Road, has now ac­cepted re­spon­si­bil­ity for a string of fail­ings in his care.

The fa­ther-of-four’s widow, Anita Mag­ill, 43, of St He­len’s Close, Uxbridge, is call­ing for lessons to be learned from the tragedy.

She said: “Rory was com­pletely let down by those who were sup­posed to be keep­ing him safe and I am still try­ing to come to terms with what has hap­pened.

“As a fam­ily we have lost a lov­ing hus­band and fa­ther be­cause of in­ad­e­quate care, poli­cies and pro­ce­dures which jeop­ar­dise the safety of vul­ner­a­ble peo­ple.” Self­em­ployed elec­tri­cian Mr Mag­ill was ad­mit­ted to A&E on June 12, 2013.

The hos­pi­tal did not have the usual drug an­ti­dote needed to treat his an­tifreeze poi­son­ing, so Mrs Mag­ill was sent out to buy al­co­hol – an al­ter­na­tive treat­ment. Mr Mag­ill was pre­scribed 500ml of vodka and one strong beer per hour, de­spite be­ing known to have had al­co­hol prob­lems.

Shortly af­ter­wards, a psy­chi­atric li­ai­son nurse as­sessed Mr Mag­ill, deem­ing him to be at a medium-to-high risk of sui­cide and self-harm and rec­om­mend­ing he re­ceive one-to-one ob­ser­va­tion.

A reg­is­tered nurse was as­signed to his care, but was soon asked to ob­serve a sec­ond pa­tient, who was be­ing dis­rup­tive.

At 4.40am the next day, the nurse went on her break and did not hand over Mr Mag­ill’s care to an­other nurse, leav­ing him free to wan­der the unit unat­tended.

He went to the toi­let and re­turned and then had a con­ver­sa­tion with a nurse. This nurse con­sid­ered he was at­ten­tion seek­ing.

Soon af­ter­wards, Mr Mag­ill re­quested a cup of cof­fee and asked whether there was some­where else he could sit be­cause he was hav­ing “lots of thoughts”. The nurse said he could sit in the day room, which he did, unat­tended. He later re­turned to his bed while the nurses went about their du­ties.

At ap­prox­i­mately 5.45am, at least 15 min­utes af­ter he had last been seen, the nurses noted Mr Mag­ill miss­ing and searched for him.

He was found hanged in the day room and, de­spite re­sus­ci­ta­tion at­tempts, was pro­nounced dead at 6.40am on June 13, 2013. Fol­low­ing Mr Mag­ill’s death, Mrs Mag­ill in­structed spe­cial­ist med­i­cal neg­li­gence lawyers at Ir­win Mitchell to in­ves­ti­gate her hus­band’s care. She is now su­ing the trust.

Mean­while, the trust car­ried out an in­ves­ti­ga­tion and pre­pared a se­ri­ous in­ci­dent re­port, which found there had been a se­ries of fail­ings.

The trust’s re­port con­cluded that the root cause of Mr Mag­ill’s death was sui­ci­dal ideation and in­tent with no one-toone ob­ser­va­tion at the time of the event.

At an in­quest held at West Lon­don Coro­ner’s Court on April 28, HM se­nior coro­ner Chinyere Inyama record the nar­ra­tive con­clu­sion: “Mr Mag­ill took his own life, in part be­cause the risk of him do­ing so was not ad­e­quately mon­i­tored.”

A trust spokesman said: “The Hilling­don Hos­pi­tals NHS Foun­da­tion Trust has car­ried out a thor­ough in­ves­ti­ga­tion into this in­ci­dent and has co­op­er­ated fully with the Coro­ner’s en­quiry. The Trust would again like to of­fer its sin­cere con­do­lences to Mr Mag­ill’s fam­ily.”

Newspapers in English

Newspapers from UK

© PressReader. All rights reserved.