Brain Injury Lawyer Demands Improvements After Needless 102-Minute Ambulance Wait Left Woman Brain Damaged
06/04/2011
A leading brain injury lawyer has demanded urgent improvements into the handling of 999 calls in London, following the case of a woman who was left with severe brain injuries after being forced to wait more than 100 minutes for an ambulance sitting just 100 metres from her home.
John Davis, a brain injury solicitor from Irwin Mitchell, has called for an urgent review into the failings and delays that left 33-year-old Caren Paterson with a number of long-term brain injury symptoms, including chronic amnesia, anger outbursts, confusion and disorientation.
Ms Patterson collapsed in the bedroom of her flat in Islington, North London, early in the afternoon of Saturday, 27th October 2007. Her condition quickly deteriorated, prompting her boyfriend to call 999 at 1.39pm and report that she was unconscious, breathing abnormally and that her lips were blue.
However, because police had previously been called to Ms Paterson's Hargrave Road address, it was registered as a 'High Risk Address ', meaning that the ambulance crew was told to wait for a police escort.
A police escort was not available at the time and, despite a further two 999 calls, the emergency medical team waited for over an hour, despite being just 100m from her flat.
Ms Paterson, who had been working as a researcher at King's College Hospital, eventually suffered a cardiac arrest at around 3.15pm, five minutes before police and an ambulance team arrived. Although she survived, she has been left with complicated long-term care needs.
After being seen by paramedics, Ms Paterson was initially taken to the Accident and Emergency Department of Whittington Hospital before being transferred to intensive care for seven days. She was eventually moved to the Reckitt Ward of the same hospital, where she remained until the end of 2007.
She was moved to the Walkergate Hospital, Newcastle, in early January 2008, near to her family home in Warkworth, Northumberland. She was subsequently admitted to the Daniel Yorath House facility of the Brain Injury Rehabilitation Trust (BIRT) in Leeds, and then moved once more in September 2008 to BIRT's York House, where she remains in care to this day, receiving ongoing occupational therapy, physiotherapy and neurobehavioral assessment.
An investigation into the way that the emergency calls were handled by London Ambulance Service found 11 breaches of duty, focusing primarily on the delay in the ambulance attending the scene. This was caused by a failure to comply with hospital trust policies, the Emergency Centre of Operations’ failure to communicate properly and effectively both with the police and the caller, failure to recognise that there was no danger to the ambulance crew, which would prevent the immediate dispatch of an ambulance to Caren's address, and a failure to react properly to the patient’s worsening condition.
Mr Davis, who is helping the Paterson family in their efforts to secure a long-term care package that will provide Ms Paterson with the support she now needs, said it was unknown why the address was on the high risk register. It is suggested that, because her flat was one of several at the same address, the grading could have related to a different flat or have been placed on the address several years before Ms Paterson moved into the house.
He added that the delays that this caused were unacceptable and welcomed the police's decision to review the way emergency calls to homes on the High Risk Address Register were handled.
Mr Davis added that these avoidable failings in communication had left a woman fighting for her life as a result of a hypoxic brain injury, caused by a number of delays to her treatment.
He said: "There is a list of failings and breaches of duty that occurred in response to the 999 call. It is particularly heartbreaking for Ms Paterson’s family to know that an emergency response team was in very close proximity to her but unable to give her the crucial treatment she needed.
"The emergency crews eventually arrived 102 minutes after the first 999 call – but even then there was nobody senior enough on hand to administer the treatment that Ms Paterson needed.
"It is imperative that people in Ms Paterson's condition are treated as quickly as possible – even seconds can make a huge difference, let alone over an hour and a half.
"The emergency services had been made abundantly aware of the seriousness of her condition yet failed on several levels to handle the situation in accordance with their own guidelines.
"But for these failings and contraventions, Ms Paterson would have received appropriate medical treatment sooner, would have been taken to A&E sooner, and consequently would not have suffered the injuries she did.
"Following Ms Paterson's case, it has been acknowledged that the way the High Risk Address Register was operated needed to be 'radically overhauled' – we endorse any review and improvement to this system which was clearly at the heart of the failings in this case.
"We appreciate the London Ambulance Service's admission of liability for the failings and we will now be working to secure a care package that will allow Ms Paterson to live in as much comfort as possible, and will afford her family some degree of peace of mind."
Her mother, Eleanor Paterson, from Warkworth, Northumberland, said: "We welcome the admission of liability as a significant step towards ensuring Caren will continue to receive the care, treatment and specialist attention she will need for the rest of her life, but nothing will return our daughter to the way we knew her.
"The thought of an ambulance crew sitting waiting while my daughter lay in her flat as her condition went from serious to life-threatening, causing irreparable damage to her brain, is still shocking.
"Although I appreciate fully that the emergency services have guidelines in place, I now know that there were further procedures that should have been followed and, if they had been, my daughter would have received the treatment she needed."
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