Home visit refused days before death
ADESPERATE mother pleaded in vain with a doctors’ surgery to treat her daughter at home days before she died of a ruptured bladder.
In one of three frantic calls made by Valerie Elsdon and her sick daughter Kerry Jane Elsdon on June 4 this year the mother told staff on the phone she was pleading for a doctor to visit their Pembroke home.
The 57-year-old was sitting in a puddle of bloody urine, she told a receptionist, hadn’t eaten for two days and had no transport.
Despite this staff at the Argyle Street surgery in Pembroke Dock told Mrs Elsdon they didn’t send out GPs on home visits unless people were housebound or terminally ill.
An appointment made earlier for a “sit and wait clinic” at 3.30pm that day was cancelled by Mrs Elsdon because she believed her daughter wouldn’t be able to make it.
Seven days later, and after also contacting an out-of-hours health service, Kerry Jane Elsdon died of urosepsis, a ruptured bladder and a large fibroid.
The inquest at Milford Haven Town Hall yesterday heard that two weeks before her death on June 11 Kerry Jane – known as KJ – suffered from a case of cystitis, which grew gradually worse.
Transcripts of three phone calls made to the surgery on June 4 were read to the hearing.
In the first KJ Elsdon said she was housebound because she was unable to get out of the house in her condition.
She was told she didn’t fit their description of “housebound” and would need to come into a clinic later that day for a “sit and wait” service. She reluctantly agreed to do so.
A second call – this time from her 83-year-old mother – heard her pleading with staff for a house call. She said they were looking at “a lot of sort of bloody urine”.
When the surgery said they didn’t make house calls in such circumstances she said she didn’t know how her daughter could possibly get to the surgery.
In a third call the same day on hearing another refusal for a home visit Valerie Elsdon cancelled the visit to the sit and wait clinic.
Speaking to the hearing Mrs Elsdon said: “I just feel she was badly let down. She desperately needed a doctor – something she didn’t seem able to get.”
Addressing the inquest Dr Jennifer Boyce, a GP partner at the practice, said her only involvement on the day was when she was asked about a request from a 57-year-old patient for a home visit for a urinary tract infection.
Dr Boyce said the reasons given to her for Miss Elsdon not being able to attend were not having transport and not being able to wait in the clinic. Home visits were not normally granted for urinary frequency and no home transport, she said, and the request was denied.
Giving evidence by video link Professor Peter Andrews, an NHS consultant in critical care medicine, said it was difficult to know with any degree of certainty whether Miss Elsdon’s bladder had already ruptured on June 4, when the calls were made.
But, on the balance of probability, the rupture hadn’t occurred, he said.
Only during surgery would you be able to detect whether it had ruptured, he said.
Coroner for Pembrokeshire and Carmarthenshire Mark Layton stopped short of preparing a Regulation 28 report, which calls for action to be taken to prevent further occurrences in similar circumstances.
It came after Dr Boyce said the surgery had already reviewed the situation following Miss Elsdon’s death. Changes included involving a GP if the receptionist was not certain if a visit was needed.
Speaking at the inquest Mrs Elsdon, who lived with her writer daughter in Main Street, Pembroke, said: “I don’t want anyone else to go through what she went through – or what I’m going through now.”
Mr Layton delivered a narrative conclusion that she died at her home address from urosepsis following spontaneous bladder rupture.