Hospital 'woefully' failed dying patient

An elderly man dying of cancer suffered through high levels of pain because of failures at the private hospital meant to be caring for him, the Health and Disability Commissioner has found. Photo / 123RF

An elderly man dying of cancer suffered through high levels of pain because of failures at the private hospital that was meant to be caring for him, the Health and Disability Commissioner has found.

The 74-year-old man, who had terminal prostate cancer and bowel cancer, was admitted for pain management and end-of-life care to a hospital owned and run by Bupa Care Services NZ.

He was prescribed drugs including OxyContin, methadone and the anti-psychotic medication haloperidol. But during the 23 days he stayed there, there were "numerous delays" in giving him his pain meds, even when he was reporting maximum pain levels and was "grimacing and grey with discomfort" according to his daughter.

In one case he did not receive his prescribed methadone for six days. He was also given haloperidol for five days after the prescription had ended. In several cases the hospital did not tell or put off telling the man and his family about mistakes it had made. In one instance his daughter said she "openly wept" when pleading with the hospital to alleviate her father's pain.

At times, the man was in "intolerable pain", according to his daughter. Her comments were in a report released today by deputy Health and Disability Commissioner Rose Wall.

"He reported to me that he rang the bell last night and screamed out 'I demand pain relief'. He said the nurse mumbled some reply he could not understand and left the room. This was very distressing to hear," she told the commissioner.

After learning - 10 days late - that her father had been receiving unprescribed halperidol, his daughter took him to another hospital, where she said he was treated well. He died a short time later.

Two registered nurses and the hospital were found to have breached the man's rights under the Code of Health and Disability Services.

Wall said this was "an example of poor end-of-life care" and the hospital "failed woefully in its duty of care to the man and his family at a critical time in his life".

She recommended the nurses and the hospital apologise in writing to the man's family and that nurses' training be improved.

The Nursing Council of New Zealand should also consider competence reviews for the two nurses, she said.

A statement from Bupa said the company accepts the commissioner's findings and "deeply regrets" the distress experienced by the resident and his family.

"Bupa has formally communicated our sympathies to the family.

"In the four years since this incident, Bupa has continued to improve our systems and processes in medication management including training, communication and documentation. We share these improvements with the commissioner on a regular basis, and continue to discuss the learnings with all our clinical staff," it said.