The grieving family of a "gentle giant" grandad are "disgusted" at the care he received at a Nottinghamshire hospital before his death from a type of pneumonia. Paul Upex, 65, died at King's Mill Hospital, in Sutton-in-Ashfield, on April 27, 2022, four days after admission.
He was devoted to grandsons Byron and Ellis, granddaughter Emily, son Karl, and son Simon, who sadly passed away seven years ago. His devastated neice, Lindsay Hall, described him as a man who had a lot of close friends and was "very likeable".
"He was just a gentle giant," she said. "Everybody knew and loved him, and he would do anything for anybody".
Miss Hall and her aunt, Mr Upex's wife, Denise Upex, believe he could have been saved after hearing the findings of an inquest into his death. They remain reeling from his sudden passing, and have many unanswered questions.
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Miss Hall, of Kirkby-in-Ashfield, told Nottinghamshire Live: "My auntie is disgusted with the care at the hospital. What he had was so easy to diagnose."
Doctors had not told them where Mr Upex's infection was coming from and they claim they were not given any updates at all. She says the family only found out, from the pathologist report last August, his cause of death for the first time.
Nottinghamshire assistant coroner Dr Elizabeth Didcock recorded "bronchopneumonia" - despite treatment with antibiotics and oxygen. Mr Upex was admitted to hospital on 24th April 2022 with a high temperature, a productive cough, and left sided abdominal pain.
The inquest heard "he was treated promptly for sepsis", with a broad spectrum antibiotic, and fluid resuscitation. The initial source of the infection was unclear, the inquest heard.
Dr Didcock had flagged "a clear missed opportunity" to give Mr Upex a better possible chance of survival, with escalation of treatment within the hospital. But Miss Hall says he was "mismanaged" and asked, "how many people is that happening to?"
It's alleged the family were told he did not need a post-mortem after he died at 5.30am.
Miss Hall said she was told "one wasn't needed because he worked in the mines". Miss Hall told Nottinghamshire Live her uncle spent much of his working life - 30 years as a security guard - and very little time working in the mines.
He had been a security guard, working nights, on 12-hour shifts before he died. He had an underlying condition, that of myelofibrosis (a rare blood cancer), and he was undergoing treatment under a hospital consultant.
Mr Upex was at increased risk of developing a severe infection, the inquest had heard.
Dr Didcock said he also had "underlying coal workers' pneumoconiosis", caused by exposure to coal dust during his occupation as a miner. This also made a contribution to his underlying lung disease, and to his death, the inquest heard.
Mr Upex, of Kirkby-in-Ashfield, became increasingly unwell, with a need for oxygen to maintain his blood oxygen saturations, and a diagnosis of pneumonia was made. By 8.30pm on Wednesday, April 26, he was very unwell, with a high National Early Warning Score (NEWS) of 8, the inquest heard.
He had a high respiratory rate, a high heart rate, and was requiring very high levels of oxygen. Dr Didcock, in her narrative conclusion, recorded: "Whilst there was a prompt response to this deterioration, with assessment, further oxygen treatment, and treatment with diuretics, there was confusion as to the plan as to where best to manage this deterioration, with regard to escalation or not to the Intensive Care Unit.
"There was an inaccurate assessment of his pre-morbid functional status. Whilst there was no clear indication for admitting him to the ICU at this time, the confusion as to whether or not the ITU team should have been recalled to further assess him then continued, with no further escalation to the team, when he further deteriorated at 01.30 hours on the 27th April 2022.
"At this time his critical clinical condition should have been re-escalated to the ICU team, and there should have been a discussion with the ICU and Haematology consultants on call as to the plan for Paul's further management. It is likely that the outcome of this discussion would have been his transfer to ICU at this time.
"Whilst it is not possible to say that this would have on a balance of probability led to a different outcome for Paul, it was a clear missed opportunity to give him a better possible chance of survival, with escalation of treatment".
The coroner found there was also "no subsequent escalation to the ICU team" at 4.06am on the 27th, when his oxygen saturation level fell to 86 percent, despite very high flow oxygen, as there should have been.
Mr Upex had a cardiac arrest at 4.30am and had prolonged and full advanced life support at this time. Despite brief periods of return of spontaneous circulation, he did not recover and was pronounced dead at 5.30am.
Miss Hall said afterwards: "He should have been escalated".
He had a severe bronchopneumonia, causing Adult Respiratory Distress Syndrome, that had not responded to antibiotics and general supportive treatment, that of oxygen and fluid management. He had a number of underlying conditions that affected his ability to respond to the severe physiological stress of this infection.
Dr David Selwyn, Medical Director for Sherwood Forest Hospitals, said: “We would like to express our deepest condolences to Mr Upex’s family for their loss and offer them an unreserved apology at what we know will be an incredibly difficult time for them.
“We are committed to providing the best possible care to all our patients and we regularly monitor every patient in our hospitals to ensure their needs are regularly assessed and that any deterioration in their condition is highlighted at the earliest possible opportunity.
“We welcome the scrutiny that this Inquest has brought in supporting our own internal review of our care that we provided.”
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