19.1.07

Part 7 - Ralph Winstanley - FACTS about his death - 22Apr2004

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

Seventh part - 22Apr2004

22Apr2004
FACT:
It is recorded in the Hospice at Home Notes:
‘Telephone call from RGN Lorna Clarke following her third consecutive night sit with Ralph – Severe family friction this morning between Ralph’s daughter Christine & his wife Nina.’
Hospice-at-Home Notes - St John's Hospice - RGN Val Derks - Lead Palliative Care Nurse - 2nd entry for 22Apr2004 - No 66a
NOTE WELL: SERIOUS COMPLAINT RECORDED

FACT: Also recorded:'Telephone call to Nina – she says Christine feels her father has been oversedated and his death accelerated.’
(note: Christine=Charlotte Peters Rock)
Hospice-at-Home Office Notes - St John's Hospice - RGN Val Derks - Lead Palliative Care Nurse - 2nd entry for 22Apr2004 - No 66b
NOTE WELL: SERIOUS COMPLAINT RECORDED

FACT: Also recorded: ‘Telephone call from Christine requesting a home visit’.
Hospice-at-Home Office Notes - St John's Hospice - RGN Val Derks - Lead Palliative Care Nurse - 2nd entry for 22Apr2004 - No 66b

FACT: Also recorded: ‘Home visit. Long talk to Ralph’s daughter, Christine. Her son was also present. Christine has contacted PCT East who are arranging the public Health Officer to contact her. She has asked for an independent Dr to visit her father. She feels Ralph Has been oversedated and that Nina has deliberately lied to the Health Professionals involved about Ralph’s condition and that this has resulted in them giving inappropriate medications. She feels any pain and distress he suffered on Sunday and Monday was due to indigestion and sore pressure areas & that he shouldn’t have been given sedation or had the Diamorphine increased. She says that Nina told the GP that Ralph was vomiting when he was only bringing up phlegm. I confirmed that I was unable to comment as I had not been involved with the situation at that point.’

What did this expert Palliative Care Nurse, do about these concerns expressed by Ralph Winstanley’s daughters? Nothing.. except she wrote them down.. and stopped the nightsitting nurse from going into the house.
Hospice-at-Home Office Notes - RGN Val Derks, Palliative Care Nurse, St John’s Hospice -2nd entry for 22Apr2004 - No 66b
NOTE WELL: SERIOUS COMPLAINT RECORDED

FACT: Roy Courts, called to the house by his mother, Charlotte, was present when Clinical Manager, Sheila Blow, arrived at the house, at his mother’s request.
He heard her state that his grandfather was definitely dying of cancer
Affidavit abstract - Roy Courts - re Thursday 22Apr2004 - No 67
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004
FACT:
Hospice at Home Notes make it clear that objections are being made about Ralph Winstanley’s treatment. ‘Christine feels her father has been oversedated and his death is being accelerated’.
Hospice-at-Home Office Notes - RGN Val Derks, Palliative Care Nurse, St John’s Hospice -2nd entry for 22Apr2004 - No 66b
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004
FACT:
It is recorded here that ‘She feels that any pain and distress he suffered on Sunday and Monday (18 & 19 April), was due to indigestion and sore pressure areas + that he shouldn’t have been given sedation or had the diamorphine increased’.
Hospice-at-Home Office Notes - RGN Val Derks, Palliative Care Nurse, St John’s Hospice - 4th entry for 22Apr2004 - No 66b
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004
FACT:
It is also recorded here that Val Derks had been made aware that lies were being told by Nina Clayton, Ralph Winstanley’s second wife. It is also recorded what the lies were.
'She says that Nina told the GP Ralph was vomiting when he was only bringing up phlegm.'
There is nothing in the records which Ralph Winstanley’s daughters have, to show that Val Derks did anything about this information – other than recording it.. and stopping any help which might have been received from the Hospice-at-home night-sit nurse, by stopping any Hospice-at-Home nurse from going into the house.
Hospice-at-Home Office Notes - RGN Val Derks, Palliative Care Nurse, St John’s Hospice - 4th entry for 22Apr2004 - No 66b
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004 - 08.30 - 08.45 - 11.30
FACT:
Nursing Notes make it clear that there was a severe problem in respect of Ralph Winstanley’s treatment. Also they state that his daughter was objecting to that treatment and had asked the Director of Public Health for help. And that she had requested a second opinion about the state of Ralph Winstanley’s health.
Nursing Notes – abstracts - District Nursing Sister Julie Marshall - 69a
Nursing Notes – abstracts - District Nursing Sister Julie Marshall - No 69b
Nursing Notes – abstracts - RGN Sarah Grimshaw - RGN Kathryn Clinton - 11.30 - No 69c
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004 - 08.30
FACT:
Nursing note at 08.30 states:
‘Val does not feel it is appropriate to send a nightsitter into the home tonight due to current situation’
Nursing Notes - abstract - District Nursing Sister Julie Marshall - 08.30 - No69a
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004 - 08.45
FACT:
At 08.45 District Nursing Sister Julie Marshall records that having discussed the treatment with ‘Mrs Winstanley’, she:
‘Reassured that the District Nursing Team would be visiting this morning to refill Ralph’s syringe driver.’
Nursing Notes - abstract - District Nursing Sister Julie Marshall - 08.30 - No69a

22Apr2004 - 11.30
FACT:
At 11.30 nurses record that Mr Winstanley’s daughter:
‘..feels that Mr Winstanley is being given inappropriate medication at the request of other family members and she feels that a second opinion is needed from an independent doctor.’

