Investigation and inquest
On 3 July 2020, I commenced an investigation into the death of Shyama Rampadaruth, aged 86 years. The investigation concluded at the end of the inquest earlier today. I made a determination at inquest of death by natural causes.
Circumstances of the death
Ms Rampadaruth had a number of co-morbidities, including renal failure, diabetes, hypertension, heart failure, asthma and cervical spondylosis.
When she attended Whipps Cross Hospital for her routine renal dialysis on 13 April 2020, she was found to have a raised temperature and so was moved to a separate waiting area and dialysed with other patients suspected of having contracted COVID19.
She was discharged home as usual, but deteriorated that night and was admitted as an emergency in the early hours of the following morning. COVID19 was diagnosed, she continued to deteriorate and died three days later.
Coroner’s concerns
When COVID19 was suspected at her routine dialysis appointment on 13 April, precautions were taken to separate Ms Rampadaruth from other patients to reduce the risk of transmission. She was re-allocated to the evening dialysis clinic with other potentially infectious patients, so that the unit could be thoroughly cleaned overnight to make it safer for patients at the next clinic the following day.
However, this meant that Ms Rampadaruth had to wait for approximately six hours on a hard chair in a hospital waiting area. This is clearly sub optimal for the health of a frail, elderly lady with multiple co-morbidities.
The patient transfer service is likely to have been busy, but Ms Rampadaruth and her husband lived nearby. Her niece, who was very involved with her care, works locally. A quick call to a family member would have resulted in immediate arrangements being made to collect Ms Rampadaruth, bring her home to sit in comfort with familiar company and her usual food and drink, and then to return her when hospital staff were ready to begin her dialysis. Her general well being could have been so enhanced by just a small change to administrative arrangements.