A woman died from a seizure days after waiting for more than eight hours in a crowded A&E waiting room, an inquest heard yesterday.
There were ‘missed opportunities’ to check on Inga Rublite who suffered ‘significant, irreversible’ brain damage after she was found unconscious under her coat in the Queen’s Medical Centre (QMC) in Nottingham on January 20 this year.
The inquest was told that she died two days later from a brain aneurysm which caused a ‘massive bleed’ on her brain and could not be contained with surgery.
The 39-year-old mother-of-two had called 111 on January 19 with a sudden headache, neck pain, and blurry vision feeling ‘as though hit by a brick’.
Ms Rublite then spoke to a clinician on the phone and was advised to go to hospital, where she arrived at about 10.30pm that night.
Inga Rublite, a 39-year-old mother-of-two who died two days after having a seizure in A&E
Staff called out in A&E three times for Ms Rublite in the early hours of January 20 and rang her mobile phone with no answer.
But her twin sister, Inese Briede, who still lives in their home country of Latvia, said there was no missed call on her phone.
Nottinghamshire coroner Elizabeth Didcock said: ‘There were three opportunities for the headache to be recognised as something more dangerous than it was thought to be.’
At 6.50am, staff registered Ms Rublite as discharged thinking she had left of her own accord.
But 10 minutes later staff found her ‘tucked behind a door with a coat tucked over her face, seemingly asleep’, but when they looked closer she appeared to fit.
According to Luke Derby, an emergency department matron, Ms Rublite had been sat in the main waiting area where it was ‘reasonable’ that staff would have walked past, but she would ‘not be physically seen’ by the person calling for her.
Inga Rublite (left) is pictured with her twin sister Inese Briede (right), who lives in Latvia
Mr Derby said: ‘We have moved the chairs where Inga was sat because they have poor visibility from the navigator’s desk. They have been moved so people can’t sit there.’
Mr Derby also confirmed that it was ‘not unusual’ to see patients with coats over their heads, especially during night shifts.
The inquest heard the waiting room was overcrowded because the emergency department’s maximum capacity was exceeded that night.
Ms Didcock said: ‘I’m aware from the investigation report that there was significant crowding and additional numbers of people.
‘I’m aware that is the background to it and has been for some time.’
Robert Jamieson, A&E consultant at the QMC, said: ‘As soon as you start to put all these targets in and look at the number of staff to do that, it becomes unachievable.
Ms Rublite was found unconscious under her coat in the Queen’s Medical Centre, Nottingham
‘We are competing with needing observations done every two hours.
‘The constant barrage of needing to do the next thing with the next person means that these things that seem so obvious don’t happen.
‘There was an opportunity missed to see how she was, how the pain was, and how she appeared, but that didn’t happen.
‘Unfortunately, Inga was sat there, and she was missed.
‘We have talked about lots of options and the investigation has talked about lots of options in terms of checking who’s in the area and managing the space.’
The inquest continues.
