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Inquest into Death at HMP assessment, planning and communication, contributed
Martin’s family believe that his death was unnecessary andavoidable. The family, which has waited five long years for
Nelsons has acted for the family of 25 year old Martin
justice for Martin, were satisfied that the jury shared their
Green from South Derbyshire, who died from dehydration
concerns as to Martin’s appalling treatment.
in HMP Blakenhurst on 15th July 2002 while serving a12 month sentence for motoring offences.
During the 22-day inquest into his death, held before HMCoronor for Worcestershire (Geriant Williams), Nelsons
The firm has recently acted on behalf of a client who initially
represented Martin Green’s partner Rachel Briggs and their
intended to bring a claim against her GP as, two weeks after
four children. The jury found that the medical care Martin
attending her GP surgery complaining of a headache and
received was inadequate and serious failures in his treatment
generally feeling unwell, she suffered a stroke.
The client was admitted to hospital having suffered a
Martin was found dead in his cell in the prison healthcare
catastrophic stroke which has left her hemiplegic. At the
centre where he was undergoing detoxification for drug
hospital, it was diagnosed that she had a predisposition to
addiction. At the time of his death he weighed just 6st 10lbs.
strokes as she had been, for some time, suffering from a clotting
The cause of death was dehydration and electrolyte
disorder called Anti-phospho-lipid Syndrome (APS). It waslikely that she had been suffering from this condition for many
imbalance, as a consequence of repeated vomiting. He was
also found to have two duodenal ulcers.
Looking back through her medical records, it was discovered
This case raised very serious questions about the quality
that she had attended another hospital four years earlier when
of prison healthcare. Martin was owed a particular duty
she had been suffering with pneumonia. She had had a blood
of care while in the custody of the state and that duty was
test on that occasion and the blood test showed that she had
a clotting disorder which, had it been investigated further,
Labeled just another druggy by the prison, nursing and
would have probably been shown up to be APS. Had she started
medical staff that came across him, no-one believed Martin
on anti coagulant medication at that stage, it is likely that this
when he told staff that he did not have the normal symptoms
would have prevented her suffering a stroke.
of withdrawal. Long-standing stomach problems were not
The case was recently settled for a substantial fixed figure.
investigated and despite his requests Martin was not takento hospital. On 14 July, a doctor was sufficiently concernedthat he arranged for Martin to go to hospital for IV fluid
treatment, but the transfer did not happen due to prisonstaffing problems on that day. Martin was found dead the
next morning. All the expert evidence is that he probablywould have survived with an IV line carrying fluids and
Over the years, the firm’s Clinical Negligence group has
developed a working relationship with AvMA. As a result ofthis, we are able to draw upon the resources that AvMA have
The jury’s narrative verdict was highly critical of the
to help us with our cases and to help our clients.
treatment Martin received, concluding that “there was ageneral lack of management support and teamwork… the
If we require help with recommending an expert or barrister
frequency of vomiting and lack of hydration in someone
or with research about a case, we are able to ask AvMA
with an extremely low body mass index, coupled with poor
15142_clinical_neg_update.fh11 23/1/08 10:22 Page 2
Death by Natural Causes in Circumstances of NeglectNelsons has represented the family of Winifred Dalton
had not had her medication. Mr Dalton had eventually
following her death from septicaemia caused by clostridium
found a doctor, who had made a complaint about the lack
difficile (C-diff) infection. The inquest was held before HM
of nurses and the medication not having been recorded on
Coroner for Coventry (Mr David Sarginson) in which a jury
the prescription chart. Extra nursing cover had then been
returned a verdict of death by natural causes in the presence
of neglect under the care of two Coventry hospitals.
On the morning of 22nd December 2005, Mrs Dalton had
Claims of neglect whilst she was at the Caludon Centre and
suffered a fall and the doctor in the Caludon Centre was
former Walsgrave Hospital, centred on whether tests for
sufficiently concerned that her physical condition was such
C-diff should have been taken sooner and whether the delay
that she should be transferred to Walsgrave Hospital. The
doctor there had disagreed and had refused to take a transferat that point, pending further investigation. Part of that
Mrs Dalton was 69 when she was admitted to Walsgrave
further investigation was the taking of a blood sample,
Hospital in November 2005 and was sent home on 26th
which got left in the wrong box in the pathology laboratory
November without any clear diagnosis. She was then re-
(although, as it happened, this omission was not causally
admitted to a different ward, with the consultant in charge
relevant to death). Later that day, Mrs Dalton’s condition
of her care describing her as largely a “social” admission.
had deteriorated such that she was sent by ambulance to
During this admission, her family became aware that she
Walsgrave, was admitted but with poor prognosis and she
died of septicaemia caused by C-diff infection on 23rdDecember 2005.
