Norwich: Woman faced 20-hour ambulance wait, inquest hears
The court was told that Alexis Mary Oxley-Brennan (72) spent the last week of her life at her bedside in her home in Norwich after she became increasingly ill.
Before that, she was waiting for an appointment from the memory clinic at Julian Hospital after concerns about her short-term memory and hoarding tendencies to hoard and hide soap and toothpaste.
Outside Norfolk Coroner’s Court – Picture: Donna-Louise Bishop (Image: Newsquest)
Assistant Coroner Samantha Goward led the inquest into the death at Norfolk Coroner’s Court in County Hall, Norwich, and explained how Mrs Oxley-Brennan received a home visit from her GP on the afternoon of 25 July 2022.
Her husband, James Oxley-Brennan, was worried because she had been ill for a week.
On arrival, the GP noted that she was confused and dehydrated. He was also concerned for her welfare, describing the house as “messy and unclean” with piles of books and newspapers strewn about.
Before leaving the house, Dr David Greenwood, of St Stephens Gate Medical Practice, arranged for her to be admitted to Norfolk and Norwich University Hospital and called an ambulance to take her.
A call handler from the East of England Ambulance Service NHS Trust advised there would be a 20-hour wait due to “significant pressure” on the day.
Mr Oxley-Brennan was provided with welfare checks over the phone by the Trust while he waited for the ambulance and made his wife comfortable before going to bed at around 2am on July 26.
At 8.22am Mr Oxley-Brennan called 999 after becoming concerned that his wife had stopped breathing. She was pronounced dead by paramedics at her home at 08:36.
In evidence read out in court, Chris Hewetson, patient safety officer at the Trust, explained that the organization had declared a serious incident the day before Mr Oxley-Brennan’s death.
He said: “The Trust was under considerable pressure at the time.
“The staff have particularly long handover waits at the [Norfok and Norwich University] hospital.”
He also gave evidence to the coroner of the steps taken since then to manage these issues.
The Trust also sent a letter of apology to Mr Oxley-Brennan following the death of his wife.
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In a telling conclusion, Ms Goward said: “She died after aspiration of food contents, leading to bronchopneumonia.
“It’s possible that if there hadn’t been a 20-hour wait for an ambulance, it might have been detected earlier.
“However, Mrs Oxley-Brennan was already weak from infection and probably dehydration and malnutrition, so it is not possible to say, on the balance of probabilities, that she would have survived.”
A post-mortem examination noted that she was “severely underweight”, weighing just 40kg (6st 3lb) at the time of her death, and had probably not eaten or drunk “for some time” before she died.
Mrs Oxley-Brennan, of Albury Walk, Norwich, was born on March 24, 1950.
The inquest took place on Wednesday, March 15. Her husband and sister, Sally Robinson, both attended.
Her funeral took place on Thursday, August 18 at St Andrew’s Church in Eaton, near Norwich. Donations for the charity Dementia UK welcomed.