‘Struggling to come to terms’ with Rona’s death
GRAN, 74, DIED AFTER VITAL OXYGEN SUPPLY WAS DISCONNECTED TWICE
THE family of a grandmother who died after her oxygen supply was disconnected twice say they are “struggling to come to terms” with her death.
Rona Anne Stevenson, 74, who lived in Clifton all her life, died on August 15, 2019.
She suffered from chronic obstructive pulmonary disease and used oxygen concentrators to help her to breathe.
But, in the early hours of August 15, an engineer for Air Liquide, who supplied the concentrators, was dispatched to her home in Listowel Crescent after one of them turned off unexpectedly.
An inquest at Nottingham Coroner’s Court last month heard that after this problem was fixed, Mrs Stevenson’s electricity supply was cut at 5.20am by Western Power, to allow maintenance for an unplanned power cut nearby.
Mrs Stevenson called for her oxygen supply company for help, but suffered a fall and was unable to get up.
An ambulance took 45 minutes to arrive after a member of staff at East Midlands Ambulance Service thought her postcode was wrong and changed it, the inquest heard.
When it arrived, Mrs Stevenson had stopped breathing and paramedics were unable to resuscitate her.
Rona’s granddaughter Lydia Stevenson, 25, also from Clifton, said: “We as a family are still struggling to come to terms with what happened. We can’t seem to get over it.
“She was so independent. She was still able to do the washing and ironing. She was just so lovely.”
In his conclusion, Coroner Gordon Clow said: “Mrs Stevenson needed oxygen supplementation at a high level in order to survive.
“The backup arrangements in place to deal with an interruption in electricity supply whilst Mrs Stevenson was asleep, both from her equipment and her electricity distributor, did not cause her to wake and summon help in time to avoid her death from hypoxia.”
The coroner criticised the alarms fitted to Mrs Stevenson’s oxygen concentrators which failed to wake her.
He has ordered for a prevention of future deaths report to be issued by Air Liquide’s standards regulator.
An Air Liquide spokesperson said: “Air Liquide Healthcare was saddened by the passing of its patient. Patient safety is a priority for Air Liquide Healthcare.
“Though the investigation found no fault with the equipment, which met strict legal and regulatory standards, we are committed to working with our partner manufacturers to further improve the safety of our patients.”
The inquest also heard the Air Liquide engineer spoke to Western Power workmen after leaving Mrs Stevenson’s house.
He was assured the power cut would not affect her and, while this was correct at the time, her supply was later cut.
Ms Stevenson received a letter from the company which did not mention that she was registered to be contacted only between the hours of 9am and 8pm.
She was therefore not told she would need to “opt in” to be notified of power cuts outside those hours.
Lydia said: “We have the original letter that was sent out to her when she was registered on the priority register. That letter didn’t state any time restrictions or mention a 24-hour option. Most of these vulnerable customers are elderly people like my nana that put their trust in a company as big and powerful as Western Power to ensure it protects its vulnerable customers.”
A Western Power spokesperson said: “We assisted the coroner throughout the inquest, and during the inquest we extended our condolences to the family.
“We have noted the narrative verdict and have no further comment to make.”
The coroner concluded it was not possible to know if Mrs Stevenson’s death would have been avoided if the delay caused by the EMAS postcode mix-up had not occurred.
Simon Tomlinson, General Manager for the Emergency Operations Centre at East Midlands Ambulance Service, said: “We would like to offer our deepest condolences to the family of Ms Stevenson.
“We had received the correct property number and road name when the call was received from North East Ambulance Service. However, the road has several postcodes assigned to it, and we sent the incorrect postcode for the incident to the ambulance crew, meaning they initially arrived at the correct road but a different house. They quickly realised this was not the correct address and drove to the correct property.
“While the coroner concluded that it is not possible to know whether Ms Stevenson would have survived if the correct postcode had been given initially, an update to the control room system prevents this issue from happening again.”