A 45-year-old disabled father-of-two died from sepsis after waiting 34 hours for vital antibiotics at a hospital in the Midlands, an official investigation has concluded.
Systemic Failures in Urgent Care
The man, who lived in supported accommodation in Ollerton, Nottinghamshire, suffered from a rare and incurable neurological disorder called Alexander disease. This condition affected his nervous system, caused developmental delays, and meant he required 24-hour care for respiratory and mobility issues, as well as help with feeding and personal hygiene.
Due to his condition, he had a permanent catheter, which made him susceptible to urinary tract infections. In November 2022, he contracted an infection that was resistant to oral antibiotics. His GP subsequently referred him to Bassetlaw Hospital, part of the Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, for intravenous (IV) antibiotic treatment.
Critical Delays and Missed Opportunities
An investigation by the Parliamentary and Health Service Ombudsman (PHSO) found that the man was given the correct IV medication more than a day after he arrived at the hospital, and even then, it was administered at only half the required dosage.
The probe revealed that paramedics and care home staff had informed the hospital he needed IV antibiotics, but medics did not follow this request. Doctors decided to try oral drugs after consulting a microbiologist, only to find the medication was unavailable. The PHSO stated that doctors should have sought further advice, which would likely have led to the IV antibiotics being given much sooner.
By the time a second, also delayed, dose was administered, the man had become septic. He died a week later. His disabilities meant he had difficulty communicating with staff to raise the alarm about the lack of treatment.
A Mother's Pleas Ignored
His 70-year-old mother raised concerns with hospital staff at the time, telling them the oral antibiotic would not work and that the GP had a microbiologist's report confirming this. "I was trying to help the doctors," she said. "But they just totally dismissed me. Their attitude was they were the doctors and I was just his mum."
She was never informed her son had not received any antibiotics during that critical period. "It was heartbreaking to finally understand the truth," she added. "I was given the impression he had at least been given some antibiotics, even if they weren't the right ones. But to find out he was in hospital for all that time with no treatment was very hard."
Trust Apologises and Takes Action
Following the PHSO's recommendations, the hospital trust agreed to write to the man's mother to acknowledge the failings, apologise, pay her a financial remedy, and prepare an action plan to prevent a recurrence.
Karen Jessop, chief nurse at Doncaster and Bassetlaw Teaching Hospitals, said: "We are truly sorry for what happened in this case and for the loss experienced by the patient's family. Immediate actions were implemented to strengthen how antibiotics were prescribed, escalated and given."
PHSO chief executive Rebecca Hilsenrath warned that complaints about sepsis care have more than doubled in the past five years. "Losing a life through sepsis should not be an inevitability," she said. "But we are seeing the same failings repeated time and time again."
The man's mother expressed hope that the accountability would prevent others from suffering similarly. "It won't bring my son back but it has given me closure," she said.
