Review of patients’ death records amid concerns of errors

Doncaster Coroner Nicola Mundy.
Doncaster Coroner Nicola Mundy.

THE death records of hospital stroke patients are being reviewed amid fears that medics told relatives incorrect information about how their loved ones died.

All in-patient deaths recorded as stroke, and all admissions to Doncaster’s hospitals coded as stroke are now being reviewed by a stroke specialist after an audit revealed errors in the note taking process by staff.

Doncaster’s coroner Nicola Mundy is writing to hospital bosses to find out whether inquests will have to be held to establish how people died, a spokesman for the coroner’s court said.

Doncaster and Bassetlaw Hospitals NHS Foundation Trust said patients had “no cause for concern.“

The trust runs Doncaster Royal Infirmary, Mexborough Montagu and Bassetlaw hospitals. A report to its board of governors said notes a sample of 55 patients diagnosed with certain types of strokes were submitted to the Care Quality Commission in November.

It adds: “Eighteen (33 per cent) of the 55 cases reviewed were considered not to have had an acute stroke but were coded as the primary diagnosis.

“An external coding audit has shown a high level of accuracy of the trust’s coders in extracting information recorded in the case notes but incomplete or poor documentation in the clinical notes led to misinterpretation of the primary diagnosis.”

The report said inconsistencies were identified between the number of cases where stroke was cited on death certificates and those patients identified with a primary diagnosis of new stroke.

The inconsistencies came to light after a 2011 Dr Foster Good Hospital Guide indicated that patients were spending longer in hospital than some other trusts.

The independent analysis had shown a “high mortality rate” of 137.4 compared with the national average of 100 in stroke patients and compared to 107 for 2009-10.

A trust spokesman said this was the result of new methodology used and the figures were within the expected range.

The report also criticised the time it took for patients to be assessed with a “significant number of patients” suspected of having an stroke not being admitted to the Acute Stroke unit or assessed by a stroke consultant within 24 hours.

The spokesman said: “Local patients have no cause for concern - we have a new acute stroke pathway, which means patients are admitted to a specialist stroke unit and seen by a stroke consultant within 24 hours.

“A routine audit has highlighted something that occurred in the past, we have sorted it out, and now continue to offer the best possible care for stroke patients.”

The trust added that the opinion of specialist reviewers who look at death certificates and the doctor who completed them sometimes differed and the “educational issue” was something that it was addressing.