Laura Booth became malnourished after she was admitted to Sheffield hospital for eye operation in 2016
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| Laura Booth, who died in October 2016. Photograph: PA |
The death of a young disabled woman following a routine eye operation was partly caused by malnutrition as a result of neglect, a coroner has ruled.
Laura Booth, 21, was admitted to the Royal Hallamshire hospital in Sheffield in September 2016 for a routine eye operation. She died the next month, on 19 October.
Booth had a number of learning difficulties and life-limiting complications, having been diagnosed with partial trisomy 13, a rare genetic disorder, shortly after she was born.
Her mother, Patricia Booth, told the inquest that her daughter stopped eating shortly after she was admitted to hospital, and that doctors ignored Laura’s attempts to communicate with them.
She said her daughter consumed only rice milk and blackcurrant juice in hospital, and she kept telling doctors: “This isn’t right, she can’t survive on no food.”
The coroner, Abigail Combes, concluded that Laura Booth became unwell while a patient at the hospital and, among other illnesses, “developed malnutrition due to inadequate management for her nutritional needs”. Combes said that Booth’s death “was contributed to by neglect”.
She said that although Booth’s nutritional intake was a “concern from her admission” to hospital, on the basis of the NHS trust’s records, feeding charts in order to ensure Booth was receiving her nutritional needs were not commenced. She said the only reference to a food chart being commenced was 11 days prior to Booth’s death, and despite this, feeding charts were not established.
Combes said: “I am satisfied on the balance of probabilities that had Laura received adequate nutrition during her admission, the outcome on the 19 October 2016 would have been altered.”
She said that on this basis she would be amending the medical cause of Booth’s death to include malnutrition. She said attributing Booth’s death to natural causes did not “adequately reflect the circumstances”.
The coroner apologised to Booth’s parents for the “concerted” effort they had had to make to get a full inquest. She intends to write to the chief coroner with the suggestion that coroners are routinely trained on the principles of the Mental Capacity Act.
The family said Booth was a “much-loved and longed-for daughter who completed our family” and had “brought so much joy to our lives”.
They added: “No one seems to understand that the risks of not feeding Laura meant that she was starving as she died in front of us. We cannot tell you how painful that is to live with.
“This has to stop. It’s not right that learning disabled people die decades prematurely. It’s not right that Laura was malnourished. We also don’t think it’s right that the only reason Laura’s inquest was opened was because a journalist contacted the coroner. How many other people are dying without anyone ever finding out why?”
Kirsten
Major, the chief executive of Sheffield teaching hospitals NHS
foundation trust, said: “We regret what happened and we have already
overhauled our nutrition service and processes so there is now a clear
lead decision-maker to review and expedite actions for patients with
complex nutritional needs. We are truly sorry for what happened, and we
will be responding to all of the coroner’s recommendations to prevent
this situation happening again.”
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