Post-op treatment blamed for woman's diabetic coma

A woman who fell into a diabetic coma following cancer surgery says a hospital trust must "show accountability" for what happened.

Katherine Ashton says she flagged her condition "every step of the way" before undergoing a major operation at Middlesbrough's James Cook University Hospital.

South Tees Hospitals NHS Foundation Trust (STHNFT) said it was likely her coma was linked to the post-operative administration of a medication known to carry the risk of diabetic ketoacidosis (DKA), a dangerous complication of diabetes.

The trust said it was taking action with the delivery of "bespoke training" to surgical staff on diabetes management.

Mrs Ashton, who has the genetic MODY3 form of diabetes, said she felt abandoned and that "nobody was paying attention" to her condition or concerns, during her time in hospital in October 2022.

In the days after the operation, she said she had bouts of vomiting and was unable to keep prescription medication down.

During this period, sick bowls were often left out of reach and some calls for help went unheeded, she claimed.

Mrs Ashton said repeated requests for alternatives to oral medication went unmet and signs of DKA were missed until her condition had deteriorated.

Her husband Colin Ashton said he raised concerns with nursing staff when he visited on 8 October and found her "barely conscious".

He said he was told his wife was sleeping.

The trust said DKA was diagnosed later that day when the ward's nursing team noticed a deterioration in her condition.

It said "all appropriate actions" were then taken to manage DKA, with a doctor requesting a follow-up visit from a diabetic specialist nurse.

However, the visit did not happen for another three days, because it coincided with a weekend.

Mrs Ashton said she now has to take insulin and her faith in the health service was "completely undermined" after being "let down at a time of extreme vulnerability".

"When you go into hospital, you are handing yourself over to who you believe and hope are caring professionals," she said.

"I was left with an overriding sense of abandonment and I continue to struggle with PTSD as a result of that."

Mrs Ashton said medical and nursing staff were "dismissive" of her concerns, inconsistent in their record keeping and there was inadequate catering for diabetics.

The trust said it found DKA was likely to have been caused by "poor oral intake" and the administration of the drug Empagliflozin, an anti-hyperglycemic medication associated with an increased risk of the condition.

Delays and shortcomings in the trust's handling of the complaint were reported to the Parliamentary and Health Service Ombudsman and the hospital trust sent its conclusion to its investigation to Mrs Ashton last week.

In correspondence seen by the BBC, group chief executive officer Stacey Hunter and site medical director Dr Diane Monkhouse said they were "very sorry" that Mrs Ashton's experience had caused her distress.

A letter outlining action to be taken said feedback would be shared with staff, and at a directorate meeting addressing a lack of information given to the patient and her family.

It also said feedback of the patient's opinion of staff being "dismissive" would be shared and an audit of discharge letters would be carried out.

Mrs Ashton said she was not satisfied with the outcome of her complaint and wanted the trust's CEO to apologise to her in person.

She said: "This was a diabetic problem but I was in hospital for a cancer problem, so the focus was on the general surgery, not diabetes.

"It's about education and awareness, because diabetes has such a fundamental impact on your total system."

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