Nursing Notes – abstracts - RGN Sarah Grimshaw - RGN Kathryn Clinton - 11.30 - No 69c
NOTE WELL: SERIOUS COMPLAINT RECORDED

22Apr2004
FACT:
Charlotte Peters Rock records her attempts to get some help to her father during Thursday 22Apr2004 – following two days and nights of asking politely for help from nurses and Dr Rachel Sykes. Recording that she first discussed with her sister Linda Kirby – who agreed that she should ask for help. Following this she spoke to
Bridget Fieldhouse at Doncaster West PCT,
Mr Mike Young at Doncaster East PCT,
Dr Tony Baxter, Director of Public Health at Doncaster East PCT,
Sheila Blow, Clinical Manager, who works from Cantley Health centre.
It also records that Dr Gillian Harding - who she had been told was the 'Expert Second Opinion on the state of her father's health' - was due to contact her but did not on that day.
Affidavit – abstract - Charlotte Peters Rock - 67a
NOTE WELL: SERIOUS COMPLAINT RECORDED - to FIVE different people

22Apr2004
FACT:
There is documentary proof that Dr Sykes was certain - before Ralph Winstanley finally died – that he did not have any sign of malignancy in his oesophagus or stomach. The Oesophageal Biopsy Report states: ‘There is no evidence of dysplasia or malignancy ‘
Scrawled across this report – which was faxed to Dr Bundy at 10.09 on 22Apr2004 is, ‘RSS File in Notes’.
‘RSS’ is believed to be the initialling of Dr Rachel S Sykes.
This report seems to indicate that Dr Rachel S Sykes knew by at least the morning of the day before Ralph Winstanley died - if not before that time - that he definitely did not have Oesophageal cancer. Yet she stated, several times on 23Apr2004 to both of his daughters that he was dying of oesophageal cancer. Until that day - which was the day he died - they had not been told what he was supposed to be dying of, in spite of having asked many times.
Doncaster and Bassetlaw NHS Trust - Pathology Services - Report sheet initialled by Dr Rachel S Sykes - 67b
NOTE WELL: THIS CONFIRMED TO DR RACHEL S SYKES, THAT HE DID NOT HAVE ANY SIGN OF OESOPHAGEAL CANCER

FACT:
THIS SHOWS THE PROGRESSION OF RESULTS FROM FIRST ENDOSCOPY - WITH BIOPSIES TAKEN - WHICH WAS PERFORMED IN JANUARY 2004.

ENDOSCOPY RESULTS
13/01/2004 - Endoscopy performed and Report made, on what could be seen by eye. This Report seems to have been posted either on that day or the following day.
15/01/2004 - Report entered into Ralph Winstanley's GP Medical Record by Mrs Emma Briggs. It stated:
'Biopsy vial 1 from lower third oesophagus x 6.
Gastritis (535.5) Biopsy for H pylori (unrease test)
Final disposition
Review in GI clinic in 2 weeks. i Comments
Eradicate if CLO +ve. Decide on further management on reciept of histology.'

This shows that nothing could be decided just by looking. Results depended on what the biopsies showed.
GP Medical Records abstract - Mrs Josie Mace - Endoscopy Report - 13Jan2004 - No 2b

FIRST BIOPSIES
13/01/2004, Biopsies taken at endoscopy, showed that there was no sign of malignancy in Ralph Winstanley’s oesophagus.
30/01/2004 - This confirmation was entered into GP Medical Record.
30/01/2004Consultant Physician and Gastroenterologist, Dr Gary James dictated a letter to Dr David J Brown, Ralph Winstanley’s GP – and to Ralph Winstanley - confirming the negative results.
10/01/2004 - those letters were typed and posted.
11/02/2004 - Those letters. were received at Field Road Surgery and entered in the GP Medical Record of Ralph Winstanley. They stated that more biopsies would be taken in 6 weeks time in order to confirm or deny the initial result.
Did Dr Brown give Ralph Winstanley the letter which Dr James had sent for him?
Consultant Physician and Gastroenterologist, Dr Gary James - Letter to Dr David Brown - No 3a
Consultant Physician and Gastroenterologist, Dr Gary James - Letter - No 3b
GP Medical Record - 30/01/2004, Mrs Josie Mace - 03/02/2004, Dr David J Brown - 11/02/2004, Mrs Emma Briggs - No 2a

NOTE WELL
FACT: Tests performed and Reports on Results of the first Endoscopy/Biopsies, performed and taken on 13Jan2004, were fully recorded in Ralph Winstanley’s GP Medical Record.
There were FOUR entries in total.
Endoscopy Report - 15/01/2004
Biopsy Report - 30/01/2004, 11/02/2004.
Report given to patient by Dr David J Brown - 03/02/2004.

This seems to be the pattern by which the results of medical investigations are reported and recorded, at the GP Surgery.

NOTE WELL
FACT:
Only one entry about the second Gastroscopy/Endoscopy (10/03/2004), was recorded in Ralph Winstanley’s GP Medical Record. That was only about what was observed by eye.
It was not about the Histology/Biopsy Report.
Why was the Histology/Biopsy Report not shown?
If it had not been received, why did Dr David J Brown not send for that result?
Why did Dr Rachel S Sykes not send for that result on 19Apr2004 when she saw Ralph Winstanley?
GP Medical Records abstract - 11/03/2004 - Mrs Emma Briggs - Endoscopy Report only - 10a

NOTE WELL: There is one further entry, which is totally unsupported by any document or Report. That entry was made by Dr David J Brown.
15.03.2004 Surgery consultation Dr D Brown
15/03/2004 Oesophageal cancer see 2nd endoscopy report Dr D Brown

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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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