Diabetic ex-nurse died of natural causes - inquest

A DIABETIC former nurse who had chronic lung, heart and kidney failure died of natural causes, days after being turned down for intensive care treatment, an inquest heard.

For 20 years Yvonne Coulson, from Pill, had been living with diabetes, chronic obstructive pulmonary disease, osteoporosis, asthma, limited mobility, a suspected leaking kidney and an irregular heartbeat, the inquest at Gwent Coroner's Court sitting in Newport heard yesterday.

In August 2012, Mrs Coulson, 69, lost her appetite and became lethargic while complaining of stomach pains, her husband Patrick Coulson told the court.

After contacting several on-call doctors she was admitted to Newport's Royal Gwent Hospital on August 3 where she was treated for severe dehydration.

Despite being given an initial discharge time of 24 hours, her chest became wheezy, her heart rate shot up and her oxygen level started to drop while potassium levels crept up, which meant she was kept in hospital and submitted to regular tests.

The court heard from Dr M Biswas, the consultant physician specialising in diabetes who took over Mrs Coulson's care in the early hours of August 6.

She said due to her general frailty and the large number of chronic illnesses she was suffering from simultaneously, Mrs Coulson, who smoked 10 cigarettes a day, was not a candidate for intensive care admission.

As her condition worsened, she was put on a drip and given antibiotics and nebulisers on the ward, as well as morphine when she became distressed, but soon stopped passing water altogether.

Being on the ward wasn't improving her condition, said Dr Biswas, so she was sent home with palliative care.

Hours later she died, said Mr Coulson, who told the court he felt "powerless" when he tried to tell staff that he felt his wife's ailing kidneys should be treated by a renal specialist.

Both Dr Biswas, and critical care consultant Dr Nicholas Mason told the inquest that due to the number of chronic illnesses Mrs Coulson was suffering from, she was "at risk of sudden abrupt acute decline at any moment".

Dr Mason said: "By admitting her to intensive care we would not have increased her chances of surviving. She was a retired nurse, she had full capacity and was able to comprehend, retain and weigh information."

Three intensive care consultants and one renal consultant all came to the same conclusion not to admit Mrs Coulson to intensive care, he said, which is only used to treat reversible conditions, not chronic problems.

A post mortem examination revealed Mrs Coulson died of multiple organ failure and Gwent coroner David Bowen recorded a verdict of death by natural causes, for which treatment was deemed inappropriate due to chronic conditions as a result of her frailties and co-morbidities.

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