Killed by a British hospital that just didn't care - a widow recounts her husband's final days

On the last morning of his life, Ian Luck phoned his wife from the hospital bed where, ten days earlier, he had been admitted for a gastric disorder. "He was crying so much I could hardly understand him," says Debra, his widow and mother of his son Ben, now nine. "Ian said he had spent most of the night in agony - the nurses had forgotten his pain-killing injections. "He was covered in his own vomit, he'd been sick on the floor, and when a nurse finally came, she told him he was 'disgusting'."

Debra will never forget that dreadful conversation in June 2002. Not least because just before he rang off, Ian said something so upsetting that it makes Debra cry to talk about it even today. "Ian had been bedridden for almost the entire ten days he'd been in the hospital," she says. "But he said if he could walk, he would have gone to the window and jumped out. He couldn't bear being in that uncaring place for another day."

Less than 24 hours later, Ian, aged just 37, suffered two cardiac arrests and died. A post-mortem showed that he had a ruptured oesophagus caused by continual vomiting. This rare condition causes massive shock and infection, which would have put fatal strain on the heart. According to medical experts, the most likely cause of Ian's excessive vomiting was a bleeding stomach ulcer, a condition that doctors initially picked up and treated. But when Ian's symptoms returned, they failed to carry out a simple exploratory process to diagnose further bleeding, which could have been treated with drugs or surgery.

As if his death wasn't tragedy enough, Debra is haunted by the misery, pain and squalor he endured at the Princess Alexandra Hospital in Harlow, Essex, during the ten days before he died. "An animal would have been treated with more compassion," says Debra. "No one wanted to help us. Every time we asked for pain relief, or to see a doctor, we were told to wait, or that we didn't know what we were talking about."

The final day of Ian's life was spent in misery and humiliation on a geriatric ward, with uncaring nurses and doctors who failed to recognise that he was dying. He had been shunted there from his surgical ward, having been told his bed was needed for a more urgent surgical patient. "That day was a nightmare," says Debra, now 43. "I knew he was dying, his usual happy character had vanished, he was frightened and very low. He looked grey and clammy, his stomach was swollen, he was hallucinating and there was vomit all over his T-shirt. "As fast as I changed him he was sick again. The nurses were not interested in helping me.

"At one point, an old man fell out of the bed next to us and lay there, crying for help. When I ran up to the nurses' station to tell them, they said: 'Just leave him.' "I wasn't strong enough to help him by myself and it was 15 minutes before anyone came to lift him back into bed. He lay there calling for help next to my dying husband. "All the time I could hear the nurses chatting and laughing. It was frustrating, terrifying, horrible. "This was a British hospital in the 21st century, yet it felt as if we were in the Dark Ages."

A fortnight ago, after nearly five years of legal wrangling, the Princess Alexandra Hospital NHS Trust agreed to pay œ200,000 damages to Debra, and a further œ25,000 to her son, Ben, without accepting liability. Although she acknowledges the money will help make Ben's future secure, Debra is disappointed. "No one has been punished or sacked," she says. "No one from the hospital has offered to meet me and tell me how things went so wrong, let alone offered an apology. "For all I know, the same appalling standard of care is still acceptable in that hospital. If that is the case, then there will be more unnecessary deaths."

Sadly, Ian's story of uncaring treatment is one that is all too common in the NHS. While many nurses and other medical professionals rightly take great pride in the high standards of care they offer patients, too often we hear of similar stories of poor nursing. The recent scandal surrounding the lack of hygiene at Maidstone and Tunbridge Wells hospitals - which led to 90 deaths from the superbug C. difficile between 2004 and 2005 - may have grabbed the headlines, but similarly shocking cases elsewhere in the country have surfaced with depressing regularity.

"Although Ian's story sounds dreadful, unfortunately it is not an isolated incident," says Vanessa Bourne, of The Patients' Association. "There has been a profound change in the nursing profession. Nurses no longer seem to want to care, or do the most basic forms of nursing. "Patients often contact us about incidents where they have been left with buzzers unanswered or in dirty bed linen. When they have broached the subject, they have been told off like naughty children."

Debra is emphatic about the "care" her husband received. "I actually feel that Ian was murdered," she says. "He died because people couldn't be bothered to do their job properly." Ian had suffered from gastric problems for two years. He was admitted to the Princess Alexandra Hospital several times in the first half of 2002 to replace the fluids lost through vomiting and diarrhoea. Ian underwent tests and was diagnosed with inflammation of the intestines and stomach, and then with Type 1 diabetes which, it was thought, could be exacerbating his problems. Finally, after a particularly serious bout of vomiting on June 12, 2002, and weak and unable to eat, Ian was again admitted to hospital. This time he had an endoscopy, where a tube with a camera on the end is passed down the throat into the stomach. "The doctor spotted he had quite a large duodenal ulcer, about 3cm in diameter, which he said might have caused the vomiting," explains Debra. "After six days in hospital Ian's condition slightly improved and, hydrated, he was allowed home."

The most common cause of a duodenal ulcer is an infection, which usually clears up with antiobiotics, but these didn't work, so the doctor arranged another endoscopy. On the morning of his appointment on June 20, Ben, who suffers from asthma, was wheezy, and Ian told Debra to stay with their son. He kissed them goodbye and headed to the hospital. It was the last time father and son would see each other. When Debra rang the hospital that afternoon, she was told Ian's ulcer had bled during the endoscopy and he'd had to undergo emergency treatment. "The surgeon told us that if left untreated, a bleeding ulcer was lifethreatening. But although Ian and I were frightened, he reassured us that we were on the surgical ward, right next to theatre, and if the bleeding started again we were in the best possible place to get it fixed."

