‘This could have been prevented’: Childcare worker, 30, died after doctors failed to spot killer bowel infection
A 30-year-old child care worker who died after a routine bowel operation could have survived if doctors had taken her health concerns seriously, a coroner said today.
Kirsty Woods died of an infection just 12 days after her operation at Barnsley Hospital, despite she and her family expressing their worries about her deteriorating health on a number of occasions.
Miss Wood was admitted to Barnsley Hospital with suspected gastric flu but was subsequently diagnosed with colitis.
She had the operation to remove part of her large intestine because it was inflamed. But doctors failed to spot the surgical stitches had ruptured, causing the fatal infection. She died on September 21, 2010 after having a heart attack.
Three days before Kirsty was vomiting and hallucinating. Coroner David Urpeth, who recorded a narrative verdict, said: ‘These were not taken sufficiently seriously or acted upon appropriately. ‘If the peritonitis had been diagnosed earlier Kirsty would have been able to undergo further surgery and would very likely have survived.’
Pathologist Dr Kim Suvarna said the childcare worker, who was ‘otherwise fit and healthy’, could have survived if the infection had been diagnosed earlier. ‘She should have walked through this type of surgical procedure easily.
‘I’m surprised this degree of inflammation and abdomen catastrophe was not identified and dealt with at an earlier stage.’
Kirsty, from Penistone, near Barnsley, South Yorks, was admitted to hospital on August 21 after suffering sickness, diarrhoea and pain in her abdomen. Doctors tried treating her with steroids and other medication but when she failed to improve, they decided to operate.
Surgeon Theodore Offori said Kirsty had a raised pulse throughout her recovery but peritonitis was never suspected. He said it was ‘debatable’ whether a CT scan should have been done earlier and denied anything should have been done differently.
Surgical registrar Christopher Whitfield agreed her heart rate was high but said blood pressure was normal following the operation.
When he visited her five days later she complained of pain in her abdomen and was suffering from diarrhoea. He said he thought she was suffering a common side effect to bowel surgery, where the bowel fails to propel or absorb the contents properly.
Another doctor flagged up the possibility of a leaking bowel but X- rays showed no signs and were consistent with his diagnosis, he said.
He admitted her chances of survival would have improved if the leak had been detected earlier.
Miss Woods’ father Bernie, 62, who was with son Peter and daughter Kelly at the inquest, described the verdict as bittersweet. He said: ‘I’m satisfied as we has proved what we said all along. This could have been prevented.
‘After her mum died she was my right hand. She loved her family and she’s really missed.’
Medical director Dr Jugnu Mahajan, medical director at the hospital, said he was sorry for their loss. ‘We will now carefully consider the coroner’s findings to ensure the chances of a such a tragic event happening again are absolutely minimised,’ he said.
Half a million incapacity benefit claimants are fit for work, British Government’s OWN figures show
Half a million people on incapacity benefit are fit for work, ministers said yesterday. Medical assessments carried out on 141,000 existing claimants found that an astonishing 37 per cent of people on incapacity benefit were capable of working immediately.
A further 34 per cent will be placed in a ‘work-related activity group’ to help them prepare to go back to work at some point in the future. Only 29 per cent of claimants were deemed to be so sick or disabled that they will never be able to work.
The figures are the first results from a programme to reassess 1.5million existing claimants of incapacity benefit, which is worth £94.25 a week. They do not include information on appeals, which are likely to reduce the number of people deemed fit for work.
But Employment Minister Chris Grayling said the figures suggested a significant proportion of people on long-term sickness benefits were fit enough to work. He said: On current projections, and based on the results so far, we expect around half a million people to see if they can return to work.
‘Without the reassessment process, those people would have been left on incapacity benefit for the rest of their lives, with little prospect of doing something else with their time.’
Incapacity benefit costs the taxpayer £4.8billion a year. Many claimants have not been assessed for years. Statistics show that those who have been on the benefit for more than two years are more likely to die than ever find another job.
Mr Grayling said it was ‘very obvious that long term welfare dependency is a trap into which it is easy to fall, and a place that many are very reluctant to leave’.
