A question of trust
Cumberland Infirmary , Issue 1681 IT IS two years since Bill Trotter died in hospital after what his family says was a catalogue of failures and cover-ups. Having taken the drastic action of leaving his body in storage as they fight for answers, they have now won a review from the attorney general into whether an inquest should be held.

The coroner originally decided one was not needed after North Cumbria Integrated NHS Trust reported that Mr Trotter had died from natural and unpreventable causes. However, his children Mike and Kelly say they have evidence that he was prescribed insulin against the advice of his diabetes team and that the hospital wrongly told the coroner he died from a catastrophic abscess he had acquired before he was admitted to Cumberland Infirmary.

They have sought via freedom of information to obtain documents, investigations and correspondence between various agencies, but say many have been returned heavily redacted or their requests have been ignored.

The trust says it has reviewed the death internally and found Mr Trotter’s treatment was “good” but will not publish the report, and the family has not been able to get hold of a “lessons learned” report by the Care Quality Commission. Now the Parliamentary and Health Service Ombudsman (PHSO) has agreed to an investigation which could force release of all relevant records.

Damning records
Bill was first admitted in May 2024 with a gangrenous toe. He was discharged but readmitted two weeks later when the gangrene had spread. His leg was amputated.

The family is not convinced there was enough investigation into the necessity of such extreme surgery. They say medical records show his urinary retention was not recognised for around 16 days, leading to agonising urosepsis, and that his blood glucose was not managed or measured properly, with insulin administered which they believe left him in a coma.

They have asked the PHSO to investigate why the medical examiner who registered the death did not refer it to the coroner for inquest.

Sore point
Mike said a postmortem was scheduled initially but the decision to hold one was reversed after he asked for one out of the county, so he paid for a private one. The siblings commissioned an independent tissue analysis which found the infected sore developed in hospital and was not assessed or treated properly, potentially compromising Bill’s safety.

Mike said: “It looked like he had been shot, it was really alarming, Mam fainted when she saw it. We feel poor hygiene care and a broken bed contributed to it and that also needs investigating. The trust doesn’t accept the insulin contributed to Dad’s death, they pinned it on the abscess. Now we have evidence they were also responsible for that.”

Several members of Bill’s care team have since left the trust, deregistered or moved abroad, including the doctor who authorised insulin, two renal consultants and the surgeon who removed his leg.

“That in itself should raise alarms,” said Mike.

Unwise council
After Mike contacted councillors to raise concerns about the use of taxpayers’ money to fund legal representation for the coroner, Cumberland council’s legal team instructed staff to report any future contact from him so it could be referred to Cumbria police. The leaked email also advised staff to call 999 if he approached them directly.

Mike said: “They won’t tell us what justification they had for painting us a threat to staff safety. We are a grieving family who just wanted answers. We’re not threatening or rude.”

The trust told Private Eye it had shared the outcome of its detailed complaint investigation with the family and could not comment further during the PHSO investigation, with which it is complying. Cumberland council was contacted for comment.