January 16 - 22 2005 ~ The Killing Pens "pulls no punches when singling out those she considers to be the main culprits: countryside minister Carwyn Jones, Wales chief vet Tony Edwards and UK chief vet Jim Scudamore..." An article in the North Wales Weekly News describes Janet Hughes' book and her legal fight in detail. Read in full

The Ecologist, March 2005

July 23 2007 ~ "I request a full, proper explanation and a thorough investigation into why he was refused intensive care and into the events surrounding and leading up to his sudden death." Readers of warmwell will be distressed to learn of Janet Hughes' bereavement - and of her continuing efforts to discover why her partner, Glyn, was hospitalised under the wrong patient number, wrong GP Practice and why his death certificate also had the wrong number. She is very concerned that his treatment was wrongly administered. She is still hoping for answers. On the day of the inquest

N THE MATTER OF

THE INQUEST OF WILLIAM GLYN OWEN

__________________________________

STATEMENT OF JANET HUGHES

__________________________________

JANET HUGHES of Laurels Cottage, Churchstoke, Powys, Mid-Wales, SY15 6SR

WILL SAY AS FOLLOWS:

1. My partner of 18 years, Mr William Glyn Owen (Glyn) died at the Royal Shrewsbury Hospital on 18 February 2007, aged 69 years.

2. In June 2006 Glyn was diagnosed with inoperable non-small cell lung cancer. Dr Dhinakaran, the locum oncologist at Royal Shrewsbury Hospital, refused to provide radical radiotherapy treatment, even though the registrar to Glyns consultant, Dr Perks, had suggested that Glyn was fit enough for aggressive treatment. Dr Dhinakaran placed Glyn in stage 4 disease, insisting that there was metastasis to the liver. This was not the case, as an ultrasound scan had confirmed that there was no spread to the liver. My understanding is that there is an international system in place for the staging of lung cancer: the TNM system. T = tumour, N = lymph nodes, and M = metastasis. Dr Dhinakaran placed Glyn as being in stage T3, N3, M1, (exhibit 1.1) whereas Dr Garcia-Alonso in July 2006 placed Glyn in stage T3, N3, M0 (exhibit 1.2).

3. Glyn obtained a second opinion from Dr Garcia-Alonso, consultant oncologist at Glan Clwyd Hospital, Bodelwyddan, Rhyl, Denbighshire. Following a consultation with him on 22 July 2006 Dr Garcia recommended an immediate course of chemotherapy and this started on 26 July. Glyn underwent four courses of treatment (palliative), and coped very well throughout.

4. Dr Garcia saw Glyn at intervals during the treatment and at the end of it, following a CT scan, offered him radical radiotherapy of 52.5 Grays over four weeks. Documentation regarding this treatment is attached to this statement (exhibit 2). Glyn travelled the 160-mile round trip to Glan Clwyd Hospital daily for the four weeks to receive this treatment, which ended on 8 December 2006 and felt fairly well at this time.

5. Over Christmas Glyn developed influenza and felt poorly for several days. In late January his breathing worsened and we requested oxygen for him at home. This was delivered on 30 January 2007. He used it very infrequently and still went shopping to the local supermarket every few days. On 2 February Glyn had a consultation with Dr Garcia at Wrexham Maelor Hospital. Dr Garcia requested a CT scan in view of Glyns breathlessness and to rule out a pulmonary embolism. The scan was done that same afternoon and a Dr Smith told us that no evidence of an embolism was apparent. He told us that the scan had showed emphysematous change. The final report, which was not relayed to Glyn, states that the patients shortness of breath is most likely due to infection on a background of emphysema. This report is attached to this statement (exhibit 3).

6. On Monday, 12 February, the Macmillan nurse, Eirian Thomas, who had been coming to see Glyn periodically, visited us. She said that she would ask for some help with Glyns breathlessness and that she would be coming to see us the following Monday.

7. On Tuesday, 13 February Glyn went out to the supermarket but felt very unwell. By Friday, 16 February his condition had worsened and at 6.30pm I telephoned the out of hours ShropDoc service. A Dr Evans called to see Glyn at 8.45pm. He examined his chest and back and told us that Glyns chest sounded quite good and felt that he might be experiencing panic with his breathing and advised him to continue with the oxygen. We explained to him that Glyn was due to see a Dr Smith in Wrexham Maelor Hospital on the following Monday 19 February as Dr Garcia was away on holiday. The doctor left at around 9.15pm. Glyn then had supper of chicken and vegetables.

