Iris May GRIMWOOD · Prevention of Future Deaths report

On 16th October 2013 I commenced an investigation into the death of Iris May GRIMWOOD, age 80. The investigation concluded at the end of the inquest on 22nd August 2014. The conclusion of the inquest was NATURAL CAUSES.

Iris was well for her age, apart from dizziness for some 14 years which had been treated with prochlorperazine. When this drug was stopped her condition deteriorated. She developed a tremor which became more prominent after July 2013. From then on her condition deteriorated and she went down hill. Drug induced Parkinsonism contributed to her symptoms in the early stages of her illness. Lewy body dementia was thought to be a cause when she developed visual hallucinations. Concerns were expressed about the quality of nursing care during her decline, but no evidence presented suggested that this contributed to her death. She died in Pilgrim Hospital on 8th October 2013 as a result of her progressive neurological disease.

1 Evidence from medical staff at Pilgrim Hospital and members of Iris's family included expressions of concern that there were difficulties in providing the level of nursing care that Iris needed. Evidence was also given that mistakes were made in the use of semi-automatic thermometers for measuring body temperature and an episode was described where a nurse attempted to apply an antifungal ointment to Iris's genital region, this having been prescribed for the treatment of oral thrush, before being stopped by a family member. The medical staff attributed these problems to less than optimal numbers of nursing staff, compounded by difficulties in recruitment and retention of nursing staff as well as problems with funding training.