Rehabilitation unit ‘killed my fit mother’

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From The Sunday Times, May 25, 2008

The son of Edna Purnell, one of several people to die in suspicious circumstances at a Hampshire hospital, says the care regime made her a zombie

When Edna Purnell was referred for “gentle rehabilitation” at a local healthcare unit after a hip replacement operation, her family thought she would be given exercises to get her back on her feet and sent home after a fortnight.

Instead she was put to bed in a darkened room and put on a regime of morphine within a day of her arrival. Less than a month later she was dead.

This weekend the full story has emerged of Purnell’s death and her family’s subsequent campaign, which led to a series of investigations of the deaths of 92 elderly people at Gosport War Memorial hospital in Hampshire between 1996 and 2000.

An inquest into 10 of the deaths was ordered earlier this month by Jack Straw, the justice secretary, as revealed by The Sunday Times last week.

The families allege that their relatives’ deaths were hastened by a regime of heavy morphine use and little or no food, drink or exercise. The inquest will be heard this autumn and is expected to raise serious questions about treatment of the elderly in Britain’s hospitals and care homes and the value attached to their lives.

Purnell, a twice-married extravert, had enjoyed an expatriate lifestyle across the world from Cuba to Hong Kong. She became frail only as she entered her nineties and moved into an old people’s home, where she had a fall in the late autumn of 1998.

Despite her age she was considered fit enough for hip replacement surgery at the Haslar hospital, Portsmouth, and within three days of the operation she was out of bed and moving around.

Mike Wilson, Purnell’s 71-year-old son, says that she was well on the mend before she was moved to Gosport. Hospital records show she had not required even the mildest of painkillers in the five days preceding her transfer.

“She was a fighter; she was out of bed, bright-eyed and bushy-tailed and moving around with a [walking] frame after the operation,” he said. “Two days after she got [to Gosport] she was like a zombie, in a completely trance-like state.”

Wilson said nurses told him the elderly could deteriorate quickly when moved but he became convinced that it was the sedation, not her underlying condition, that was the problem.

“When I complained about the morphine, they said it was to help her sleep at night, but in fact they were giving it to her all day long as well,” he said. “She became extremely dehydrated.” By the hospital’s own admission Purnell was given little or nothing to drink.

Despite her son’s complaints, not only high doses of morphine were administered to Purnell, but also mida-zolam, a sedative three to four times more powerful. It is meant to be used only under close supervision because of its dangerous nature and the extreme variability of individual responses to it.

As he became more concerned, Wilson began a diary chronicling his mother’s treatment. The diary and notes he has obtained from the hospital include a threat to have him arrested for trying to feed his mother.

“If he tries to do this again the police should be called and he should be arrested on the technicality of assaulting his mother,” the notes read.

Purnell died in December 1998, three weeks after her transfer to Gosport. “It is my belief that, intentionally or otherwise, she was being deprived of the basics to sustain life,” Wilson said.

After his mother’s death Wilson delivered leaflets to local surgeries and health centres asking for other families with similar experiences to come forward. Complaints flooded in with stories of recovering patients referred for rehabilitation but given large doses of painkillers. Most relatives had been urged to go home or even to go on holiday in the final days of their loved ones’ lives.

A series of police and other investigations petered out, although some experts continued to believe there were reasons for suspicion at Gosport.

Richard Baker, professor of clinical governance at Leicester University, studied the deaths six years ago. Baker, whose statistical analysis of mortality among patients of Harold Shipman helped to convict the Manchester GP of mass murder, believes there is a need for further investigation. “I hope this [investigation] does eventually get somewhere,” he said last week.

A spokesman for Hampshire primary care trust, which runs the hospital, declined to comment on specific cases but said: “Since a 2002 investigation and the introduction of new clinical procedures, the level of clinical incidents has been entirely normal for a hospital of this size.”