A frail pensioner who had contracted Covid-19 and was isolating in his room at a Nottinghamshire care home was admitted to hospital “extremely emaciated” and with skin damage which raised a red flag, an inquest heard.
He was malnourished, had an “acute kidney injury” – where the kidneys suddenly stop working properly – and had tested positive for Covid earlier in December 2020. All of these issues would have contributed to his ability to fight pneumonias.
The proposed medical cause of death was pneumonia and undiagnosed ischemic heart disease, the inquest heard.
He also had multiple superficial pressure ulcers on hospital admission, which, the inquest heard, would be a red flag to refer to safeguarding, which happened in his case.
The inquest was told Murray was a resident at the Willow Tree Care Home, Mansfield, where all but one of the residents seemed to have come down with the Covid-19 infection and were isolating in their rooms.
He was admitted to hospital on Christmas Eve pretty unwell and extremely emaciated.
Dr Steven Rutter, a consultant geriatrician at King’s Mill Hospital, said Murray had tested positive for Covid-19 on December 11.
Hospital blood tests suggested he might also have an infection. He had a “fairly significant acute kidney injury” and was given intravenous antibiotics.
Dr Rutter told the hearing, “in all honesty the skin damage was not a significant part of his initial presentation” and there was no evidence of infection associated with the skin damage.
“The feeling is that they (the skin damage) would have developed probably within 24 hours. The feeling was they would have been present at the point he was picked up (by ambulance) at the care home”.
Despite being on IV fluids and antibiotics, Dr Rutter said it was fairly clear very early on “we were not going to manage to keep him alive, I am afraid”.
“I think the problem was he was so frail and unwell when he came in. We were never going to win, I am afraid”.
Murray was put on end of life pathway.
Sally Morgan, who was a senior carer at the home, said, at the time of the isolation, care was given in the room, residents were not mobilising as much as they would under normal circumstances and were limited to who they saw and interacted with.
The day before his admission to hospital, Murray declined medication. Two carers assigned to him bathed him that morning but his diet and fluids were “not very good,” said Ms Morgan.
She could not get through to a doctor, which she said went on for 50 to 55 minutes, and in the meantime she got in touch with Murray’s wife, who lived in the adjoining building, to come across to see if she could get him to eat or drink.
His son, Andrew Hyslop, arrived as well and they were given PPE to wear. Andrew got through to a GP who advised for a 999 call to be made for an ambulance to take Murray to hospital.
Andrew Hyslop had found out his dad had Covid-19 on December 19, he said, and claimed he had tried to get updates on his condition. On December 20 he claimed “we got a visit through a closed door”, and his dad was not responsive.
“I had serious concerns what I saw that day,” he told Ms Morgan. “He was quite clearly infected and his legs were pencil thin”.
He asked Ms Morgan: “Would you expect any change in his care plan, if my father was in that condition?”
She replied: “Yes”
The inquest, at Nottingham’s Council House, continues.
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