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April 8, 2014

Medicine Balls, Private Eye Issue 1363
Filed under: Private Eye — Dr. Phil @ 3:59 pm

The Anguished Death of Thomas Milner

Thomas Milner, a kind and gentle man, was 76 when he was diagnosed with myelodysplasia in June 2005. By October 2005 this had developed into leukaemia and he began weekly blood transfusions.  On 7th January 2006 he suffered a large gut haemorrhage and was losing blood from the rectum. He was admitted to the A & E at Sheffield’s Northern General Hospital where he was given IV fluids. There was a ‘Do Not Resuscitate’ notice in his medical records.

Once rehydrated, it was confirmed that Mr Milner was dying and he was given morphine on demand by injections, when his family noticed his distress.  On January 9th, on the Medical Assessment Unit (MAU) a morphine syringe driver was set up and he was transferred to the MacMillan Palliative Care Unit (MPCU).  This involved wheeling him 500 metres outside in the cold wearing only his pyjamas, to sit in a wheelchair for 4 hours whilst administrative forms were filled in.  Once on MCPU he needed two extra morphine doses as he was very agitated, cold and frightened. .

On 10th January, staff on the MPCU started refusing to give morphine, writing that his family were giving him ‘dandelion and burdock’ which ‘settled’ him. For 15 hours on Thomas’s penultimate day he received no morphine and by the time night staff came on duty he was very agitated and lying  in his own blood and urine (a scene his daughter describes as heartbreaking and pitiful). The day staff  failed to wash and toilet him, and failed to dress a huge sacral bedsore.  By the morning of the 11th January Thomas Milner was pulling at the bed sheets with tears rolling down his face. The family called staff and two junior nurses attended saying that they could not give him anything and that the doctors would attend on their morning round.  In desperation Thomas’s daughter called the family GP, who summoned a junior doctor who finally administered morphine at 9.00am. Thomas died at 10.40am.

A complaint was made to the hospital and for the next 6 years the family sought answers from the hospital, the Nursing and Midwifery Council, the General Medical Council, the Healthcare and Care Quality Commissions and the Healthcare Ombudsman. The answers became more absurd and contradictory as to why Thomas had suffered so much, why he was denied morphine and why his family had to resort to calling their GP for help. The NHS Regulators took no action.

Thomas’s story was highlighted by the Patients Association in their 2009 Report ‘Patients not numbers, People not statistics’. 4 years after Thomas’s death the family obtained copies of the controlled drug register and other drug charts that the hospital had originally said did not exist and found that they had been altered. His family believe that instead of logging the intervention of the GP and reporting a ‘significant untoward incident’ on the day Thomas died, which would trigger an investigation, the matter was covered up.

The family alleges that the syringe driver was initially set up at the wrong rate on MAU, and that the MPCU staff failed to correct this mistake and did not refill it correctly or take into account the extra injections of  morphine that had been needed. On Thomas’s last night staff failed to refill the morphine syringe driver at all. They also believe that unqualified staff had handled and administered morphine to Thomas, the details of which were later altered, perhaps to make it appear the syringe driver on his last night had been refilled

The hospital has confirmed that there were no MacMillan or Palliative Care nurses on duty the two nights that Thomas was on at the MPCU, just very junior nurses. The trust  apologised in 2010 for lack of attendance to hygiene and the long wait in the wheelchair but not the lack of pain relief. In March 2012 South Yorkshire Police began an investigation to ascertain whether any controlled drugs were unaccounted for, whether there had been deliberate cover up of failings in care following the complaint and whether there had been any genuine errors in record keeping. This investigation is still ongoing, over 8 years after Thomas Milner’s anguished death.  As with other NHS failings, the suffering may well have been prevented had there been enough specialist nurses on the ward.