Family’s anguish over mum’s rare cancer death

Joyce Spratt was given strong pain relief when she was admitted to Belfasts City Hospital
Joyce Spratt was given strong pain relief when she was admitted to Belfasts City Hospital

A cancer patient who volunteered for clinical trials of a new chemotherapy treatment was let down by a promised dedicated helpline, an inquest has heard.

Joyce Spratt, 53, from Drumaghlis Road, Crossgar, was suffering from ovarian cancer and one of 128 women testing the new drug.

At the hearing in Belfast, Robert Spratt said his wife wanted to help others by taking part in the trials, but was told to “phone your own doctor” when she became unwell and should have been referred to a specialist.

The mother-of-three rang the helpline on March 18, 2002, and again on March 20 when her husband said she “was screaming with pain”.

Coroner Joe McCrisken, who will announce his verdict on Thursday, heard how Mrs Spratt was eventually admitted to Belfast City Hospital in the early hours of March 21 and treated for suspected appendicitis.

She was later found to have been suffering from typhlitis – a form of intestinal inflammation affecting only one in 100,000 chemotherapy patients.

The condition led to peritonitis which proved fatal and Mrs Spratt died on March 22.

A barrister for the Belfast Trust apologised to the Spratt family for the shortcomings, particularly around the helpline, but the inquest also heard how the treatment for suspected appendicitis was similar to that which would have been provided had Mrs Spratt been under the care of a specialist at the first opportunity.

The barrister said the trust recognised that there were “certain elements of the treatment” that were “not of the standard it ought to have been”.

He said: “It is accepted that the [helpline] advice she was given, to speak to her GP, was not appropriate.”

However, the lawyer also said that typhlitis was “much better recognised in 2016,” and that a number of improvements in how chemotherapy patients are treated have been implemented over the 14 years since Mrs Spratt’s death.

These include better management of the “toxicities that flow from chemotherapy,” and improved guidelines for medical staff.

He also said patients are given more information of the warning symptoms to look out for and have a reliable 24-hour helpline service operated by “chemotherapy-competent nursing staff.”

In relation to the chemotherapy trials, the coroner said he had spoken with the oncologist who compiled a report on Mrs Spratt’s treatment for the inquest, Professor Poole, who reported having “no concerns” about their safety.

Mr McCrisken said Prof Poole’s opinion was: “Serious diseases kill people – we have to use serious drugs to treat people.”

In his report, Prof Poole said the signs of the condition that ultimately killed Mrs Spratt would not have been apparent during the first couple of days she felt particularly unwell.

Responding to the coroner quoting from Prof Poole’s report, Mr Spratt said: “I can’t accept that.”

Mr McCrisken then told Mr Spratt: “You are going to have to keep an open mind on this. I have read out what Prof Poole says – ‘This condition could not have been foreseen on 19 March’.”

Wednesday’s inquest was ordered by the attorney general following a review of two previous reports into Mrs Spratt’s death.

Mr Spratt told the coroner his late wife had been a full-time payroll clerk who reduced to part-time hours to look after her three sons. He said she was an indoor bowls enthusiast and qualified bowls referee.

Mr Spratt recalled how his wife began to feel a bit better once given strong pain relief on admission to the City Hospital.

“She told me to go home and tell the boys I’m not too bad now,” he said.

The coroner told Mr Spratt his wife had been “very brave” in agreeing to try the experimental treatment.

Cancer surgeon Miss Sigi Refsum gave evidence that, even with hindsight, Mrs Spratt may not have been treated differently due to her chemotherapy at the time.

Miss Refsum said emergency surgery could have been considered but, as chemotherapy put a strain on the heart, a general anaesthetic was out of the question.

“Mrs Spratt was too sick to go anywhere near an operating theatre. No anaesthetist would anaesthetise you,” she said.

An oncology registrar who examined Mrs Spratt on March 19, Dr Paula Scullin, said she did not detect a high temperature, although she did not record the actual temperature on the patient’s notes.

“That is my error and I apologise for that,” she told several members of the Spratt family who were in court.