Following submissions from the family, the coroner has agreed to fully investigate the death of a disabled woman who died last November after all her teeth were removed at Kidderminster hospital, Worcestershire under a general anaesthetic. 49-year-old Rachel Johnston died after developing aspiration pneumonia following surgery.
The inquest into her death is scheduled for three days in August at Worcester Coroner's Court. The hospital trusts involved in the case will now also run serious incident investigations.
The family of Rachel Johnstone, who was left severely disabled after contracting meningitis as a baby, said they did not want doctors to remove all 19 of her teeth in one operation under general anaesthetic.
Caron Heyes from Fieldfisher, who is representing the family at the inquest and in a civil claim for negligence, said that the law around consent clearly states that doctors must discuss all material risks with patients and state why alternatives are not appropriate. Where patients lack capacity, doctors decide for them. In Rachel's case, doctors were expected to take into account her family's concerns when making treatment decisions. Rachel's mother Diana was responsible for giving that input and should have been closely consulted on the best treatment for her daughter.
"Prior to surgery, Diana clearly stated that she did not think complete extraction was the right option for her daughter. She was never told the risks of general anaesthetic, nor was she asked if Rachel had previously had a general anaesthetic or her reaction to it," Ms Heyes said.
"Even after surgery, medical staff still did not tell Diane how many teeth they had removed. She only found out after a Learning Disabilities Mortality Review (LeDeR) investigation was launched.
"We are also investigating why Rachel was treated as day patient and not kept in overnight for monitoring following the surgery."
The Coroner will also investigate whether staff at the care home who looked after Ms Johnston following surgery were given sufficient information about post-operative care. Rachel's mother was only told she might be 'a little sore' following surgery.
The next day, after becoming seriously unwell at the care home, Rachel was readmitted unconscious to Worcester Acute Hospital with aspiration pneumonia. Her family were later advised she had suffered brain injury and would not survive.
The family, who described Rachel as 'always happy, always loved', took the decision to take her off life support. She died of her injuries two weeks later.
Cause of death listed in the post-mortem were:
1. Cerebral hypoxia
1b. Aspiration pneumonia
1c. Dental extractions
2. Hydrocephalus and epilepsy following childhood meningitis
Image credit: Rept0n1x [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]