To think the hospital just let him die?

[sadaboutlife]

My uncle was 73.
He was taken into hospital last Thursday with severe stomach pains and vomiting.
They gave him a scan and found out he had a perforated stomach ulcer.
Now they said normal treatment would be a operation but they said they didn't think he would survive the operation so refused to do it.
They gave him antibiotics and fluids and 3 days later told us he was dying.
He died yesterday.
I'm angry.
Why wouldn't they just try the Op?
They knew he would die anyway so why not at least give him a chance to live.
I'm so upset.
This time last week he was watching tele happy and now his gone
I just don't understand

I'm sorry for your loss
From what you say they made the right choice as awful as that is for you to come to terms with.
The 5% chance of survival maybe would have meant they would still operate, this added to the poor quality of life he'd have meant they were putting the patient first.
I'm so sorry.

I have observed similar things myself. I don't think I can say more here. Everyone should look and listen. Something massive is going on in UK hospitals.

Oh give over with the conspiracy theories. This would have been a clinical decision, pure and simple. Nothing to do with money.

By all means, raise a complaint with PALS but I really think you need to set expectations as grief may be making you think irrationally.

It’s an actual operation that you wanted medical staff to “try anyway” - you’re acting like it’s a simple antibiotic tablet with minimal risks etc? I think your grief is making you underestimate the risks of surgery on a patient that didn’t have a great prognosis of surviving the operation. Unfortunately the patient’s care and dignity outweigh the wants of their family, medical staff can’t just try everything willy nilly if it is to the detriment of the patient. It’s like having a patient on life support indefinitely if they couldn’t survive without the machine - who is that really fair on? Certainly not the patient.

I think your grief is making you angry and so you want to blame someone. If he had the operation and didn’t survive, you’d probably be angry too and also blame the NHS (as it’s a normal reaction of grief).

There’s no rush to file a complaint, you have 3 years. You have more important things to deal with now, such as spending time with your grieving family, so feel free to wait a few months before filing a complaint as it may be a cause of additional stress.

But surely the patient (or those closest to them, if they're not well enough) should be the one(s) to decide when to give up on active treatment, not the hospital?

No, because the family are not the expert clinicians and don’t necessarily have the knowledge to make a good decision.

We are bloody lucky to have the nhs, Even with all its failings, and I don’t like seeing people criticising it without knowing what they’re talking about. He won’t have been ‘let to die’, fgs

Well said bookworms

The NHS, despite all of its failings, and the fact that the government has consistently underfunded it for years is STILL one of the best and most cost effective systems in the world.

They don't "leave people to die".

My neighbour went to GP with indigestion, was given meds. came home that night he collapsed and was dead before the ambulance arrived. He was in his forties with two children under 5. No-one knew about a duodenal ulcer until his autopsy.

So sorry to hear about your uncle, I know it’s hard when you see someone you love one minute fine and next minute days to live

It happened with my mum earlier this year, she had been in hospital for a few weeks sorting out edema(it wasn’t going as quickly as we have liked) they found out she had a protein in her blood problem , on the Wednesday she taking herself to the toilet doing the crossword etc she had some treatment, a couple of days later they told us she had days to live, she died a week later

We were full of questions, should she have had the treatment? We spoke to her doctors both in the hospital and surgery, she had more things wrong than we thought but talking to the staff has really helped and it’s helping find some closure

I’m so sorry for your loss.

The peripheral artery disease would have given them an indication of his (already weakened by infection) chances - if it’s in the legs it’s going to be elsewhere too. A horrible decisions to have to make but the idea of medically keeping him ‘in name only’ alive following the insult that surgery brings, even if you’re not very unwell and have CVD, is awful.

I think surgery is so part of day to day life the enormity of what surgery entails for the human system is not fully appreciated. 95% chance of not surviving surgery is pretty conclusive.

I hope the com8ng day’s bring you some peace and acceptance xx

OP

In the kindest possible way- YABU. I’m sorry for your loss and I know it is hard to be objective and rational when you are grieving. But, honestly, from what you have said it sounds like the team looking after him did the right thing for their patient. It is his best interests which really matter at the end of the day. I’m a doctor and please believe me when I say these decisions are never taken lightly or on a whim.

From what you have said, what you wanted to have happened (the operation) would have almost certainly resulted in his death on the operating table. This is not a dignified death when compared to passing away comfortably in bed either in hospital at home. And even if he had survived, they have said he would certainly have come to harm and have no quality of life. In other words, treatment was futile but may have been painful and lacking dignity. Would you honestly have wanted that for him? I don’t think life at all costs is a good principle. Performing the operation in the face of futility would not have been a kindness to your uncle.

I hope you find peace and acceptance OP. My condolences on your loss.

