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Thread: Should the death certificate state infection as well as cancer?

  1. #1
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    Should the death certificate state infection as well as cancer?

    My 88yr old Mother has recently died of Pancreatic cancer or complications arising from it. I am wondering if anyone could provide any views whether the death certificate and the Coroners view has any credibility in view of the following history.

    Mum had been ill for 6 months from what was thought to be a bladder infection, but she appeared to be gradually improving. However in March she took a turn for the worse, and on the 21st March she was taken into hospital with jaundice and abdominal pains. After a scan she was diagnosed with pancreatic and bile duct cancer which of course was a short terminal condition for someone of her age. A stent was fitted via the Mouth and Stomach on the 28th March to open up a blocked bile duct. Immediately after this she seemed to improve slightly, started to eat again and the jaundice disappeared. However, the consultant informed me that there were signs of an infection which were ‘common during these types of procedures’ which was being treated with antibiotics.

    A week later just before Easter her pain increased, however, I discovered from her bed file, that Mum was refusing pain killers due to vomiting. Unfortunately, the palliative care team were on Easter leave, and the nurse on change was initially unaware. However, Mum was so confused it was difficult to tell what was happening. I asked for the drugs to be administered intravenously and the consultant subsequently apologised for the mix up. As far as I know the antibiotics were already being administered intravenously, whether they were administered continuously since the operation I am unsure.

    A week later the consultant mentioned my Mother was ‘failing to respond to antibiotics’ , but he anticipated two more months of life, and refused referral to a hospice (a typical route for an end of life patient with only weeks to live). The case manager also carried out a ‘continuing healthcare assessment’ which judged her too well to qualify for funding since she was responsive and the drug administration was straightforward in her view. However, I disagreed, complained and by the time I got home they had changed it.

    The next two days was particularly traumatic since she deteiorated rapidly, was confused, semi-conscious and un-restful, probably due to the increasing pain medication. By then the Doctors only gave us a few hours so me and some relatives stayed with her all night. In fact she struggled on for two more days on a morphine syringe, dying on the 17th April.

    To my annoyance the death certificate only mentions Panceatic Cancer followed by Cholangiocarcinoma (Cancer of the Bile duct) with no mention of infection. I questioned this at the Death registrar’s office and they sent it back to the Coroner. However, they rejected any change due to the fact she was deteriorating on admission to hospital. There may have been more information, but I don’t have anything in writing. The coroner’s assessment was dealt with quickly at my request without an autopsy.

    How would everyone else feel about this, is it me or is there a potential cover up here? My sole concern is to get the record straight so these infections are recognised, however perhaps their is a reluctance to admit to infection due to the litigation culture which would be tragic?

    I understand that in the UK, the Doctor certifying death should list:

    1) the disease or condition that led directly to death
    2) the intermediate cause
    3) the underlying cause.
    Last edited by Didee; 05-05-2012 at 01:28 PM. Reason: Link violation new member. Please read forum policies.

  2. #2
    Administrator Top User ChemoMan's Avatar
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    Hi Perseus

    How would everyone else feel about this, is it me or is there a potential cover up here? My sole concern is to get the record straight so these infections are recognised, however perhaps their is a reluctance to admit to infection due to the litigation culture which would be tragic?
    That question is beyond the scope of this forum. I might add however that what happened with your mother is not an ucommon story. Anything that affects the pancreas has a risk of death be it cancer, pancreatitis or obstruction to the bile duct. The pancreas has a habit of auto digesting itself if obstructions are present for whatever reason. My Mother in law was in Intensive care for 8 days after a stone removal which is a simple procedure in itself. Irritation led to inflammation which then led to obstruction. MIL was lucky to survive the ordeal. BTW severe vomiting is common with pancreatic disease of any type.

    I feel for your loss but I doubt a cover up is going on here.

    Take care
    Age 58
    Diffuse Large B cell Lymphoma
    Stage 2a
    Finished six cycles of R chop 21 26th May 2008
    Officially in remission 9th July 2008
    Remission reconfirmed 1st October 2008
    Remission reconfirmed 17th June 2009
    Remission reconfirmed 7th June 2010
    Remission reconfirmed 6th July 2011
    NED on the 2/01/2013
    No more scheduled visits to the Prof
    http://cancerforums.net/viewtopic.php?t=9620

    RULE NUMBER 1.....Don't Panic
    RULE NUMBER 2..... Don't forget rule Number 1

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    I may not have gone where I intended to go,
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