The family of a woman who died after being repeatedly overdosed on paracetamol at an NHS hospital have called for action for her death amid allegations of NHS cover-up.
Laura Higginson, a trainee lawyer and mother of two, has died after seeing a doctor for illness and pneumonia. She died two weeks later from multiple organ failure and sepsis.
Whiston Hospital in Merseyside has admitted the overdose but has denied it caused his death and rejects any suggestion of wrongdoing.
But expert reports, seen by The independent, including from a liver specialist, questions the Trust’s account of what happened, the quality of her autopsy, and concludes that the mother of two – who weighed just 36kg – suffered from ” hepatic failure after consuming too much paracetamol in April 2017.
The overdose error was acknowledged by staff on the third day, but Laura’s family were never made aware of it.
The trust did not record the error as an incident and only opened an investigation 14 months later when concerns were raised by Laura’s family. Her husband Antony Higginson says the subsequent investigation report is “littered with inaccuracies”.
He said The independent: âWe just want justice; we don’t care about the money. Laura died needlessly and all of these institutions responsible for ensuring safe care and accountability failed blank and made Laura’s life essentially worthless and unimportant, when she did. did.
The ex-soldier spent thousands of pounds to force the system to take a fresh look at his wife’s death. A third coroner has now opened an inquest.
The Crown Prosecution Service (CPS) has confirmed that it is considering bringing manslaughter charges against the St Helens and Knowsley Teaching Hospitals Trust, which operates the Whiston hospital, after a file was passed to them by the Merseyside police.
Delays in making a decision on the case prompted Laura’s family to speak out.
Laura’s mother Denise said The independent she wanted justice. She said: âWe are embarrassed at every turn, which is not fair. It’s hard to believe that no one seems willing to move the case forward, or even make decisions on the next step. “
Laura’s case is not unique. The overdose of underweight adults in NHS hospital wards was reported by the safety watchdog, the Healthcare Safety Investigation Branch, in a report earlier this year.
There have been six incidents at St Helen’s Trust in the past four years where patients have been given a higher dose of paracetamol than they should have due to their low body weight.
Laura suffered from a genetic condition called Gitelman Syndrome and weighed only 36kg when admitted to hospital on April 5, 2017. Medical records show she received six 1g doses of paracetamol over two days. Due to her weight, she should have received only 540 mg.
The hospital accepted that Laura received a third more paracetamol than she should have.
Blood tests seen by The independent show Laura was suffering from liver failure on April 7, when a pharmacist requested a checkup.
Doctors discussed Laura’s condition with specialists in Birmingham who said Laura’s liver injury was likely the result of a number of factors, including toxic drugs.
Laura deteriorated and was admitted to intensive care and treated with anti-toxic drugs, but by then it was too late and she never recovered.
Dr Charles Millson, clinical manager of liver disease at York Hospital, told a coroner after reviewing Laura’s case in 2020: âI have to conclude that the liver failure was caused by the paracetamol overdoseâ¦ this lady received a significant excess of paracetamol and It was this overdose that caused the liver failure and sepsis resulted. Sepsis overwhelmed her and death resulted.
He admitted Laura had sepsis and existing liver problems, but believes it could survive without the liver caused by paracetamol.
At no time was Laura or her husband made aware of the medication error and a diary kept by the ICU nurses made no mention of it or the antidote treatment, although it did describe many other treatments and the reasons for it. for which Laura was in intensive care.
Mr Higginson said: “I am a former military man, I took a tour of Belfast and thought I saw it all but the way Laura died was horrible. For two solid days they were pumping her with too much IV paracetamol Everything is there in the notes.
“Why didn’t they tell him?” Why didn’t they tell us? If there was a serious risk of death, we could have brought the children to see her. They stole an inheritance from him.
He thinks the hospital was not going to tell Laura how sick she was. I remember Evie, being on the bed and she was holding Laura’s hand, stroking her face. Stephen was yelling at the nurses ‘there is nothing you can do’ and he was nine years old.
âNothing prepares you for this. “
Mr Higginson only learned of the paracetamol overdose when he received a copy of an autopsy report from his GP months after Laura died.
“I replayed every minute of his death.”
When he read the report, he was shocked: âWhen I saw what he was saying, I knew it was wrong. I got home and broke down, lay awake all night replaying every minute of his death.
Laura’s parents had taken the couple’s children to camp in Anglesey but Mr Higginson couldn’t wait.
âI went downstairs to talk to them. When I got there I passed it to Ian and saw it turn purple in front of me. He said that “no one has told us about paracetamol”.
After buying a packet of over-the-counter paracetamol and reading overdose symptoms such as jaundice and vomiting blood, Mr Higginson realized that was what had happened to Laura.
“We all agreed to get the records first and see what happened – then over the next couple of years, we reverse engineered a horror show.”
The hospital autopsy report concludes that Laura’s multiple organ failure was caused by micronodular cirrhosis in her liver, suggesting an underlying disease. He added: “The suggested staged paracetamol overdose contributing to his liver injury is possible but difficult to prove with certainty.”
This autopsy has now been criticized by a chief medical examiner, Professor Guy Rutty.
In a letter to the hospital, seen by The independent, it raises the question of why the autopsy was not performed for a coroner and lists multiple errors, including Laura’s wrong date of birth and her weight 23kg heavier than she was.
Professor Rutty criticizes the “general inaccuracies” in the autopsy and the discrepancies with Laura’s medical history in life. He also underlined the non-compliance with the rules concerning direct debits.
Confidence said The independent he had investigated Professor Rutty’s complaint with a clinical assessment concluding that there was no major problem and a referral to the General Medical Council (GMC) was not necessary.
Whiston Hospital says it has documented evidence that the then coroner was informed of the paracetamol overdose.
In July 2019, a second investigation attempt by a second coroner was also rejected after doctors at the trust suggested the overdose had been properly treated with an antidote and the effect was “short-lived.”
Dr Millson told the coroner in February 2020 that the overdose antidote was only effective if given within eight hours and Laura had received repeated doses over two days.
Concluding that the overdose was what killed Laura, he added: “The delay means that it would have been of little or no help at all.”
It was only after Mr Higginson spent Â£ 8,000 on a legal letter challenging the coroner that a new inquest was opened. It was adjourned in July of last year as the police investigation continues.
John Doyle, senior attorney at Slater and Gordon, representing the family, said Laura’s case raised many unanswered questions.
He said: âOur own extensive investigation with leading experts will say that the careless and repeated administration and overdose of paracetamol caused the death of Laura. Although the trust admitted that it breached its obligations and caused harm, it maintains that his negligence did not cause his death. This admission and formal apology from the CEO of the trust did not come until several years after Laura’s death. “
He added that Laura’s family had to wait “an unreasonable amount of time for the CPS to respond due to its own due process, then the coroner will have to meet again before we are able to seek to resolve the civil claim.” All of this only adds to the mental anguish they endure on a daily basis.
The trust accepted that there was no record of the overdose discussed with Laura or the family and admitted that an incident report should have been filed at the time.
he said The independent the responsible staff member was unable to explain why this was not done.
A spokesperson for the St Helens and Knowsley Teaching Hospitals Trust said: âThe trust offers its sincere condolences to Mrs Higginson’s family.
âAs soon as Confidence was informed that she had received a higher dose of paracetamol than recommended for her low body weight, we responded openly and honestly. The trust launched a full and thorough investigation informed by independent medical experts. This concluded that any effect of the paracetamol dose was transient and did not contribute to Ms Higginson’s death.
Merseyside Police and the Sefton, St Helens and Knowsley Coroner’s Department declined to comment.