Two missed chances to help tragic Inga: Twin sister of woman who died in crowded A&E hits out over hospital failings

30 August 2024, 00:02 | Updated: 30 August 2024, 09:30

The sister of a woman who died after being found unresponsive in an A&E department has criticised the NHS trust for not doing enough to improve patient safety and for failing to communicate with her family.

Mother-of-two Inga Rublite, 39, attended Queens Medical Centre, Nottingham, at 10:30pm on January 19 complaining of a severe headache, blurred vision and nausea.

Staff in the A&E department later discovered her beneath a coat covered in her own vomit and urine.

After being transferred to intensive care, Inga was found to have sustained “significant, irreversible” brain damage. She died two days later.

Following LBC’s reporting of Inga’s case, an inquest was called to assess the circumstances surrounding her death. Last month, that inquest concluded that whilst a “catastrophic bleed” on Inga’s brain would likely have been fatal, the hospital missed two opportunities to treat her, failing to identify “persistent and escalating symptoms of brain haemorrhage”.

Read more: Woman who was found collapsed under coat at A&E after seven hours ‘might not have died if someone checked on her’

Read more: Mother, 39, collapsed under her coat and died after seven-hour wait at crowded A&E

In an interview with LBC shortly after the inquest’s conclusion, Inga’s twin sister, Inese Briede, said she is no closer to closure, and lamented the hospital’s treatment of her family.

Asked whether the hospital had done enough to keep in contact with her, Inese bemoaned the lack of communication: “No [they have not been good at keeping us updated]... they provided me with the steps that they’re going to change, and they told those steps at the inquest as well - [but] that’s it.”

Seven months on, Inese is struggling to comprehend both her loss and the circumstances surrounding her twin sister’s death.

She said: “It wasn’t just that we shared that sisterly bond. It was so much more than that. She was also my best friend.

“It seems to me that the aneurysm burst at the wrong time, she went to the hospital at the wrong time and she chose the wrong seat. It’s like it’s her own fault.”

Inga was examined twice at the A&E department, with the coroner finding that, on both occasions, her case should have been escalated to a doctor. Staff called her name three times between 4:30am and when she was discovered by ‘shocked’ staff at 7am.

Just ten minutes earlier, Inga’s name was read out for the last time in the emergency room, with the registering her as discharged when she did not respond.

The inquest also detailed the significant pressures that the hospital was under on the night of Inga’s death.

The A&E ward was described as “excessively busy” by Dr Elizabeth Didcock, an assistant coroner for Nottinghamshire, with seventy-six people waiting in the emergency department upon Inga’s arrival - more than double its safe capacity.

As a result, the hospital has implemented a series of measures designed to act as guardrails against a repeat of Inga’s case and improve patient outcomes. These steps include reviews of the triaging system and staffing levels, as well as installing a new public address system.

Although Inese welcomed the changes introduced by the trust, she feels they should go further.

“They are very good steps, yes, but I don’t think that’s enough,” Inese added. “I just can’t believe that Inga had to be a victim. I don’t think that was the only Friday when [the] hospital was overcrowded.”

Inese’s determination to ensure meaningful change is brought forward as a result of Inga’s death is palpable.

Though she lives in Latvia, she intends on travelling to the UK next month with the hope of meeting the health secretary to discuss other measures that can be brought forward.

Dr Peter Carter, who served as chief executive of the Royal College of Nursing for seven years, believes that given the pressures on emergency departments are not unique to Queens Medical Centre, the steps taken by the trust should be rolled out nationally.

“Because of the overcrowding in many A&E departments, there are places where people cannot be observed,” he said.

“At Queens, they had a capacity of 36 patients, but they actually had 76 patients and that sort of pressure is typical of what’s being experienced across the country.

“I think the steps that Queens have put into place are very, very sensible. The relooking at the triage service, reexamination of the staffing levels are all very sensible initiatives that will hopefully prevent another one of these terrible tragedies.”

Responding to LBC, Dr Manjeet Shehmar, Medical Director at Nottingham University Hospitals NHS Trust (NUH) said: “We would like to offer our sincere condolences to the family of Inga for their loss. Although due to the nature of the bleed on the brain the outcome is unlikely to have been different, we accept there were missed opportunities in Inga’s care and are truly sorry that we did not meet the standards we strive to deliver.

“We recognise there are times when our hospitals are under extreme pressure which can impact patient experience. Our teams continue to work hard to maintain safe services and improve flow across our sites. We apologise to patients who experience delays in their care, and continue to prioritise patients with the highest level of need.

“We have completed an investigation in order to assess and implement learning, and as a result have introduced changes in our Emergency Department to ensure we can deliver better care to patients and support our staff to do this in the future.

"We fully accept the coroner's findings, and are determined to take all action possible to improve our care.”