Harrowing account of Martha Mill's death at 13 in Guardian today

[StaplesCorner]

I don't think there's another thread on this already I did a search, but I think this needs to be widely read - there seems to have been no lack of NHS resources here whatsoever, but consultants' arrogance by the spade; shades of This is Going to Hurt? Every parents' worst nightmare:

www.theguardian.com/lifeandstyle/2022/sep/03/13-year-old-daughter-dead-in-five-weeks-hospital-mistakes

The Instagram post two days after she died brings it home how we are just numbers to these people. It was just another day in the office to him.

That's an awful thought. When it's people losing their lives it's just horrible. I think you're right though.

News article naming some of the various medical people involved - Richard Thompson who was one of the last people to fail to act (amongst many others) despite being called at home to discuss the new rash and symptoms still appears to work for KCL.

amp.theguardian.com/society/2022/mar/04/girl-13-likely-to-have-survived-if-moved-to-intensive-care-coroner-rules

Reading that made me feel physically nauseous. Just… devastating. Heinous. What a beautiful young lady she was 😭

sounds like the liver team thought very highly of themselves therefore did not refer on

The most heartbreaking account I think I've ever read, but thank you for sharing it OP.

I also feel shaken by it, to my core, I won't forget Martha, I hope to god the people responsible for her death don't either. I also hope her family can forgive themselves, they did absolutely nothing wrong, they shouldn't have had to fight for her to get the care she needed. Absolutely devastating.

I used to work in clinical negligence and remember an awful case of a teenage girl who was dismissed for back pain and tiredness by her GP several times. Her mum took her to physio privately after 6 months and on the first visit the physio was alarmed to feel a goofball sized lump on her spine. She was rushed through referrals but sadly died from cancer 3 years later. The saddest part was having died a week after her 18th birthday we had to tell her mum that her life was worth nothing in litigation. It was very sobering to hear her mum say that the extra week with her was worth far more than the bereavement award for children.

This smacks of the ‘hierarchy in the cockpit’ that airlines suffered for so long (many air crashes causes because nobody would challenge the captain). Medical teams - everyone should have a voice. They need the same training to ensure this can never happen. That poor family. The poor sister. Just awful.

I was thinking the sooner the medical profession adopt a similar approach to airline pilots the better. My late DF had his rare cancer diagnosed late because the GP repeatedly dismissed my DM’s concerns. The galling thing about this is that my DM worked for many years in oncology and has probably forgotten more about cancer than the GP ever knew. But because she was just an old woman, she was ignored. She should not have had to go ‘hysterical’ (her words) before DF was referred. The cancer didn’t kill him, but he might have had a better chance against the flu if he’d had a spleen…🙁😡

As for the poor woman above, she shouldn’t be blaming herself. The truly terrifying thing about her situation is the family’s utter lack of power. I have a horrible feeling that if it were me in that situation I would be considering both murder and suicide. 😭😡

The nhs is supposed to have adopted an airline mentality. The nhs trusts all paid for training about a decade ago, an ex airline pilot toured the trusts delivering lectures. Theatre checklists were introduced, admission checklists. Soon after this sepsis bundles and NEWS scores. I struggle to understand how things like sepsis are still being missed.

That is just tragic. 💐

Obviously I am here to tell my tale but my story is somewhat similar to that…

Spent a year going back and forwards to the doctors with chest and back pain. And breathlessness. Was given an inhaler and basically told I was suffering from anxiety - I was anxious because I felt something was seriously wrong and I wasn’t being taken seriously. I trusted them though and so carried on. The back pain got worse. They referred me to the senior physiotherapist at the hospital. She read through my notes whilst I sat there and I could see on her face that she’d already decided I was wasting her time. She gave me a lecture on bad posture and told me exercises to do and discharged me. The back pain continued - trusting them I did try the exercises and posture work.

Things became worse and worse. I was ending up at my doctors nearly every week crying saying I knew something was seriously wrong. The worst appointment I had the doctor saw me for
two minutes, literally two minutes, moved my arm up and down and told me I had tennis elbow and was visibly annoyed with me.

I begged to be referred to endocrinology because I had existing thyroid problems and I wasn’t sure what was going on but wondered if they could help. The doctors grudgingly referred me.

Several months later - during which time I ended up on diazepam trying to trust the doctors I was anxious - I saw the endocrinologist. They did some blood tests. I was diagnosed with Addison’s disease. I was on the verge of dying due to lack of cortisol, it’s fatal if untreated- I could have literally gone into adrenal crisis and a coma and died. My symptoms hadn’t been imagined. It wasn’t all in my head. I began treatment.