He went on: ‘These first figures completely justify our decision to reassess all the people on incapacity benefit. To have such a high percentage who are fit for work just emphasises what a complete waste of human lives the current system has been.
‘We know that for many it will be a long haul back to work but it’s much better to help them on the journey than to leave them on benefits for the rest of their lives.’ Those deemed fit to work immediately will be moved to Jobseekers’ Allowance, which is worth £67.50 a week.
Others will be placed on Employment and Support Allowance, which is worth up to £99.85 for those who are considered too ill to ever work again.
Critics claim that the drive to reassess hundreds of thousands of people on sickness benefits is driven by the need to cut costs rather than a genuine desire to help the long-term sick.
A spokesman for Disability Rights UK described yesterday’s figures as ‘misleading’. He pointed out that in some parts of the country up to 40 per cent of those who appeal against their assessments are found to be unable to work.
The spokesman said: ‘There is a huge amount of money being wasted on appeals because the initial assessments are not identifying the needs of disabled people.
‘By the time you account for appeals, the figure will probably be closer to a quarter rather than 37 per cent. Even then it is misleading to accuse people of abusing the system because Employment and Support Allowance is a different system from incapacity benefit.’
Brendan Barber, general-secretary of the TUC, also criticised the figures, saying: ‘It’s hardly surprising that a test specifically designed to make fewer people qualify for disability benefits is passing more people as “fit to work”.’
A spokesman for the Department for Work and Pensions defended the reassessment process, which is carried out by private doctors. He said adjustments were being made to reduce the number of appeals.
Don’t use the words husband and wife! British government’s same-sex wedding reforms would axe terms from official documents
It sounds like the Liberal tail is wagging the Conservative dog
Reforms to allow same-sex marriage will see the words husband and wife removed from official forms, it was revealed last night. Tax and benefits guidance and immigration documents must be rewritten so they no longer assume a married couple is a man and a woman.
And private companies will be told to overhaul paperwork and computer databases containing the words.
Marriage certificates could even be affected by the Coalition proposals, with rules possibly axing terms such as bride and bridegroom.
The reforms – promised by Prime Minister David Cameron last autumn and set out in a consultation paper launched yesterday – intend to open civil marriage to gay and lesbian couples for the first time. A different category – religious marriage – will be reserved for male and female couples.
The proposals have triggered a furious row, with the Church of England accusing the Coalition of misunderstanding the law of marriage.
But Equalities Minister Lynne Featherstone warned religious leaders not to ‘fan the flames of homophobia’ with ‘inflammatory’ language. New versions of documents will‘replace references to husband and wife with the more neutral terms spouses and partners’.
The cost of the red tape revolution demanded by the ‘Equal Civil Marriage’ plans will run into millions, according to an official analysis published alongside the consultation paper.
Businesses will be given ‘lead-in time’ – a period of grace to change their websites and databases before their failure to recognise same-sex marriage runs foul of the law.
The consultation paper, produced by Home Secretary Theresa May and Miss Featherstone, has set aside three months for public responses before civil servants begin to draw up the new legislation. And the axing of the terms husband and wife is spelled out in an ‘impact analysis’ published by the Home Office alongside the paper.
It said UK Border Agency forms and staff guidance would replace husbands and wives with spouses and partners.
‘Some tax, National Insurance Contributions and tax credit legislation will have to be changed where there is a specific reference to a husband and wife,’ it added.
References to go include direct mentions of husband and wife and phrases about couples ‘living together as husband and wife’. Forms and IT systems and guidance for Revenue and Customs staff will need to change, it added.
The removal of gender-specific language also has sweeping implications for marriage services. The Home Office declined to say yesterday how ministers intend to change the wording of ceremonies. Currently couples marrying in a register office must pledge to take each other as ‘my wedded husband’ or ‘my wedded wife’.
If marriage law is reformed in line with the rewrite of red tape, then couples will be required at a civil wedding to pledge themselves to ‘my wedded partner’.
The Church of England said: ‘Arguments that suggest “religious marriage” is separate and different from “civil marriage”, and will not be affected by the proposed redefinition, misunderstand the legal nature of marriage in this country. ‘They mistake the form of the ceremony for the institution itself.’