8. Glyns condition worsened during the night and at around 10.30am the following day, Saturday 17 February, I telephoned the advice line. The lady who answered advised me to telephone for an ambulance. The ambulance crew arrived at around 10.45am and felt it necessary to take Glyn to hospital. They left at around 11.15am. He was taken to the A&E department of the Royal Shrewsbury Hospital. I telephoned an hour or so later and was informed that Glyn was having x-rays taken. I telephoned again about an hour later and was told that Glyn had been transferred to the Medical Emergency Centre at the hospital.

9. In the afternoon I went with our son Matthew to visit Glyn and at that time, around 3.30pm, he was still in the Medical Emergency Centre. A nurse explained to me that Glyn was being treated for bilateral pneumonia. I then told Glyn that he had pneumonia. He had obviously not been told this, as he seemed fairly shocked. We stayed with him and approximately an hour later, at around 4.30pm, a nurse came to say that a bed had become available on Ward 21. I later discovered that this was the ward for cancer patients and could not understand why Glyn was being placed on this ward when I had been told that he was being treated for pneumonia. As Glyn was taken to the ward a medical officer came to speak with Matthew and myself. He took us into a room and informed us that they were giving Glyn two types of intravenous antibiotics for bilateral pneumonia. He went on to say that they would monitor his response for around 6-24 hours. He told us that the next stage for patients, in the absence of a positive response to the antibiotics, would normally be intensive care. However, to my dismay, he told me that this option would not be provided for Glyn. I asked if this was because he had cancer and the officer told me that this was the case. He also told me that Glyn had agreed to this. I do not believe this to be the case at all. Glyn was so ill at this time and did not even know which hospital he was in. He thought he was in Wrexham Maelor hospital and would have been devastated had he known they would not be offering him intensive care.

10. We then went to sit at Glyns bedside on Ward 21. I told him I had brought his wash bag and he asked if I had put his toothbrush in. He asked me what ward he was on and I told him. He asked me why he was on a cancer ward. I had no proper answer but tried to reassure him by saying they knew how to help him. He told us that he really would like a cup of tea and I asked a nurse if he could have one, as I had also done in the Medical Emergency Centre. However, nothing had been provided there. A nurse brought him a cup of tea and I helped him drink a little of it. He was being given oxygen through a mask alternated with, I think, a nebuliser of prednisolone which I understand to be a steroid. He told me that he was hungry and hadnt eaten at all. I gave him some egg sandwich and asked a nurse if he could be given some food. She said some would be provided but this does not appear to have happened.

11. He said that they kept asking him if he was in pain and that he told them he had no pain. The cancer was under control; he had pneumonia which I understand to be a reversible and treatable illness, for which he required critical care. He asked me if they would be letting him come home that day and I said that it would not be that day but very soon.

12. Whilst Matthew and I sat by his bed Glyn was given more intravenous antibiotics. He was also given an anticoagulant injection into his stomach.

13. A nurse asked if we would like to stay for the night. She said that a bed could be made up next to Glyn in a side room. I explained that we had to return home as our dogs were shut in and needed to be fed. Before we left, a doctor came to look at Glyn. He said nothing to any of us and did not examine Glyn. He then went to speak with a nurse at the desk nearby. At approximately 7pm we left to come home to feed our cats and dogs. Glyn was still having difficulty with his breathing but seemed a little more at ease and his colour was better. He was hungry but still no food had been brought for him and I do not think he was given any food at all throughout the whole day.

14. At 9.30pm I telephoned the ward as I had been advised to do. A night nurse called Marjorie told me that Glyn was very poorly and mentioned the fact that I could stay there for the night. She said that he had said he would like to settle down for the night but wanted to go to the loo. She said he had agreed to a catheter. She also said he had refused to have blood taken. I do not understand this, as this was highly contrary to Glyns nature. Marjorie said they needed more blood as an earlier sample had haemolysed. I told her to say to him to allow them to take the sample. At around 10pm I decided that we would return to the hospital in view of the nurses comments as to his condition and I telephoned the ward to tell the nurse that we would return to the hospital to be with Glyn.

15. At 10.30pm I drove back to the hospital with Matthew. We arrived on the ward at around 11.30pm and were taken to see Glyn who was now in a side room on his own. I asked the nurse, Marjorie, if she had taken any blood but she said she hadnt done it yet. I was surprised at this, as it had been deemed important over an hour prior to us arriving there. Glyn was very pleased to see us and I noticed immediately how much better he looked. I felt so relieved. I remarked that the antibiotics must be working, and the pneumonia obviously responding to the treatment. We told him that Matthews friend Nathan was worried about him and Glyn asked if we had seen Nathans father. He was able to speak without being breathless. I asked him how his breathing felt and he said it was more tolerable now. He told us he had had a shot of morphine. Both my son and myself wondered why. The nurse named Marjorie, came back into the room and told us she was going to give Glyn some morphine and that he had agreed to have it. She said it was to calm him down. I was very confused because he had just said that he had already had some. She put an amber ampoule onto the bed and went out of the room. I almost picked it up to look at it but she then returned. She administered the injection to Glyns stomach. This was at approximately 11.40pm. A few minutes later she took some blood samples. We stayed with Glyn until shortly after midnight and then said goodnight. I told him we were just around the corner in the accommodation and said to him that we would see him in the morning. I wanted to let him get some rest.

