A MAN from Wokingham died of sepsis after his artificial bladder was accidentally perforated while in hospital, an inquest has heard.
Stephen Hales-Owen, of Diamond Way, was 64 when he died on May 5 this year after receiving treatment for a urinary tract infection at the Royal Berkshire Hospital.
The inquest, held at Reading Town Hall on Thursday, October 12, heard how Mr Hales-Owen had been diagnosed with bladder cancer in June 2015, and had subsequently had his bladder removed as part of his treatment.
He had received a neo-bladder, an artificial bladder created from tissue in his bowel, but this was prone to infection.
On April 28 this year, Mr Hales-Owen contacted an out-of-hours medical service complaining of serious abdominal pains and an inability to pass urine.
The service agreed that he should be admitted to the Royal Berkshire Hospital, and he was transferred by ambulance in the early hours of April 29.
Upon his arrival at the hospital, Mr Hales-Owen was examined and doctors decided to insert a catheter to help relieve his urine retention.
Once inserted, no urine was drained from the neo-bladder which suggested that there wasn’t a retention after all.
As Mr Hales-Owen’s condition continued to deteriorate, he was sent for a CT scan which revealed that his neo-bladder wasn’t draining properly, and he was referred for surgery to manually drain the bladder.
It was only during this treatment that doctors found that the catheter had been mis-sited and therefore wasn’t functioning properly, and that it had also perforated the wall of the bladder, causing infected urine to leak out.
Tests revealed that E-Coli was present in Mr Hales-Owen’s urine, which had leaked into his peritoneum.
By now, Mr Hales-Owen was showing signs of septic shock and was transferred to the Intensive Care Unit, where he was put on a course of strong antibiotics.
Dr Jerome Cockings, a consultant intensive care physician who took over Mr Hales-Owen’s care gave evidence at his inquest.
He told the coroner, Peter Bedford, that Mr Hales-Owen’s condition started to improve and the decision was made to stop the antibiotics.
He said: “We were very encouraged given his improvement that he would go on to recover, given that his condition has such a high mortality rate.
“The problem with adminis-tering such strong antibiotics is that you only want to target specific organisms, and do not want to kill the healthy ones.”
Dr Cockings said he did not feel the decision to take Mr Hales-Owen off the antibiotics was wrong, but when his condition started to deteriorate, he was put on them again.
He told the inquest, which was attended by Mr Hales-Owen’s wife, son and daughter, that due to the nature of the antibiotics, it was very likely that they hadn’t had time to leave his body before he was put on the new course.
However, by May 5 Mr Hales-Owen’s condition had further deteriorated, and he was experiencing multiple organ failure as a result of the septic shock.
Dr Cockings explained that Mr Hales-Owen had most likely experienced what is known as a septic shower, caused when the infected waste which had accumulated in his intestines had been drained.
The movement of the blockage caused previously trapped septic organisms to flow through his body, causing him to fall into further shock.
Despite the best efforts of the Intensive Care Unit physicians Mr Hales-Owen was unable to recover, and he passed away on the evening of May 5.
A post-mortem examination revealed that Mr Hales-Owen died from peritonitis and E-Coli septicaemia.
When asked by Mr Hales-Owen’s family whether realising the initial catheter had been mis-sited earlier would have made any difference to the outcome, Dr Cockings said he did not believe so as Mr Hales-Owen was not displaying any signs of shock until the morning of April 30.
Mr Bedford was satisfied that the peritonitis and E-Coli septicaemia was caused by an accidental perforation of the neo-bladder, which resulted in Mr Hales-Owen’s death.
