An inquest has heard how a patient bled to death during surgery at Northwick Park Hospital in Harrow, because of a “spelling mistake”
Pensioner Irmgard Cooper, 85, bled to death on the operating table after blood which was intended for her was sent back due to the incorrect spelling of her name.
An inquest at North London Coroner’s Court heard her name had been spelt as “Irngard” instead of Irmgard.
Ms Cooper – who is originally from Germany – had undergone an operation to repair a large bulge in the main artery to her heart when the mistake occurred.
In addition, the surgeon had not been told there was no blood supply avaliable until he had already started the operation.
By the time replacement blood had been located, she had bled to death on the operating table.
Ms Cooper’s daughter, Lorraine Booker, said her father, Raymond – who was married to Ms Cooper for 62 years – had suffered nightmares since her death.
She told the Brent and Kilburn Times: “My father has suffered from nightmares over my mother’s death ever since. We just feel very let down and betrayed by the hospital for a death that should never have occurred.”
She said she was taken to intensive care to see her mother, who she found “lying in a pool of blood, which was running off the bed” and the “floor was drenched in blood”.
Coroner Andrew Walker found gross failings in the effort to provide blood at a critical time when it was already known that supplies would be required.
A serious incident investigation report by the hospital found Mrs Cooper died from serious blood-clotting difficulties, cardiovascular collapse and haemorrhage – and that the blood delay caused her death.
Solicitor Renu Daly, acting on the behalf of Ms Cooper’s family, told the court: “The first error was the mis-spelling of the patient’s name on the blood sample. The lack of communication between the anaesthetist and the surgeon over the absence of blood was the second error.
“Mrs Cooper was effectively dead from the time she arrived in intensive care. She was already suffering from catastrophic internal bleeding, which meant death was inevitable.”
The chief executive of London North West Healthcare NHS Trust, Jacqueline Docherty, said: “I would like to offer my sincere condolences to the family of Irmgard Cooper and say how sorry I am for what happened.
“We accept the coroner’s verdict. Prior to the inquest, the trust undertook a full internal investigation, and has implemented systems to ensure that incidents of this nature do not occur again.”
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