Decision report 201101574

Summary
Miss C complained to the board about aspects of the care and treatment that her late father, Mr A, received in hospital. Mr A, who had irreversible chronic obstructive airways disease (COAD), suffered a cardiac arrest at home. He was resuscitated by paramedics and taken to the hospital's intensive care unit. Initially he was on a ventilator to help him breathe, but this was discontinued the day after he was admitted. The same day, Miss C spoke to a doctor who told her that she had spoken to Mr A and that he had said he did not want to be put on a ventilator. The doctor also told Miss C that Mr A's health was too poor for him to benefit from ventilation and that he would not survive. Although initially Mr A had improved, his condition later deteriorated and he died a week after being admitted to hospital. In her complaint, Miss C said the family contested the fact that Mr A's health was too poor for him to have benefitted from ventilation.

We took advice from one of our medical advisers, who said that as an emergency admission, it was appropriate to initially place Mr C an a ventilator until his condition stabilised. He was taken off the ventilator once his condition improved. However, when his condition deteriorated staff had to take into account Mr A's irreversible COAD. We found that the records show that staff took steps to explain the situation to Mr A and decided that further ventilation would not be of benefit to him. We found that the decision not to place Mr A on ventilation was appropriate in view of the poor prognosis, that staff had fully consulted with Mr A in the process and that he was in full agreement.