The Roman Catholic bishops of England and Wales said in a statement: ‘It is alarming to note that children are not mentioned at any stage in this consultation document about marriage.’
But Miss Featherstone said yesterday: ‘I believe that if a couple love each other and want to commit to a life together, they should have the option of a civil marriage, whatever their gender. ‘Marriage is a celebration of love and should be open to everyone.’ [It’s actually a reproductive contract, historically]
Britain’s great heart attack mystery
An amusing exposition of disagreement among the “experts” — showing how little they really know
Good news at last – deaths from heart attacks are down and falling fast, according to research from Oxford University published a few weeks ago. This showed the death rate has dropped by an extraordinary 50 per cent in just ten years. There were also fewer heart attacks.
The researchers said half the decline was because we’ve cut back on smoking and take statins to lower cholesterol. The other half they put down to better emergency care.
But this comes as something of a surprise because as a population we are actually getting unhealthier: our rates of diabetes and obesity are soaring and they push up heart disease risk. What’s more, even if we aren’t obese or have diabetes, 60 per cent of us don’t take nearly enough exercise and we are still eating too much heart-clogging fat and sugar. So could there be some other reason for the fall in deaths from heart attacks?
‘The Department of Health naturally wants to claim the drop in heart attacks shows their prevention strategies are working,’ says Edwin Gale, emeritus professor of clinical sciences at the University of Bristol. ‘But it does look as if the benefits of bringing down risk factors like high blood pressure, raised cholesterol and too much fat and sugar could be riding on an existing downward trend.’
Professor Gale is referring to the fact that deaths from heart attacks have been dropping for decades and some experts say they don’t really know why. When it comes to prevention, it’s widely agreed that bringing down blood pressure and stopping smoking have helped to lower risk, but there is disagreement about just how important cholesterol, obesity and exercise are.
Some suggest our current obsession with these means we’re in danger of ignoring the part played by other factors such as stress and microbial infection. The mystery of the falling heart attack figures has been investigated by Dr James Le Fanu, a leading GP and author.
‘People generally assume heart attacks have been around for ever,’ he says. ‘In fact, they haven’t. They first appeared on the medical radar in the 1930s and by the end of the war the number of deaths they caused had shot up ten times.’ They kept on rising until the end of the 1960s when, just as mysteriously, they started to decline. ‘Low-fat diet became the big explanation by the 1970s,’ says Le Fanu. ‘But it’s not convincing.’
As he shows in his book, The Rise And Fall Of Modern Medicine, fat consumption in various countries stayed at around 40g daily between 1960 and 1980, while deaths from heart attacks fell. It is only slightly lower in the UK now.
So what caused the rise in the first place? Le Fanu suggests it could be due to a microbial infection. ‘The pattern of a fast rise in deaths and then a decline is typical of an infectious epidemic,’ he says. One possible culprit is the bacteria in the mouth that normally cause gum decay (known as periodontal bacteria). Inflammation is a feature of heart disease and the body responds to infection with inflammation.
Just last month the American Heart Journal reported that Japanese scientists had found periodontal bacteria in blood clots of patients who had suffered a heart attack. ‘These bacteria might have a role in plaque inflammation and instability,’ commented the lead researcher. Other studies have found similar links, although exactly how the process works is unclear.
‘It is tempting to speculate that the rise and fall in heart attacks may be due to differences in the rates of infection,’ says Dr Yoon Loke, senior lecturer in clinical pharmacology at the University of East Anglia medical school. Another more controversial theory is that the decline in deaths since the Sixties is linked to stress: as the very high stress levels caused by the Great Depression and then World War II dropped away, so did heart attack deaths, goes the thinking.
There is little denying that stress can be dangerous. Several years ago, a large study of more than 24,000 people published in The Lancet recorded: ‘Persistent severe stress makes it two-and-a-half times more likely that an individual will have a heart attack compared with someone who is not stressed.’
Dr Malcolm Kendrick, a GP and author of The Great Cholesterol Con, argues that stress is an ignored factor in heart disease. ‘We are not talking about a stressful day at the sales,’ he says. ‘But you see a fast rise in deaths from heart disease in war zones and places where there has been major social breakdown, like the Soviet Union after the Berlin Wall came down. Compared to that, social conditions in Europe and the U.S., where heart attack rates are falling, have been pretty stable.’
