19.1.07

Part 2 - Ralph Winstanley - FACTS about his death - 11Apr2004 - 18Apr2004

Click for A Full Index - but stay on this page if you want to read the main facts



Table of FACTS in respect of Ralph Winstanley’s death
23Apr2004 - plus numerous supporting document abstracts
Second part - 11Apr2004 to 18Apr2004
11Apr2004
FACT:
Ralph Winstanley spent the hours between 9am and 3pm – on 11 April - with his daughter, Linda, going out to lunch for her birthday and appearing perfectly normal & happy. He was walking well and ate his meal with evident relish. Afterwards he was happily chatting for a couple of hours before she went away. He seemed well at that time, to his daughter.
Affidavit - abstract - Linda Kirby - No 16

11Apr2004around18.00
FACT:
In a telephone call, made less than 3 hours later, by Nina Clayton to Linda Kirby, Ralph Winstanley was stated to be dying. Nina Clayton had him rushed, ‘dying and on oxygen’ into Doncaster Royal Infirmary.
Affidavit - abstract - Linda Kirby - No 17

11Apr2004 - 17.40
FACT:
Ambulance Communications Record, shows that the person (a married female), South Yorkshire Ambulance Service - Communication Record Transcript - No 18
was stating – at 17.40 - that Ralph Winstanley
‘..is quite ill he has had a lot of problems breathing ……at the moment he is just getting chest pains and he can’t seem to get any breath.’
Also that he had been seen by the nurse ‘a couple of days ago’ and that ‘he can hardly walk’ and that ‘she took his blood pressure and it was very low it was 85 over 40’
South Yorkshire Ambulance Service - Communication Record Transcript - No 18

FACT: The Nursing Record shows that when his blood pressure had been taken on 8 April, by the nurse, it had been ‘100 over 57 sitting’ and ‘83 over 50 standing’
Nursing Record - 08/04/2004 - signature indecipherable - No 20

11Apr2004
NOTE WELL:
The box which should be crossed if the patient is in pain has not been crossed.
FACT: Under ‘Description Given’, it states:
‘Chest Pain’ also ‘SOB’ (shortage of breath)
Under ‘Comments & Observations’ it states:
'SOB + chest pains for 2 days. Pale Resp 24 Pulse 100 SpoO2 on air 97 BP 110 systolic Patient feeling dizzy when stood up’Also
‘PMH/Leukaemia/CA? Lung?/Fluid retention stomach problem’
South Yorkshire Ambulance Service - Single Responder Form - MH No 542 - call sign DP5

FACT: He had not been short of breath nor having any chest pains when he had spent 09.00-15.00 with his daughter on that day. He had been walking well.
Affidavit abstract - Linda Kirby - No 16

11Apr2004 17.56-18.20
NOTE WELL
FACT:
At top right hand corner of the Single Responder Form there are numerous boxes in which crosses need to be put, to state as clearly as possible the state of the patient.
He is marked as ‘conscious’
In respect of his airways and breathing his breathing is
‘clear’ and ‘normal’
It is noted that his circulation has:
‘radial pulse'
that his skin is ‘pale’ and ’>2Sec’
Also that he is ‘calm’
He is marked as being ‘alert’
The box, which should be crossed if the patient is in pain has not been crossed. This seems to indicate that he was not found to be in any pain.
South Yorkshire Ambulance Service - Single Responder Form - No 542 – call sign DP5 - No 22

11Apr2004
FACT:
Ralph Winstanley had spent 6 hours with his younger daughter that day (9am-3pm), when she had found him to be quite well and in a happy mood. He had no chest pains. He had gone out to a pub for lunch. He certainly was not complaining of ‘stomach pain’. He ate a hearty meal. The false information, given to the First Responder, was less than 3 hours after Linda had happily left him.
Affidavit abstract - Linda Kirby - No 16