Perforated ulcer would have probably caused Sepsis. Sepsis as well know can be quick and deadly

I am so very sorry for your loss

You need an advocate in hospital, to argue your case. 100%. To fight for you. Always.
I am so sorry for what happened.

Clearly nobody on here has been misdiagnosed. I was, at 45, I nearly died, they thought I would die, I was left to die. They apologised a year later. The consequences have changed my life.

I will never be the same again, I also have, I am sure, PTSD. I won't step foot in a hospital again, I would rather just die at home. They make horrendous mistakes, they are human. You can't say otherwise. Doctors make mistakes.

I am not saying this is the case here, but it happens and until it has happened to you, you cannot imagine the horror, when you cannot fight for yourself.

The issue really is that "he would havr poor quality of life if he survived".

There’s a tool that surgeons use that works out the chance of the patient dying in theatre as a percentage based on their comorbities, current presentation and quality of life prior to admission.

Although it may feel like they just left him to die, it would have been a carefully made decision, a patient dying on the operating table is much more traumatic for everyone involved. Conservative treatment (the IV antibiotics and fluids) does often work for a perforation and I’m sorry this wasn’t the case for your uncle

mmm I spent 5 months in rehab learning to sort of walk again.

My 'poor quality of life', they were amazed, had thought I was better off dead.

I don't understand what they meant by "no quality of life" if they did the op I'm unsure how his quality of life would be poor.

I think you need to talk to someone involved with his case and ask some pertinent questions, if possible. Perhaps write down what it is you would like to know and approach PALS with that and see if they can find some answers.

I am sorry for your loss. By no quality of life I expect they mean pain, a lack of function, and no chance of improvement. I used to work in non-clinical roles in the healthcare system. It really opened my eyes to the fact that in some situations, some people just need to be allowed to pass away peacefully. When we were contacted with requests for emergency care we did have to ask if there was a "do not resuscitate" (DNR) order. It sounds as if the operation would have been the equivalent of trying to resuscitate your uncle when he wouldn't have survived.

I looked up the wiki article on perforated ulcers. It has a depressing list of people who have died from the condition. I do hope you manage to find out more OP and have someone answer your questions. But it sounds as if the best thing they could do was allow your uncle to pass away peacefully.

Intervention is not always the best thing.

Sorry but yabu, you do not know that they just let him die, he sounded like he had sepsis, and the Drs would of discussed this with your uncle first.

I'm sorry for your loss. Another NHS staff member here, and whilst general isn't my area of practice, I can reassure you that it was very unlikely to have been about funding, and in all likelihood to do with his chances of surviving the operation and/or anaesthetic. I can promise you that trying to save someone by doing CPR can be pretty horrific/violent and not a nice way to go at all, honestly it's grim. Much better to slip away peacefully IMO.

OP I am sorry for your loss. But YABU. I work in health care and my experience is losing someone “on the table” is the worst way for a person to pass - unless they are c young and have had an emergency and it’s all or nothing.

I’ve worked alongside some pure wanker surgeons in my 30 plus years but I’ve never yet met one who would just let someone die. They like a challenge at the very least.

It sounds like a genuine case of him having a ruptured ulcer, probably peritonitis as well and surgery would mean he died unconscious away from loved ones being by his side.

There comes a point when the best outcome is a good death - surrounded by loved ones. Not being anaesthetised and dying in surgery and then you seeing him in the mortuary. You’ve got to let go sometimes and accept none of us are immortal, doctors aren’t gods and people die. Sorry

@sadaboutlife so sorry for your loss. I hope you get answers. One thing I don’t understand- if they did nothing was his chance less than 95%? I had an elderly relative die in similar circumstances (different illness) and I have the same questions as you.

I'm so sorry.

"It is a waste of medical equipment and time in the eys of the nhs." is categorically untrue. Decisions about life-saving procedures are never financial. I promise you.

The P-Possum score is calculated using the actual patient's details. It isn't a score for 'that type of surgery', it's a score for that patient having that surgery.

They would have carefully considered every option.

I work in surgical nursing and i can guarantee you, if there was a chance of the surgery working, and them surviving, they would have tried it. Surgical departments are very much we are not giving up until we absolutely have to, surgeons by nature are egotistical, and will rarely give up. They havent just let your uncle die, they have considered every possible option and outcome and made the best decision based on him. Money doesnt really come in to. the chances of successful, life prolonging result are what they considered.

Im sorry for your loss x

My brother is 71. He has peripheral artery disease in his legs and elsewhere caused by smoking. He had one leg amputateed below the knee caused by gangrene, last year. He didn't stop smoking.

This year he developed gangrene in his remaining foot. The surgeon explained that another operation would possibly kill him but if they didn't operate the gangrene would.

So they operated. During the operation he suffered a stroke. He can only move his head, his speech is non existent. He has to be moved with a hoist and has no quality of life. No chance of improvement. I can barely bring myself to say it but it would have been better if he had died.