Paramedics said there was a four-hour wait with a queue of ambulances in front of them
A 91-year-old woman died after waiting for four hours in an ambulance to be admitted to hospital. Christina Chisholm, 91, was taken to A&E at Raigmore Hospital, in Inverness, on December 8 after she developed breathing difficulties.
The ambulance arrived at the site shortly after 11pm, at which point daughters Elizabeth McDonald and Grace Chisholm were told she faced a likely four-hour wait to be admitted, with three other ambulances queuing ahead of them. Christina had been unwell for several days and a GP had visited her out of hours the night before she was taken to hospital.
“She suggested she could go into hospital then, but mum was always absolutely clear that she never wanted to go in unless it was to be treated for something that could only be cured by going there,” Elizabeth said. “Otherwise she wanted to stay at home and she had a DNR (do not resuscitate) note in her records.”
The following night, after Christina’s condition worsened, they called the GP again, looking for another home visit. At that point they were advised to call an ambulance. Christina was unwilling but was eventually persuaded that this was the right thing to do.
Paramedics gave her access to oxygen and, Elizabeth said, the difference it made was immediately obvious. “While she was taking that, her [oxygen] levels were at 99, which was excellent,” she said. “But as soon as it was removed that level immediately dropped.”
Christina was eventually persuaded to go to hospital and she was placed in the ambulance, with Elizabeth and Grace following by car. When they phoned for the ambulance they assumed it would be to take Christina to Nairn Town and County Hospital, but paramedics told them that was not the procedure and they found themselves heading for Raigmore.
On arrival they also discovered for the first time that Christina was not going to be admitted straight away. “The paramedics cared for her throughout her wait – we don’t want to blame any one individual for what happened,” Elizabeth said, “but as time was going on my mum was finding the oxygen mask more and more irritating and she was starting to feel quite claustrophobic in the ambulance where myself and my sister were being allowed to wait with her.”
Christina asked if she could go into the waiting room instead, but was told this was not possible as she required oxygen and that could not be administered in the waiting room. A nurse came out to check on Christina at around 3.30am – the first time she had been assessed by hospital staff. Shortly after, at about 4am, Elizabeth said her mum said she needed to go to the toilet.
The paramedics then took her in on a chair while Elizabeth and Grace made their way into the A&E waiting area. “Within about two minutes of getting in the door we heard an alarm going off and then shortly after that a paramedic came and told us we needed to come through,” Elizabeth said. “We were told that mum had had a turn in the toilet and that the doctor needed to speak to us.”
Elizabeth and Grace were then told that their mum’s heart had stopped, she was in resus and they needed to go in quickly as she didn’t have long. She died shortly after. “I thought immediately that she was 91 and if it was just a case that her heart had given out, well, you could console yourself with that,” Elizabeth said.
“But there was a kind of atmosphere when they were telling us that she had passed away, among the staff – they all seemed really upset – that made me think there was something more going on here.” At a subsequent meeting with hospital authorities Elizabeth said they were told by a consultant that the wait in the ambulance had been the cause of Christina’s death as she did not receive the care she required.
They were told that, had she been admitted to hospital sooner, “she would still be with us”. It also became clear that oxygen had not been taken with Christina from the ambulance to the toilet and Elizabeth says the hospital later confirmed they believe this was a contributing factor to the final outcome.
Because of the manner of her death, a police investigation and post-mortem examination had to be carried out, delaying Christina’s funeral until Christmas Eve, which Elizabeth described as “horrendous”.
The cause of death was ruled as RSV, the virus Christina had at the time, exacerbated by COPD – a condition the family said she had been diagnosed with but never directly treated for. “She had asthma,” Elizabeth said.
The matter is now in the hands of the procurator fiscal. It is the family’s belief that, if Christina had been told that she would have faced such a long wait to be admitted to hospital she would not have agreed to go and, despite what that might have meant for her health, she should have been given that choice.
“She had full capacity,” Elizabeth said. “She knew what she wanted. If she had decided not to go to hospital then we would have requested a GP home visit. “We believe a GP referral would have allowed her to be admitted direct to a ward and not A&E. That is what should have happened.”
Elizabeth and Grace said they were also shocked by how routine and accepted the long wait their mother faced at Raigmore seemed to be. “We blame the system,” Elizabeth said, summing up the whole family’s thinking about what had happened.
“Paramedics are working in conditions that are not acceptable but they are coming to expect that on shift they will be sitting outside Raigmore Hospital for six hours or more – that’s not right. Something needs to be done about that.”
Originally from the Clydebank area, just outside Glasgow, the family moved to Nairn in the mid-1970s when dad John got a job as a pipe mill operator at the former McDermott’s yard in Ardersier. It was a family affair as Christina also worked there, in catering, and their children went on to get office jobs at the site.
Of their mother-of-six, who also had 22 grandchildren, three great-grandchildren and four great-great-grandchildren, Elizabeth said: “Dad passed away nine years ago but mum was still very active right to the end. She was able to stay in her own home with family nearby to look in on her; she did crosswords, took care of her own bills with online banking, got out and about regularly and always had goals – she was always looking to ‘what comes next’.
“Last year there was a family wedding she was getting to, and did, and this year she was looking forward to another two great-great-grandchildren coming. Well she just missed the arrival of one of them, just after new year, and another due in April. Even at 91, we feel she still felt in herself that she was capable and had a lot to live for. We just want to do what we can to make sure another family doesn’t have to go through what we have.”
A spokesperson for the Scottish Ambulance Service said: “We would like to extend our deepest sympathies to the patient’s family at this extremely difficult time. If the family would like to directly discuss any concerns about our response, we’d ask them to contact our patient experience team.”
For NHS Highland, a spokesman said: “Our sympathies are with the family at this time. Due to patient confidentiality it would however not be appropriate for us to comment on individual cases. We would encourage the family to contact us directly to discuss their case.”