11Apr2004 - 18.01-18.10
NOTE WELL
FACT:
The Single Responder handed over to the Ambulance Staff at 18.01 - who left the scene with Ralph Winstanley at 18.10.
Description given to them: ‘chest pain’
Their description of signs and symptoms:
Pre. Med History: ‘Lymphatic leukaemia Hypotension’
At time of arrival they were told:
‘PT C/o pains in stomach since yesterday, SOB and appears confused, feels generally unwell, dizzy,
and significantly –
‘Not c/o pain at moment.’
Also
‘Wife travelled with PT’
South Yorkshire Ambulance Service - Ambulance Patient Report Form - Attendent 24 - Driver 535 - No 23
South Yorkshire Ambulance Service - Ambulance Patient Report Form - Attendent 24 - Driver 535 - No 24

NOTE WELL: As the comment,'appears confused’, was also written – about the patient - it seems likely that the information gleaned by the Ambulance staff came from the ‘wife’ who ‘travelled with him’ rather than from the patient. It is difficult to see where else it could have come from.

NOTE WELL: It states – above – that he had 'pains in stomach since yesterday'.
Yet only three hours before, he had shown no sign of any pains in stomach, when he went out to lunch with his daughter. Nor did he show any signs from the time when she first arrived at the house at 09.00 until 15.00 when she left him. He ate a hearty meal – with evident pleasure.
Affidavit abstract - Linda Kirby - No 16

11Apr2004
FACT:
For the 6 hours between 9am and 3pm, which he spent with Linda, he had not appeared confused. Nor had he complained about feeling unwell in any way
.Affidavit abstract - Linda Kirby - No 16

11Apr2004 - 18.01-18.31
NOTE WELL
RALPH WINSTANLEY WAS UNAWARE THAT HE WAS DYING
FACT:
Written along the left hand side of the Patient Report Form are the words:‘Terminal CA Patient unaware’It is interesting to speculate where this information came from. It certainly could not have come from the patient, since the patient was stated to be ‘unaware’.The only other person in the Ambulance was Nina Clayton.
South Yorkshire Ambulance Services - Ambulance Patient Report Form - Attendant 24 - Driver 535 - No 25

FACT: There is no medical evidence for the statement,
‘Terminal CA Patient unaware’, since both Consultants, separately, agree that the patient, Ralph Winstanley, was not in any danger of dying from cancer.
Consultant Physician and Gastroenterologist Dr Gary James - letter of 14Mar2006 - page 1 - No 10i
Consultant Physician and Gastroenterologist Dr Gary James - letter of 14Mar2006 - page 2 - No 10ii
Consultant Haematologist Dr Gautam Majumdar - letter of 08Mar2006 - No 26

11Apr2004 - 18.01-18.31
NOTE WELL: RALPH WINSTANLEY WAS UNAWARE THAT HE WAS DYING -
possibly because he wasn't?

FACT: At 18.31 the Ambulance arrived at A & E, Doncaster Royal Infirmary. Handing over not only the patient but also the Patient Report Form. Since the words ‘Terminal CA Patient unaware’ were written down the left hand side of this Form, that is the information which nurses and Senior Houseman, Dr Jamasp Dastur had to work from, in respect of this ‘confused’ patient . That copy of the Patient Report Form was retrieved, by Linda Kirby from A& E at Doncaster Royal Infirmary. – quite separately to the Ambulance records which also show it.
South Yorkshire Ambulance Service - Patient Report Form - No 25

11Apr2004 - 18.37
FACT:
At 18.37 Triage Nurse notes state ‘no pain at present’
Doncaster Royal Infirmary - A & E Records - Michele Breeze, Triage Nurse Notes -No 27

11Apr2004 - 20.32-22.00
FACT:
At 20.32 Senior Houseman, Dr Jamasp K Dastur records: ‘No pain now’.
Ralph Winstanley was kept under observation for three hours, no problems were seen; he was given one Paracetamol and then allowed home at 22.00, the same evening. Any supposed ‘chest pain’ was put down as being ‘musculo skeletal’.
Doncaster Royal Infirmary - A & E Records - Senior Houseman, Dr Jamasp K Dastur - No28

11Apr2004 - 17.00-22.00
FACT:
Both daughters saw him for most of his time in
A & E, arriving at 19.00 and leaving at 22.00, as he also left. He was looking confused but stated that he wanted to go home - and that he was not in any pain. He didn’t seem to understand what he was doing there.
Affidavit abstract - Charlotte Peters Rock - No 29

13Apr2004
NOTE WELL:

Following his chest x-ray and antibiotics, of 6 weeks earlier, Ralph Winstanley should have returned for a second chest x-ray at around this date.

