Woman died after two London hospitals refused to admit her for surgery due to lack of beds

Refused treatment: Mary Muldowney died after two London hospitals refused to admit her
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Patrick Grafton-Green16 February 2017

A woman died from a brain haemorrhage after two London hospitals refused to admit her for surgery because they had no intensive care beds.

A coroner ruled that 57-year-old Mary Muldowney would probably have survived if she had been given immediate life-saving surgery to stem the bleeding.

Ms Muldowney, who had two children and grandchildren, was initally admitted to East Surrey Hospital in Redhill on July 20 last year where doctors suspected a bleed on the brain.

A CT scan carried out just over an hour later showed heavy bleeds and doctors requested an immediate transfer to a specialist neurosurgical unit for surgery.

However three units – St George's Hospital in Tooting and King's College Hospital, as well as the Royal Sussex County Hospital in Brighton – refused the request due to having no beds.

Other hospitals also said they did not have an intensive care bed for Ms Muldowney, from Crawley, West Sussex.

Ms Muldowney was turned away by St George's Hospital in Tooting and King's College Hospital
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In a letter to bosses at NHS England, inner north London coroner Mary Hassell said: "In desperation, knowing of the neurosurgical expertise of a former colleague, one of the East Surrey Hospital doctors went out of area and rang a consultant neurosurgeon at the Royal London Hospital (RLH).

"Invoking the universal acceptance policy, he accepted transfer immediately, though in fact the RLH had no intensive care bed available at that time.

"Meanwhile, at about 1pm, Ms Muldowney woke up very briefly while intubated and interacted with her daughter.

"Ms Muldowney was transferred to the RLH and taken straight to theatre at 4.40pm.

"Unfortunately, her pupils had become fixed and dilated in the ambulance during transfer to the RLH and surgery did not save her.

"If she had been transferred promptly, it probably would have."

Mary Muldowney would probably have survived if she had been given immediate life-saving surgery, the coroner said
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The coroner, who recorded a narrative verdict, said evidence showed that Ms Muldowney "could have been transferred, undergone surgery, spent time in recovery, and then an intensive care bed procured".

She added: "With prompt transfer and surgery, Ms Muldowney would probably have survived.

"In my opinion, action should be taken to prevent future deaths."

NHS England medical director Sir Bruce Keogh said he was "very sorry" to read of the circumstances around Ms Muldowney's death and that a serious patient safety issue had been raised.

He said Professor Simon Mackenzie, from St George's Hospital, had suggested Ms Muldowney "was not deemed by the neurosurgical services to which she was being referred to require immediate life-saving surgery" and fell outside the scope of the universal acceptance policy.

Prof Mackenzie said he believed St George's provided acceptable care because Ms Muldowney suffered a re-bleed during the ambulance transfer to the RLH.

However, Sir Bruce added that there was a clear "difference in perspective" between doctors at East Surrey Hospital and St George's.

A spokesman for St George's Hospital told the Daily Mail: "St George's neurosurgical department operates a 'universal acceptance policy' to accept patients that require emergency specialist support.

"Unfortunately, at the time of referral, Ms Muldowney was not deemed to require life-saving surgery which led to her transfer to Royal London Hospital."

A spokesman for King's College Hospital NHS Foundation Trust said: "Patient transfers are only accepted when medical specialists have been consulted and it is clinically safe to do so.

"We continue to see high levels of demand for our services and are currently in the process of building a new critical care centre. This will add significant bed capacity to our existing four critical care wards.”

A spokesman for Brighton and Sussex University Hospitals NHS Trust told the newspaper: "Unfortunately, at the time of referral, Ms Muldowney was not deemed to require life-saving surgery and therefore there was no indication that emergency transfer was appropriate."

Additional reporting by Press Association

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