Doctors twice placed 'do not resuscitate' orders on medical notes of Janet Tracy, against her and her family's wishes
A dying woman was “badgered” by doctors so much about agreeing to a do not resuscitate order that she was reduced to terrified tears, her husband said today.
Janet Tracey, 63, had been determined to fight cancer but within days of being admitted to hospital after a car crash, she became “anxious and distressed”.
“At one point she told me they were trying to get rid of her and I told her not to be silly, which proved to be a mistake. She was panicked. They were questioning her all the time about a DNACPR (do not attempt cardio-pulmonary resuscitation order),” her widower David Tracey told the High Court today as he explained that he and his daughters asked for the order to be removed.
Days later, on 7 March last year, Mrs Tracey died after second DNR was placed on her files, explicitly against her family's wishes. Cambridge University Hospitals NHS Foundation Trust are disputing the case, insisting relatives were consulted and agreed to the order.
In a landmark case, lawyers for Mr Tracey and his late wife are seeking a full judicial review into the matter as well as the laws surrounding do not resuscitate (DNR) orders which have become increasingly controversial and the subject of several legal cases.
The case against the Cambridge trust and the Health Secretary raised “real issues of public importance,” the family's QC Philip Havers said yesterday, adding that the solicitors had been contacted by a large number of people “who have suffered similar experiences”.
Separately today Care Services minister Norman Lamb said hospitals that fail to consult adequately with patients and their families on matters such as end-of-life decisions could face legal action.
Despite being diagnosed with terminal lung cancer, Mrs Tracey had been determined to “soak up all the joys of life” and agreed to take part in a clinical trial, her daughters said. But two weeks later, on a trip to buy food for a family Sunday roast, she was hit head on by another car and suffered a broken neck, ribs and clavicle.
She was transferred to a specialist unit at Addenbrookes hospital, Cambridge, where doctors decided within days to place a DNR order on her records. While the hospital insists this was with the family's consent, they categorically deny the issue was ever discussed with them and asked for it to be removed.
“She broke down in tears at the fact that it had been put on at all. Obviously we tried to reassure her that it was clearly nothing to do with us, which it was not. She was just shocked,” explained Mr Tracey, a 65-year-old retired engineer. “I would rather they hadn't kept badgering her all the time. They told her she had a one per cent chance of leaving hospital. What sort of thing is that to say to someone in hospital?
“She didn't want a DNACPR and it was not my decision to make, it was hers, it was her life.”
One of her four daughters, Alison Noeland, told the court that, despite doctor's reservations that CPR could be painful for Mrs Tracey, who had been given six to 18 months to live because of cancer, the former care home worker was knowledgeable and aware enough to make her own decisions.
“My mum's tolerance for pain and her hunger for life were very, very strong. My mum could do pain,” she said.
The day the first DNR was placed on her file – 27 February – her mother had begged her oncologist not to exclude her from a clinical cancer trial as she would “do her damnedest”. That night she appeared to be doing well despite ventilation being withdrawn and was happy and “doing a jig in her bed”, Mrs Noeland said.
Opening the case for the family, Mr Havers pointed to numerous annotations in Mrs Tracey's medical notes that indicated she wanted to be resuscitated. Yet the family were shocked to find upon her death on 7 March that a second DNR had been added two days earlier. The Trust claims it was with the agreement of three of her four daughters.
During the ten-day hearing, Mrs Justice Nicola Davies is considering evidence to determine issues of fact before a full judicial review in February, which will seek to clarify whether there is a legal duty to inform patients with capacity whether a DNR has been placed on their notes and whether they have any right to be consulted about it.
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