FACT: There is nothing in the GP Medical Records or other Records, which Ralph Winstanley’s daughters have, to indicate that he ever returned for a second chest x-ray. Why was that?
GP Medical Records - Ms Julie Watson - No 6a

14Apr2004
FACT:
A letter arrived at Dr Brown’s Field Road Surgery, from Senior House Officer, Dr Jamasp Dastur, of A & E, Doncaster Royal Infirmary, confirming Ralph Winstanley’s visit to A & E, and stating that any pain, which he might have felt was only ‘musculo-skeletal’. The contents of that letter were entered into the GP Medical Record by Mrs Emma Briggs.
Dr Brown’s name is appended as having seen that entry.
GP Medical Records abstract - Dr David J Brown - entered by Mrs Emma Briggs - No30

14Apr2004
NOTE WELL: He was on Oramorph for 4 days & nights before 18Apr2004

FACT: Dr David J Brown decided to put Ralph Winstanley on Oramorph (Morphine-by-mouth) every 4 hours, mentioning ‘chest pain’ as the reason why he had been seen at A & E over the weekend. (This was a man trying to recover from chemotherapy, who needed to eat well to aid his recovery). It seems - from the record - his only presenting complaint at Dr Browns consultation was shortness of breath - not 'chest pain'. Having just completed a course of chemotherapy, wouldn't it be likely that he would have shortness of breath as his system tried to recover? Chemotherapy is designed to kill blood cells - which then have to replenish; taking up to 40 days (Fludarabine)
GP Medical Records abstract - Dr David Brown - No 31a
GP Medical Records abstract - Dr David Brown - No 31b

FACT: Ambulance and A&E records state that no chest pain was observed over the weekend either.
South Yorkshire Ambulance Service - Ambulance Records abstract - 11Apr2004
Doncaster Royal Infirmary - A & E Records abstract - 11Apr2004

FACT: It is clear from the GP Medical Record that Ralph Winstanley was not experiencing any chest pain at the time the Oramorph was prescribed
GP Medical Records abstract - Dr David Brown - No 31a
GP Medical Records abstract - Dr David Brown - No 31b

15Apr2004
FACT:
At his request, Ralph Winstanley’s ex-wife, Nettie, was brought to see him, by his daughter Linda. Whilst she was there, Nettie was not left alone with him at all. Rosemary Cheesman was constantly hovering in the room, listening closely to the conversation. Ralph put his finger up to his lips at one point, to stop Nettie speaking in front of Rosemary.
(For quite some time, Ralph Winstanley had not knowingly been left alone with any of his own family – his two daughters. Now he was not left alone with his elderly ex-wife either.)
Affidavit abstract - Linda Kirby - No 32
NOTE WELL: Also see Nettie Winstanley for more information on this

16Apr2004
NOTE WELL
FACT:
Urine examination revealed that there was no growth apparent in the solution. However, in spite of this, no suggestion was made that the urinary catheter could be removed. It was still in situ – for some reason - when Ralph Winstanley died.
No appointment seems to have been made for him to see any specialist in respect of his prostate or his ‘incontinence problems’, though that would normally have been expected, where a patient had needed catheterisation. Why was no appointment made for him to see a Consultant Urologist?
GP Medical Records abstract - Dr David J Brown - No 33

2 comments:

ami said...

Another person murdered on The Liverpool Care Pathway.

ami said...

Another person murdered on the Liverpool Care Pathway.Please keep protesting something very dark is going on in our country which I liken to a holocaust.
We need a miracle.

Protest songs and poems - coming shortly

  • A Full Index
  • Abide With Me (mine)
  • Dead An Buried? Ardly!
  • Director of Public Health - Dr Tony Baxter
  • If - (not by Rudyard Kipling)
  • Jayne Brown - The Cover-Up Woman
  • Practice - Field Road Made
  • Quack Quack Dr Lee
  • St John's Hospice - My Father Was Not Dying
  • Thanksgivin? Thanksgivin? Ah'll be Waitin On
  • The NHS/PCT Thinks You Should Go
  • The Palliative Gillian
  • The Power behind the Patient Dr Brown

Who was Ralph Winstanley?

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