But the doctor's optimism was not reflected in the remainder of Ian's care. From the day he was admitted to the day he died, Debra feels she struggled to get him even the most basic level of nursing care. "He was vomiting ten times an hour, and there were bowls around his bed to catch it," says Debra. "Often they weren't emptied for more than an hour and they smelled awful. The first time that happened I found a nurse and asked if she could empty them. When she said she was too busy, I offered to do it myself.

"What I've learned since is that his urine and vomit should have been monitored continuously. Both were vital to working out just how ill he was and whether he would need further investigations. The fact that no one kept a record probably added to his lack of correct treatment."

Debra found herself doing other basic nursing tasks, too. "Many times the vomiting came on so suddenly that Ian would vomit over his pillow, bed or T-shirt. It was often ages before someone came along to clean him up. I would arrive in the morning and he would have dried stains on his pillow or a filthy T-shirt. "I started bringing in clean pillow cases and changing them myself. I would leave him at night feeling guilty because I knew he wouldn't be looked after until I came back. "The next day I would walk up the stairs to his ward with my stomach in knots, terrified of what I'd find next."

And all the time, Ian was deteriorating before her eyes. "In the last two days of his life I saw only junior doctors. After four days in hospital he was so weak and he'd stopped eating or drinking because he felt too ill. If he did try to sip water, it would come back up straightaway," she says. The hospital continued to carry out tests. Ian had a CT scan, which indicated looped intestines, although later tests discounted this as a cause of his pain. One junior doctor casually mentioned to the horrified couple that Ian might have pancreatic cancer, although this was never mentioned again. Another junior doctor tried to put a tube down Ian's throat to drain his stomach but gave up after 20 minutes of Ian retching.

By June 27, Ian was receiving six injections of the painkiller penthidine, plus three injections of Maxalon, an anti-sickness drug, each day. Yet despite the battery of tests, there was no definitive diagnosis about whether the ulcer was still bleeding or if his symptoms were caused by something else. "I made two appointments to speak to a consultant during the course of those ten days," she says, "and both times he didn't turn up. When I tried to talk to junior doctors they were either too busy or didn't know enough.

"We had health insurance so I rang our local private hospital and they agreed to take him, but the Princess Alexandra wouldn't release him, saying he wasn't fit enough to travel. I felt at a loss about what to do next. "I really tried," she says plaintively. "But I shouldn't have let them brush me off; I should have shouted until he got the help he needed."

Indeed, according to Vanessa Bourne, making as much fuss as possible is exactly what you should do if you feel that your care is inadequate. "You have to stand up for yourself," she says. "A useful weapon is to state that you are keeping notes of everything. Speak to the sister, then the senior doctor. If they don't help, demand to see the chairman."

During the night of Friday, June 28, Ian was seen by a junior doctor who was sufficiently alarmed about his condition to request an examination by a consultant with a view to carrying out a laparotomy - an exploratory stomach operation. During the night the consultant did visit Ian. He requested more fluids but failed to order the laparotomy. Independent experts later found that had this procedure gone ahead, it probably would have saved Ian's life. The next morning another junior doctor was sufficiently concerned to call for another consultant review. This was never done.

"When I arrived on Saturday morning Ian looked dreadful," remembers Debra. "He was grey and clammy. I stayed for the rest of the day, nursing him, and went home scared."

On Sunday morning, after his emotional call to Debra, Ian was seen by the on-call physician, a geriatric consultant. After considering the notes of the two junior doctors, she found nothing that warranted immediate action. "When we arrived at the hospital around mid-morning Ian was lapsing in and out of consciousness," said Debra. "He was covered in vomit and had wet himself. I changed him, but when I asked for clean surgical stockings the nurse said there were none left in his size. "I couldn't change his T-shirt without help, because of his drip, but I was told by the nurse she was too busy and to leave him dirty."

As night fell, Ian told Debra to go home to Ben. "I was frightened to leave him, but he said he'd hang on until the morning ward round and a doctor would help him. I left in tears." An hour later, Ian was struggling to breathe. A junior doctor suspected a collapsed lung and, while undergoing a chest X-ray, Ian suffered a cardiac arrest and was resuscitated. However, by the time Debra and other family members arrived, Ian had suffered another arrest and died.

"My father was shouting at the staff saying they had murdered Ian," says Debra. "I asked to see a doctor who had been with him when he died, but no one came." Two days after Ian died, Debra told four-year-old Ben that his father had gone to Heaven. He was inconsolable and later saw a psychologist to help him cope with his grief.

A spokesperson for the Princess Alexandra NHS Trust said: "The trust looked into Mrs Luck's complaint thoroughly in 2002 and we have taken on board many of the issues raised, particularly with regard to communication between doctors, nurses and patients. "Since then we have introduced training both for nursing and medical staff and we continue to strive to improve in this area. "The trust offers Mrs Luck and her family best wishes for the future."

This is little consolation to Debra. "If I had that time again I would not let the nurses fob me off, or try to tell me that it was normal to leave patients in filth. "I wouldn't allow the doctors to make me feel I was being a nuisance. I would raise the roof until my loved one got the help he needed and I'd advise anyone else to do the same. "Ian was a kind man who enjoyed helping other people. It is a tragedy that when he needed help, in the very place he should have got it, there was none."

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