Portsmouth 88-year-old grandmother who died after five-hour wait in ambulance and two hours on a hospital trolley ‘did not suffer neglect’

Josephine Smalley, 88, of Manners Road, Southsea, died on New Year's Day 2018 at QA Hospital.
Josephine Smalley, 88, of Manners Road, Southsea, died on New Year's Day 2018 at QA Hospital.

A CORONER has ruled that an 88-year-old woman who died after a five-hour wait in an ambulance and two hours on a hospital trolley did not suffer from neglect and died of natural causes.

As reported in January, Josephine Smalley endured the wait at the Queen Alexandra Hospital in Portsmouth after her family called for an ambulance after she suffered breathing difficulties at her home in Southsea.

The Portsmouth inquest heard that her family called for an ambulance just before midnight on December 30 and it took an hour to arrive at her home and it was another hour before they departed for hospital.

She then spent five hours in the ambulance before being moved on to a trolley in a hospital corridor for two hours before she was found a bed.

The inquest heard that Mrs Smalley was monitored and given refreshments while awaiting a bed but she suffered a heart attack in hospital and died in the early hours of New Year's Day.

The hearing was told that during the New Year period, the Queen Alexandra, along with hospitals across the country, was under ‘extreme pressure’.

Pathologist Dr Judith O'Higgins said that a post-mortem examination showed that Mrs Smalley suffered from chronic heart disease and died of a heart attack with contributory factors including peritonitis from an ulcer.

She said: 'The heart muscle was massively enlarged, there is nothing you can do about that, there was such limited blood flow to the heart muscle. There is nothing in my opinion that could have been done to alleviate that.'

Recording a verdict of natural causes, coroner David Horsley said: 'It's distressing to think of someone kept in an ambulance and on a hospital trolley for hours before being admitted to a bed.'

He continued: 'Hospital staff were dealing with an almost impossible situation on that Sunday night but from the evidence, her care and attention was not different and in some respects better than it would have been had she gone straight into a hospital bed.'

He added: 'I do not believe on the balance of probabilities that either her time in the ambulance or the trolley or the fact that she was undergoing a myocardial infarction which was not diagnosed until Sunday afternoon amounted to neglect contributing to her death from the consequences of long-standing disease.'

Her daughter Lesley Bryant told the inquest by videolink from Australia: 'I think she was neglected, I think she was old and a smoker and they thought she was less deserving than anyone else and I think that should be changed for old people and all smokers.'

Dr John Knighton, medical director at Portsmouth Hospitals NHS Trust, apologised to Mrs Smalley's family and said it had worked with staff to improve patient flow ahead of this winter.

He said: 'The delay Mrs Smalley experienced is unacceptable and we are extremely sorry.

'While we cannot predict how severe this winter will be, we are better prepared this year than we ever have been.'