16. I said to Matthew that I felt Glyn would be better by the morning, as he was responding so well to the antibiotics. Around an hour and a half later, just after Matthew and I had settled down to sleep, a knock came on the door. A nurse said that his condition was deteriorating. We quickly followed her and found him slumped back on the pillow, with very depleted, congested breathing. He was trying to gasp for breath, but died within a couple of minutes. No moves at all were made to resuscitate him and the nurse said he was taking his last breath. The whole situation was completely overwhelming and dreadful. I sat by his side for a few moments but the nurse then said she must straighten him out. I noticed how stiff his arms were and his fists were clenched.

17. The nurse, Marjorie, said to me that Glyn was no longer in any pain. I told her that he had not been in any pain. She looked blankly at me.

18. We sat with Glyn for quite a long time. A couple of hours earlier he had been looking so much better and I had been so relieved. Now he was dead.

19. We went back to the accommodation room eventually at around 3.45 am, after telephoning Glyns daughter to tell her what had happened. She had planned to come to see her father the next morning with his grandchildren.

20. Before we left the hospital the next morning we went and collected Glyns pyjamas and watch. His body was still there in the side room, some 6 hours later. We then left the hospital, at around 7.30am on Sunday 18 February.

21. On Monday, 19 February I telephoned the hospital to ask about the death certificate. I was informed that because Glyn died within 24 hours at the hospital, his death had to be referred to the coroner. By Wednesday morning this had still not been done. I had to request repeatedly for it to be sent to the coroner and on Wednesday it was sent through.

22. I then requested a post-mortem, as I was not satisfied that the hospital had done all they could to save Glyns life whilst he was in their care. The post-mortem took place in the afternoon on Thursday 22 February. The pathologist was Dr Kenneth Scott. It was completed before 4pm and I was told that Dr Scott had concluded that Glyn died of natural causes and that the 2.5mg of diamorphine had not contributed to his death. It was not until the following day that I discovered that diamorphine should not be administered to a patient who is suffering from chronic obstructive airways disease, as Glyn was and is stated in his hospital records. It is also not prescribed for someone with pneumonia.

23. I requested that there be a blood test, as the pathologist did not order one. In his evidence given regarding the Harold Shipman case, he cited morphine as being highly dangerous for patients with respiratory problems, such as asthma. This is recorded in the British Medical Journal among other publications and the relevant page from the British Medical Journal is attached to this statement (exhibit 4).

24. Glyn was given diamorphine and a further drug, which we saw being administered at around 11.40pm on Saturday 17 February. I understand that diamorphine comes in clear glass ampoules as white powder to be reconstituted for injection and morphine as a clear solution in clear glass ampoules. The drug I saw being administered must have been a light-sensitive drug as it was in an amber/brown-coloured ampoule and was not in powder form.

25. My understanding is that the manufacturers product information sheet clearly states that diamorphine is contra-indicated for obstructive airways disease and this information is attached to this witness statement (exhibit 5). This information is also contained within the current Medicines Compendium, held by pharmacists including Boots the Chemists. This sheet is also attached to this statement (exhibit 6). NetDoctor, a web site with medical information for members of the public and health professionals, contains information on diamorphine. It states that diamorphine is not to be used in chronic obstructive pulmonary disease (COPD) (exhibit 7).

26. Glyns pneumonia was beginning to respond to the antibiotics within just a few hours, as both our son and myself witnessed just two hours before he died and I believe that he would have recovered had he not been given diamorphine. His condition was not deteriorating.

