New Zealand - Investigation into the death of a disabled woman finds that the hospital staff did not understand her needs

According to the New Zealand Herald, an investigation into the death from "an undiagnosed infection" of a 52-year-old woman with muscular atrophy at Hutt Hospital ( Hutt Valley, Wellington region, New Zealand) found that the hospital staff did not understand her needs. From the article:

Following her death in May 2008 an independent review was commissioned by the Hutt Valley District Health Board.

Having encountered problems during previous hospital stays, the woman had met with doctors, managers and health board members to create a support plan which would be implemented during future visits, The Dominion Post reported.

However, the review found that while staff had tried to provide nursing care, they had "little understanding" of her needs.

Staff considered her demanding and were reluctant to respond to her requests for help.

Six days into her stay a dietician noticed a naso-gastric tube was draining away food as she ate it.

Four days later the tube was still in place.

After two weeks a feeding tube was inserted into her intestine.

The woman complained of pain but there was no consideration of whether the procedure had caused a bowel perforation.

She died four days later from peritonitis, brought on by a small cut to her bowel from the tube.

According to the article, the report says that the woman, who worked as an analyst with the Health Ministry's disability policy team, was seen by 27 different people, including 15 nurses, during her stay in hospital. It also says that "it's not clear if the woman might have survived had her weakened condition being detected." The health board has since appointed more permanent workers and reorganised the medical ward to form smaller teams with a senior nurse to oversee the care of each patient.

The story in full is here. See also this report by the Dominion Post.