I made a complaint against the doctors. I think they all came together to conspire against me as they labelled me as an anxious woman and a time waster. Addisons is very rare but they should have - at the very least - referred me to endocrinology much earlier or done more extensive blood work. Instead they labelled me as having an anxiety disorder and gave me drugs to get rid of me.

The NHS isn’t fit for purpose right now. Too many egos stroking other egos.

(And before I get slated - I know they save lives too. They’ve saved mine several times including when I nearly died from losing 2.5
litres of blood during an elective c section that revealed a placenta prévia - that hadn’t been picked up on. I am grateful for the good but the bad is really, really bad).

perhaps Dr checked shirt arrogant was busy and missed that training, or more likely didnt think it applied to them in their glory

there have always been egos,
there have been egos for as long as there have been surgeons

Martin Bromiley has been campaigning about the problem of the hierarchy in the NHS for years since he lost his wife.

m.youtube.com/watch?v=JzlvgtPIof4

I agree. Sepsis education and Sepsis procedures are everywhere in hospitals. Did the nursing staff follow the Sepsis pathway and the consultant just over ruled it all?

I think what I find most frightening was Martha knew something was wrong and the doctors should have too.

Yes, he’s the guy who came to our trust. The most moving and powerful thing I’ve ever seen and I think of his wife many, many times at work. Anytime I’ve ever felt worried about calling a doctors decision out I remember her and do it!

I echo @chilliesandspices and also work as a clinical negligence lawyer. This pattern is all too familiar. When I started out in 1993, I was told changes would be made to address this type of incident yet here we are in 2022... just awful.

@QuebecBagnet that's so good to hear to work is paying off. It's awful it hasn't reached everyone. He has true strength to do the work he does, as does Martha's mum for writing that article.

I had a hospital appointment this week, asked a why I needed a test I was told I was getting and the HCP replied "because I'm the expert". The NHS is terrifying for me, I had to leave when no answers were forthcoming.

There has to be change

that video from the airline pilot was interesting.
and he wanted all the staff back to work, to learn from their mistakes,
unlike the other junior doctor linked to, in JAck Adcock case, who was initially the scape goat

Yes, when he said all good doctors make mistakes. What an amazing, generous, forgiving man. I don't think I'd be the same.

He is right though, those hcps, if they acknowledge their mistakes and the factors that contributed to them can be a massive force for culture change in their hospitals.

My heart goes out to this family. What an absolutely appalling and utterly preventable tragedy.

My DS was recently very unwell and I had to advocate in the strongest terms for his treatment in hospital. I felt like I was fighting to get him admitted - when he eventually was I had to push for further tests and finally he received the treatment he needed.

Just last weekend I had to take him to a walk-in centre and when I dared to ask the nurse prescribing his medication whether a different antibiotic might be more effective (based on my own research) she said ‘if you don’t trust me you can go elsewhere’ - I mean what?! I was advocating for my child. I’ve made a complaint as she also said some other very unprofessional things to me.

I didn’t want to read it but couldn’t stop reading it, it felt right to read it, to honour that brave girl.

It was a very harrowing read. I think we are conditioned to believe and be deferential to doctors. However, this really isn't the way things should be. I will remember this article in every dealing I have with the NHS in the future. I read not long ago about a woman who died of advanced cervical cancer who had presented numerous times with symptoms and had been told there was no cause for concern.

The mother has so much dignity. Poor Martha and her family. I will never forget her.
My dad died the same day three ambulances refused to take him as he was not unwell enough. He died in A&E in agony alone. We met with the hospital and the notes had all been lost. Same with ambulance service. It’s a closed shop. I really don’t trust a lot of HCPs. Pils and bil are drs, good doctors who worry about their patients, but still they don’t accept anyone understands medical issues unless they have been to med school. Baffling .

Also my second child was born on a Sunday he was a declared healthy new born and we were discharged on the Monday, within 48 hrs he wasent drinking properly and our gp referred us back to the hospital, he was diagnosed with reflux kidney disorder ,he was given long term antibiotics and appeared fine
Subsequently he was diagnosed with a rare chromosome disorder and autism and learning disabilities I know this couldn't have been picked up at birth but the kidney disorder was one of the indicators, who knows what an early diagnosis of his chromosome disorder could have had maybe nothing but maybe something