27. I have had the opportunity to read Glyns hospital records and I understand that a non-resuscitation order was made at or about 1.30pm on 17 February 2007, only an hour and a half following his admittance to the hospital. This decision was made whilst he was still in the A&E section and it was made under an incorrect patient number. Glyns patient number was 033908A, but he was given a wrong number of 788764 and a wrong GP Practice, in Donnington, Telford, Shropshire. The certification of his death is also under the wrong number of 788764. Shropshire County Primary Care Trust Policy on Cardiopulmonary Resuscitation, states at 4.3, that responsibility for the DNAR order lies with the Consultant or GP in charge and must be communicated to all relevant health professionals. It is also their responsibility to enter the DNAR decision in the patients medical records including the rationale for the decision and those who are involved. The same standards are contained within the Cardiopulmonary Resuscitation: Standards for Clinical Practice and Training: A Joint Statement from the Royal College of Anaesthetists, the Royal College of Physicians of London, the Intensive Care Society and the Resuscitation Council (UK), (exhibit 8.1). The decision to place a non-resuscitation order on Glyn was made by a Senior House Officer (SHO), in the A&E: not the consultant Dr Metcalf. No rationale for the decision was placed in his records. The decision not to provide CPR seems to have been made under an assumption that Glyns condition was terminal and that he had received palliative radiotherapy, when in fact he had received radical, curative radiotherapy at Glan Clwyd Hospital. Pages with the relevant sections from the Resuscitation Policy document are attached to this statement (exhibit 8.2).

28. The NICE Guideline for Chronic obstructive pulmonary disease states that patients with exacerbations of COPD should receive treatment on intensive care units and this information is attached to this statement (exhibit 9). I request a full, proper explanation and a thorough investigation into why he was refused intensive care and into the events surrounding and leading up to his sudden death.

__________________________

Janet Hughes

Laurels Cottage

Churchstoke

Montgomery

Powys

Date:________________

Jan 29 2003 ~ Janet Hughes is charged £17,000 for daring to question the postcode killing of the FMD policy and the new draconian provisions of the Animal Health Bill

Jan 30 ~ Janet Hughes

Jan 31 ~ "Defra claim they have no option but to take Miss Hughes' possessions to recover taxpayers money,

Feb 1 ~ Janet Hughes and the demand from DEFRA for £17,000 in costs

Feb 2 ~ the arguments used to persuade the farmers to part with their flocks in the Brecon Beacons were based on the assertion that these flocks must have been heavily infected. Nothing could have been further from the truth.

Feb 2 ~ "Defra fights dirty with anti-cull campaigner"

Feb 3 ~ Concern for Janet Hughes continues

Feb 7 ~ Janet Hughes, still waiting to hear for herself that she has won a last-minute reprieve.

Feb 12 ~".. local reporters have been finding out as much as they can for me from DEFRA , and otherwise I would have been kept quite in the dark."

Feb 14 ~" I have written to the judge, Mr Justice Stanley Burnton, who made the order for costs against me on 11 October 2001..."

Feb 14 ~ Janet Hughes' cheque already processed - but High Court denies receiving the application

Feb 17 ~ Janet Hughes' property is still under threat from DEFRA

Feb 19 ~" The High Court has still not acknowledged my application, even though I have telephoned them and written to them twice"

Feb 21 ~ Defra Dilley-Dalleys over Janet Hughes.

Feb 21 ~ "the newsdesk has been holding onto his reports on the issue," says Janet Hughes

Feb 21 ~ "..the bailiffs left no contact number, gave no ID nor notice of authority."

Feb 22 ~"I confirm that Defra will not take any further action against you at the present time."

Feb 24 ~" I can show that they have certainly not acted in accordance with the law in this instance.."

Feb 26 ~ "The way in which the High Court has acted has made me very angry indeed."

Feb 27 ~ Janet Hughes' worry goes on and on

March 2/ 3 ~ Defra courts confusion

March 24/25 ~ "It is so deceptive. They say they have no idea as to how the warrant was in fact issued."

March 28 ~ I am sending you a copy of a letter faxed through to the High Court today.

April 5 ~ The collusion between the High Court and the government really needs a public airing

June 1 2003 ~ "just wanted to let you know what is happening re this issue of Defra etc."

August 14 2003 ~ "This Defra business looks as if it is coming to an end at last. .."

Aug 17 2003 ~ "Yesterday I handed over the cheque to the solicitors and DEFRA will receive it on Monday."

Aug 28 ~ Janet Hughes' story appears in Private Eye

Aug 30 2003 ~ A footnote to the Janet Hughes story.

December 28 2003 From Booker's Notebook round-up of 2003 Sunday Telegraph

June 23 2004 The Killing Pens

July 3 ~ Ordering "The Killing Pens" Janet Hughes will be unable to complete the printing

September 7 2004 ~ The book is now published.

December 3 - 7 2004 ~ Chief vet Jim Scudamore's signed witness statement a "fiction"?

The Ecologist, March 2005

THE INQUEST OF WILLIAM GLYN OWEN

STATEMENT OF JANET HUGHES

JANET HUGHES of Laurels Cottage, Churchstoke, Powys, Mid-Wales, SY15 6SR