Belfast Telegraph

Health Trust criticised by Ombudsman over investigation into death of 78-year-old woman

The Public Service Ombudsman called the investigation by the Western Health Trust 'wholly inadequate'

By Allan Preston

A grieving family have been told a report into how their 78-year-old mother received 34 fractures after her death was "wholly inadequate".

Maureen McGinley from Strabane in Co Tyrone died at Altnagelvin hospital in Londonderry in January 2007.

After her body was found to have suffered multiple fractures, the Western Health and Social Care Trust launched an investigation.

The family were unsatisfied and soon lodged a complaint with a public watchdog.  The Detail investigative website said the subsequent report by the Northern Ireland Public Service Ombudsman (NIPSO) was highly critical of the Health Trust's investigation.

The NIPSO report, which was published in December, ruled out any deliberate actions by staff and said the fractures were most likely to have been caused accidentally.

“It is impossible to understand why the trust, one of whom’s stated aims is to learn lessons from complaints, did not adequately investigate this serious adverse incident which was also attracting significant public attention and indeed serious adverse comment that was having serious implications for the public standing of the trust.”

The McGinley family's complaint was held in full and found the trust were guilty of "maladministration" in relation to how it carried out investigations.

Mrs McGinley had initially been admitted to hospital on December 31, 2006 after being injured after falling out of bed at home. On admission she was also diagnosed with a heart condition and developed pneumonia.

Her condition deteriorated and she died three days later.

A post-mortem examination revealed that Mrs McGinley’s body had sustained 34 fractures to the chest area, 32 of which were believed to have occurred after death. The post-mortem examination also found a fracture in Mrs McGinley’s neck.

It was stated the trust should apologise to the family and pay £2,500 to each of Mrs McGinley's eight children for “the injustice of upset, distress and uncertainty caused by the failure to conduct an adequate investigation as to the possible causes of the post-mortem fractures”.

While it was not possible to determine the exact cause of the injuries, the report went on to say the damage was most likely to have occurred during the "Last Offices" on Mrs McGinley's body.

This procedure follows the death of a patient and involves preparing the body for viewing by relatives, this may include the changing of clothes.

Mrs McGinley was also known to suffer from osteoporosis, a condition causing her to have weak bones.

While NIPSO reports are usually confidential, the Detail said that they were publishing the main findings due to the "overriding public interest issues" raised during Mrs McGinley's case.

Mrs McGinley's son Martin told The Detail the long wait for answers had been a difficult time for the family.

“Ten years is a very long time to wait and it has taken its toll on our family," he said.

"We haven’t been able to grieve properly, there’s barely a day that has gone by that it hasn’t been on my mind."

“We welcome the report as we’ve found out more from it than we have known over the last decade. At the end of the day our mother is greatly missed and it’s important to us that this issue is raised in public as we hope no other family has to go through what we have.”

The family had previously lobbied in 2009 for a full public inquiry into their mother's death, which the Department of Health rejected at the time.

The decision not to grant the public inquiry was then debated in the Northern Ireland Assembly, with the McGinley family filing their complaint to the Ombudsman in 2013,

The Western Health and Social Care Trust have declined to comment on the report saying it is confidential.

However, the Ombudsman report is said to indicate the trust has accepted the main findings of the NIPSO report and have passed on their condolences to the family.

A representative of the trust is quoted as saying there was “no definitive evidence to prove, or even strongly suggest, that the fractures were caused whilst the body was in the care of the trust and that it is extremely difficult for the trust to provide a definitive explanation as to how the injuries to Mrs McGinley were caused.”

They added that they had been honest with the family and were always committed to having their concerns "fully investigated."

The NIPSO report refuted this saying: "This has not been borne out by the facts of this case which in my view reflect a wholly inadequate response.”

Among the apparent failures by the trust were the failure to interview relevant staff face to face and that key actions were not always recorded.

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