You see a fast rise in deaths from heart disease in war zones and places where there has been major social breakdown
The British Heart Foundation (BHF) denies there is anything mysterious going on. It concurs with the Oxford researchers, saying that half the decline in deaths is down to improved emergency treatment and that the rest is due to people following the standard advice for cutting heart risk.
More recently, that includes taking statins, the drugs that lower cholesterol. Indeed, the BHF suggests statins might have saved us from the effects of rising obesity and diabetes. ‘The late 1980s was also the time that obesity and type 2 diabetes rates began to rise,’ says a spokesman. ‘It’s a plausible hypothesis that, without the introduction of statins, we could now be looking at an increasing rise in heart attack deaths rather than a fall.’
Remarkably, in fact, the BHF claims certain lifestyle changes such as eating a low-fat diet, keeping your weight down and exercising have never had much effect. This may come as a shock to anyone who’s been watching what they eat, taking measures such as removing the skin from roast chicken.
‘Compared with cutting smoking, and lowering hypertension (high blood pressure) and cholesterol levels, obesity, fat consumption and exercise have a relatively weak influence on the risk of coronary heart disease,’ says the BHF.
Other experts don’t agree that statins have been that successful, or that relying on drugs is the best way to keep us healthy. Two major recent studies have found that as many as 1,000 otherwise healthy people have to take them for just one person to avoid dying from a heart attack.
‘Drugs can be beneficial if you’re ill or have a seriously raised risk, but many people are being over-diagnosed and over-medicalised,’ says Professor Gale. ‘The best advice for staying healthy is to remain slim and eat sparingly but well, take exercise and swallow as few pills as you can.’
This means there still seems to room for debate about what exactly has been cutting deaths from heart attacks. So apart from taking steps to handle stress better and maybe being more aware of the risks of gum disease, what else should you be doing?
If a low-fat diet isn’t the solution, maybe a low-carbohydrate one will turn out to be more effective. It certainly seems to be better for keeping blood sugar down. High blood sugar is one of the factors fuelling the rapid rise in diabetes. Finding how best to avoid developing heart disease in the first place is still important because even if you don’t die from a heart attack thanks to excellent emergency care, you may be at risk of other things, says Dr Loke.
‘Heart attack survivors are much more likely to die from a nasty debilitating condition called heart failure.’ This causes extreme tiredness and weakness, breathlessness and swelling in the legs, ankles and feet. Dr Loke warns: ‘Over two million people are living with heart failure in the UK and the number is rising.’
Number of people in fuel poverty will reach eight million by 2016 despite pledge by Britain’s Labour government to eradicate the problem
In an alternative universe cheap power generated by East German brown coal would be warming much of Europe. The Australian State of Victoria has lots of brown coal too and has been using it in power stations for decades without ill effects. And, as in Germany, it is cheap to mine and thus enables cheap electricity for everyone
The number of people living in fuel poverty is set to hit 8.5million by 2016 – the year by which the previous government had pledged to eradicate the problem.
The legally binding target to end fuel poverty `as far as reasonably practicable’ will not be met, according to a report commissioned by the Coalition.
Some 7.8million were struggling to pay their heating bills in England in 2009, the latest year for which figures are available.
A review led by Professor John Hills suggests this will have risen by 700,000 by 2016. Professor Hills said: `The outlook is profoundly disappointing.’
He warned that the Government’s definition of fuel poverty – spending more than 10 per cent of income on energy bills – was flawed as it did not adequately address the problem of large fuel bills for low-income households.
He also claimed that the Energy Company Obligation, which would allow energy firms to charge a flat fee on bills to subsidise home insulation, could be `regressive’ as poorer people would be forced to pay higher bills.
In addition, low-income families were found to spend £414 more a year on heating their homes because they could not benefit from discounts offered to other customers, such as those paying by direct debit.
Poor heating is linked to nearly 3,000 deaths a year.
How uncontrolled immigration to Britain has created primary schools with 1,000 pupils and forced children to eat lunch in shifts
One of the first lessons learned at Ladybarn Primary School is not to linger over lunch — a recent surge in pupil numbers means there isn’t enough room in the dining hall for that.
