THE clinical manager at a heavily-criticised hospital where a elderly patient died nearly 15 years ago has told an inquest that she was given medication to help ease her pain in her final days after her condition deteriorated.
Philip Beed, a nurse in charge of the Daedalus ward at the Gosport War Memorial Hospital (GWMH), said that when patients such as Gladys Richards were placed on syringe drivers, a device which continuously administers drugs, they were likely to die.
The inquest at Portsmouth has heard that Mrs Richards, 91, was taken to the Hampshire hospital in August 1998 for recuperation following a hip operation after she had a fall.
But after she suffered a haematoma, Mrs Richards, of Lee-on-the-Solent, Hampshire, was given diamorphine administered through a syringe driver and died four days later on August 21, 1998, the hearing was told.
Her daughters, Gillian Mackenzie and Lesley O'Brien, have campaigned for several years for a full inquest to be held into her death.
Mrs Mackenzie, of Eastbourne, East Sussex, has told the hearing that the hospital's medical staff placed her mother on a course of palliative care which ''condemned'' her mother to death.
Mr Beed told the hearing that when Mrs Richards was admitted to the hospital for rehabilitation she was ''confused and agitated''.
He said: ''I did not think at that point she would die but I did think it would be difficult for her to regain mobility.''
But Mr Beed said that a note made by Dr Jane Barton, the doctor responsible for the ward, on Mrs Richards' file, which stated that she would be happy for nurses to certify death, was standard practice.
He said: ''Because we were a community hospital and because we relied on out-of-hours cover, it wasn't uncommon for Dr Barton, with the type of patients we were dealing with, to cover all possibilities.
''With any patient, even if we are planning rehabilitation, their condition may deteriorate.''
The inquest was told that Mrs Richards had a further fall at the GWMH and was taken for a further hip operation before going back to the hospital on August 17.
Mr Beed said her condition had worsened by this stage.
He said: ''She was in considerably more pain, some of that pain was from the hip, my impression was that it may have been more generalised in nature as well.
''She was generally less responsive, getting her to eat or drink was difficult for nursing staff, helping her with personal hygiene was more difficult.
''She was being nursed in bed and it was felt there was nothing else we could do but nurse her in bed.''
He said that Dr Barton then prescribed for Mrs Richards to be placed on a syringe-driver to relieve her pain.
He explained that Dr Barton set the parameters for the dosage but the level used could be applied on the agreement of two nurses.
When asked by coroner David Horsley if this was deemed to be terminal care, Mr Beed agreed and said that this was discussed with her daughters.
He said: ''I think that was the feeling at this point, as she was a patient who wasn't getting better, whose symptoms were running out of control.''
He added: ''We discussed (with the family) that this was the expected outcome of this stage of treatment.''
Mr Beed also said that a patient on a syringe driver could die in a short period of time or as long as several weeks.
A previous inquest, specially authorised by then Justice Secretary Jack Straw, was held in 2009 into the deaths of 10 other patients at the same hospital, all in the late 1990s.
The jury found that medication had contributed to the deaths of five patients and three of these had been given ''unsuitable medication''.
And the General Medical Council (GMC) has also ruled that Dr Barton, who has since retired, was guilty of multiple instances of professional misconduct relating to 12 patients who died at the hospital.
The panel found a catalogue of failings in her treatment of the patients, who later died, including issuing drugs which were ''excessive, inappropriate and potentially hazardous''.
The failings included inadequate examinations of patients, failing to consult colleagues and poor note-keeping.
Hampshire Police previously conducted a criminal investigation into the deaths of 92 elderly patients at GWMH but no prosecutions were brought.
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