The family was given a bag of soiled laundry to take home,which they discovered contained clothing soaked in half a
Evidence at the inquest was that none of the nursing staff
litre of diarrhoea. Following this, the family had telephoned
at the Caludon Centre had heard of C-diff and that when
the hospital to complain and ask that they provide hospital
given the name of the condition, had to download
underwear and pyjamas to Mrs Dalton, since she was still
information about it from the hospital computer. The
suffering from diarrhoea. Notwithstanding this, the nursing
coroner called an expert in C-diff, Professor Wilcox, who
notes did not contain any observations that Mrs Dalton was
had been instructed by one of the hospital trusts involved.
suffering from diarrhoea. In fact, as the jury found, this
The family had, for various reasons, not invited the coroner
to call other expert evidence. Professor Wilcox was of theopinion that the C-diff infection was hospital acquired and
Before going into hospital, and well into her admission,
had based his opinions as to when on the nursing
Mrs Dalton had been receiving two “broad spectrum”
observations of diarrhoea. He expressed the opinion that
antibiotics, cephalexin (9 to 23 Nov) and co-amoxiclav
starting treatment from 14th December had not made a
(“augmentin” – 20 Nov to 5 Dec). She had also been given
difference to the outcome and maintained this view even
omeprazole for vomiting and lactulose for constipation
when pressed about possibly earlier dates of infection.
Professor Wilcox did however state that this was the matterupon which he was least confident.
The prescription of broad-spectrum antibiotics (especiallyaugmentin) and also Mrs Dalton’s age, made her particularly
The jury unanimously returned the verdict of death bynatural causes in circumstances of neglect. Furthermore,
susceptible to infection with C-diff, the principal physical
the coroner said he will use his powers under rule 43 of
symptom of which is diarrhoea. The presence of C-diff can
the Coroners’ Rules to report a number of matters
be detected by a simple laboratory test of a stool sample,
concerning the quality of care received by Mrs Dalton in
which ought normally to take 24-48 hours to come through,
hospital and would write to the hospitals involved and also
but Mrs Dalton was not tested until much later.
the Secretary of State for Health about his concerns.
On 9th December 2005, Mrs Dalton was transferred to apsychiatric hospital, the Caludon Centre. The family saidthat her diarrhoea had continued there, confirmed byentries in nursing notes and in notes taken by her doctor.
The clinical negligence team at Nelsons has a national
On 12th December, a stool sample was taken and sent to
profile and is one of the few firms franchised by the
the laboratory to be tested. Results were obtained on 14th
Legal Services Commission (LSC) for clinical
December showing that her diarrhoea was positive for
negligence claims. We can advise from any of our
C-diff. However, that lab result was placed on a computer
three offices on birth injury claims, mis-diagnosis,
to which the nurses did not have access, the doctor who
complication during surgery or cases where wrong
had ordered the sample was away for five days and the
or faulty medication has been given.
piece of paper recording the result was not taken to theward but put in a correspondence file. Accordingly, it was
We are also on the LSC’s Multi Party Action Panel
not until 19th December 2005 that Mrs Dalton started
and have members of the Association of Personal
receiving treatment with metronidazole, the principal
Injury Lawyers (APIL), and the Solicitors Regulation
treatment for tackling C-diff infection.
Authority Personal Injury and Clinical NegligenceAccreditation schemes. We also have members of
On 21st December, Mrs Dalton’s husband had attended the
special interest groups such as the Child Brain Injury
ward and found his wife lying in her own faeces, with no
Trust, Headway and Spinal Injuries Association.
nursing staff available and his wife telling him that she
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REPUBLIC OF KENYA THE JUDICIARY KEYNOTE ADDRESS OF THE DEPUTY CHIEF JUSTICE AT THE ELECTORAL DISPUTE RESOLUTION TRAINING FOR COURT OF APPEAL JUDGES ON 29TH JULY, 2013 Hon. Chair of the Judiciary Working Committee on Election My sisters and brothers, let me begin by telling you how much I miss this Court. Not that I do not value and appreciate my current appointment, but