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The shocking death of Thomas Milner
Palliative care, Issue 1363
thomas milner.jpg
THOMAS MILNER: A police investigation into Mr Milner’s stay at Sheffield’s Northern General hospital continues... more than eight years after his death
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 7 January 2006 he suffered a large gut haemorrhage and was losing blood from the rectum. He was admitted to A&E at Sheffield’s Northern General Hospital where he was given intravenous 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 9 January, 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 four hours while administrative forms were filled in. Once on the Macmillan unit he needed two extra morphine doses as he was very agitated, cold and frightened.

Heartbreaking and pitiful
On 10 January, staff on the unit 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 11 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 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 9am. Thomas died at 10.40am.

A complaint was made to the Northern General and for the next six 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.

Covered up
Thomas’s story was highlighted by the Patients Association in its 2009 Report Patients not numbers, People not statistics. Four 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 believes 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 in the assessment unit, and that the palliative care unit staff then failed to correct the 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 was no Macmillan or palliative care nurse on duty on the two nights Thomas was at the palliative care unit, just very junior nurses. The trust apologised in 2010 for the lack of attendance to hygiene and the long wait in the wheelchair but not for the lack of pain relief. In March 2012 South Yorkshire Police began investigating 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, and it is now more than eight years since Thomas Milner’s death. As with other NHS failings, the suffering may well have been prevented had enough specialist nurses been on the ward.

M.D.

Columnists
Issue 1363
signal failures
With Dr B Ching: “Better railways are vital to northern England’s future prosperity, says the government when it wants to bolster support for HS2. But behind the scenes the same government wants to reduce subsidies for northern trains, even if that means cutting services, ending free parking at stations and raising fares to force commuters off the most undersized trains… The last Labour government asked consultants to find ways to cut rail spending in the north – only to be warned in 2006 of ‘net negative economic benefits’. Ministers and accountants have moved on, so the review process begins again…”
eye tv
With Remote Controller: “Sir David Hare, the NT’s most prolific living playwright, spent years sniping at the BBC for ‘dumbing down’, prompting the drama department to attempt to silence him with a big commission…Unfortunately for an author so prone to pontificating about the state of culture and of the BBC, Hare’s plays were scheduled on BBC2 immediately after the conclusion on BBC2 of Jed Mercurio’s critically-adored thriller Line of Duty, which showed a sophisticated understanding of plotting and dialogue on television. Hare’s plays don’t.…”
[Reviews of Turks and Caicos and Salting the Battlefield, both BBC2.]
keeping the lights on
With Old Sparky: “When it was revealed last month that French operator EDF had quietly shut Dungeness nuclear power station for five months in 2013 to build new defences against sea-water flooding, the news would not have surprised Eye readers. As long ago as 2007 Eye 1182 warned how susceptible Britain’s nuclear power stations had become to flooding and rising sea levels, after the dangers were revealed by the government’s Committee for Radioactive Waste Management – which identified Dungeness as being “the most vulnerable”…
nooks and corners
With Piloti: “Edinburgh, that miraculous fusion of the romantic Old Town and the formal Georgian New Town which has been declared a World Heritage site, is in a mess – largely thanks to the incompetence and worse of its council. There is its notorious inability to complete its tram system (a simple line out to the airport); and the quality of the new architecture the city council encourages is so culpably mediocre and insensitive as to provoke public protest… Then there is the long-running scandal of the incompetent, exorbitant and often unnecessary statutory repairs to the older buildings of Edinburgh enforced by the council. In many cases the repairs endanger the buildings’ future…”
music and musicians
With Lunchtime O’Boulez: “Roger Wright’s announced departure from joint control of Radio 3 and the Proms took everyone by surprise – not least because you don’t swap the most powerful position in British music (salary: £227,000) for the attractive but more modest task of running Aldeburgh Music (salary: nothing close) unless you’re desperate for a quieter life. Desperate is probably the word…”
books and bookmen
With Bookworm: “He certainly isn’t sick of writing about sex. Even a tarpaulin covering some stuff on a truck is ‘bulging scrotally’. And, as ever with Maupin, there is much hetero-bewildering detail about gay types - it helps with the dialogue to know the distinctions between ‘faerie’, ‘bear’, ‘nellie’ and ‘butch’ stereotypes - and het-enlightening scenes of gay sexual behaviour: including an orgy featuring a young man dressed as Pan, covered with ‘some sort of faux fur through which an actual penis was spiking heroically’…”
[Review of The Days of Anna Madrigal by Armistead Maupin.]
in the city
With Slicker: “We will huff and we will puff – but we will not blow down your Mayfair or country mansions. Nor will we threaten your enviable London lifestyles or the lucrative fees of your lawyers, bankers or estate agents. So long as you leave no fingerprints on Crimea, Ukraine or any other part of the former Soviet Union targeted by Vladimir Putin, the 21st-century tsar of all ethnic Russians. That would appear to be Britain’s Treasury-driven approach to sanctions on Russia in the wake of its annexation of Crimea…
Letter from Detroit
From Our Own Correspondent: “
Just as the grousing about the federal government’s role in the 2009 bankruptcy reorganisation of General Motors had begun to die down – a pet peeve for America’s far right and far left – the General has suffered another epic blowout. It follows the revelation that the carmaker, only recently the world’s largest, spent six years between 2001 and 2007 selling cars with a faulty ignition switch that could suddenly shut down engines and disable airbags… By GM’s account there have been 31 crashes and 12 people dead as a result so far…”
To read all these columnists and more in full, you can buy the latest edition of Private Eye - or subscribe here and have the magazine delivered to your home every fortnight.

Next issue on sale:
15th April 2014.
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Next issue on sale: 15th April 2014.

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