Instead, more than 400 children at the Manchester school eat in five shifts — the first wave sitting down to their lunch at 11.15am.
‘The trouble is that the ones who eat early are hungry again by 2.30pm, so we then have to give them a snack,’ says headteacher Lisa Vyas.
‘And because the dinners take longer to serve, I can’t provide every child with a gym and dance lesson because there’s not enough time available in the hall.’
It’s clear the school is bursting at the seams: there are temporary buildings in the playground, the cloakroom has been turned into a library and the 60 teachers can’t all fit into the staff-room.
‘The temporary classrooms are state-of-the-art, but they are separate from the main building, so some children don’t feel as if they are part of the school,’ says Mrs Vyas. ‘We can’t all fit in for assembly.’
Educational analyst Professor John Howson, a senior research fellow at Oxford University, has warned that a shortage of places for five-year-olds ‘is the biggest problem facing schooling in Britain’.
Due to a baby boom caused in part by a decade of open-door immigration under New Labour, and also because many women born in the late Sixties and early Seventies delayed motherhood, the pupil population is rapidly rising.
By 2015, the number of children at primary school is predicted to increase by 10 per cent compared with last year. By 2020, the increase will be 20 per cent — a total of 4.8million primary school pupils, a figure not seen since the early Seventies.
The increase in demand is sharper in some areas of the country. In the London borough of Barking and Dagenham, for example, the local council is predicting a 43 per cent increase in primary school pupils between 2011 and 2015.
Other London boroughs are expecting 30 per cent increases, while places such as Bristol, Birmingham, Leeds, Kent and Hampshire are also predicting heavy demand.
Overall, it is estimated that an extra 450,000 primary places will need to be created in England by 2015.
The problem is that many primary schools where demand is most acute are already over-subscribed and unable to expand any further. As a result, temporary classrooms are popping up on playing fields, and store cupboards are being converted into teaching areas.
One council in East London is drawing up plans to lease an empty Woolworth’s store and a vacant MFI building and turn them into makeshift classrooms.
In Brighton, it has been mooted that pupils could be taught at a football stadium, in a bingo hall or in redundant churches.
Super-sized primaries with five forms of 30 pupils for each year — 1,000-plus across the school — could soon become the norm.
Desperate council chiefs are even calling for the law that sets maximum class sizes at 30 to be scrapped.
More radical still are proposals to teach in ‘split shifts’, where one group of pupils would attend from 8am until 2pm and a second from 2pm until 8pm.
Frank Field is the joint chair of the Cross-Party Group on Balanced Migration. He is also a Labour MP — one of the few voices from the Left prepared to speak out about the strains placed on the country’s infrastructure by immigration.
Mr Field says that the situation facing primary schools today was ‘entirely predictable’.
‘The birth rate has risen among the host population, but the big stimulus is people who have migrated here and brought children or had children here — mainly the latter,’ he says.
‘We had the figures showing what proportion of babies were being born to mothers born overseas, so the figures and the trends were clear — people just wanted to ignore it.
‘They continued to vote for what was, in effect, an open-door policy, irrespective of being told what the outcome would be. It was serious when public expenditure was actually increasing, but when it is being cut, it is proving to be chronic.’
While the Government is providing an extra £1.3 billion this year to help provide more places, schools complain that the money is too little, too late to do anything more than provide a stop-gap.
‘You don’t need to be a statistical genius to realise that an increased birth-rate in the middle of this decade is going to lead to a massive increase in the need for primary school places later,’ says Gavin Williamson, Conservative MP for South Staffordshire.
‘I think immigration was, and still is, a pertinent issue in politics. There was a desire under the last government to deny this was going to have any impact in terms of a need to deal with this issue. ‘They buried their heads in the sand and hoped the problem would go away. The trouble is that it hasn’t.’
In 2000, 15.5 per cent of all births in the UK were to mothers born outside the country — in 2010, it had risen to 25.1 per cent.
This is because the number of foreign-born women living here has increased, but also because they have more children than British-born women, and because they are more likely to be aged 25 to 34, when fertility is at its highest.