Secret 'not for resuscitation' code on pensioner's notes

Doctors treating a 66-year-old woman with cancer who developed an infection secretly noted that if she suffered a heart attack she should be left to die.

Jill Baker, who has since recovered, says neither she nor her husband was asked about the instruction on her notes during a stay at St Mary's Hospital, Portsmouth, last July. She discovered it when she requested the notes be sent to her because she was dissatisfied with other aspects of her care.

Mrs Baker, a retired teacher from Portsmouth, said yesterday she had found "Not for 555", written on her notes, a code meaning "not for resuscitation": 555 is the hospital number for the emergency team called to cases of cardiac arrest.

"Why should I be killed off just to save NHS money? My husband broke down when he discovered it. He said he thought they were going to help me, not kill me," she said.

The case was highlighted yesterday by the charity Age Concern, which has been campaigning against age discrimination in the NHS.

The charity said it had received six similar reports over the past six months of the notes of elderly people being marked "not for resuscitation" without their agreement or knowledge.

Hospitals routinely mark the notes of terminal patients with "not for resuscitation" to allow a dignified death and to spare unnecessary suffering. However, national guidelines say the decision must be based on the wishes of the patient or family.

Sally Greengross, director general of Age Concern, said: "The evidence points to a disregard of the national guidelines. Once again we hear from older people who believe they are written off by the NHS because of their age."

Mrs Baker developed cancer of the stomach a year ago, after having breast cancer. She was treated as an out-patient with chemotherapy and on one visit contracted an infection.

She was admitted to St Mary's Hospital in July 1999 with a high fever. After four days she discharged herself, claiming the standard of care wasinadequate.

When she asked for her notes she found the statement: "In view of the underlying diagnosis of metastatic breast carcinoma [breast cancer which has spread] and the palliative nature of the treatment [aimed at easing symptoms], in the event of cardiopulmonary arrest resuscitation would be inappropriate."

The notes were signed B Wilson. A spokeswoman for the Portsmouth Healthcare NHS Trust, which runs St Mary's, said B Wilson was a junior doctor who had left the hospital. "We have admitted to Mrs Baker that her notes were marked inappropriately. We do have a clear policy on marking notes with 'do not resuscitate' orders. It appears they were not followed on this occasion."

* Parents of 130 babies treated in a neo-natal unit were contacted yesterday because a doctor there had contracted tuberculosis.

Medical chiefs at Leicester Royal Infirmary, where the unnamed doctor worked from February to last month, said the risk to the babies was "minimal." However, special clinics were being set up for parents to take their babies.

Nick Naftalin, acting medical director of the University Hospitals of Leicester NHS Trust, said: "We recognise that the patient population that this doctor was caring for are particularly vulnerable."