‘Loving, caring' Rhuddlan mother will be ‘hugely missed'
At the resumption of the inquest into her death, held in Ruthin today (June 20), John Gittins, senior coroner for North Wales East and Central, gave a medical cause of death of pneumonia as a result of a fall with rib fractures and chronic pulmonary disease and contributing pulmonary heart disease.
Mrs Sellwood was born in Accrington on December 8, 1951, and was a retired nurse who had also run a pub with her husband Paul.
Her son Paul told the inquest his mother had 'loved people', and described her as a 'great, loving, caring' person who 'looked after other people before herself'.
In the five years before her death, her health had declined – she had arthritis in her back which caused mobility issues and 'made her introverted and reserved over time'.
She also had a history of chronic obstructive pulmonary disease (COPD), and was on medication including an inhaler.
The inquest was told she had suffered some falls in the months prior to her death, and had been admitted to Ysbyty Glan Clwyd in October (7-11), November (1-10) and again between November 25 and December 4.
This was because of low sodium levels, and these levels had dropped during hospital visits.
Upon her second admission to Glan Clwyd, her sodium levels were again low, with a cut on her thigh evidence of a fall four weeks prior.
Dr Sanghamitra Chakrabarti, a consultant in acute geriatrics who treated Mrs Sellwood, said they started her on steroid replacement medication, which gradually saw her sodium levels improve.
She was discharged on November 10 having 'never complained of chest pain or cardiac problems during this admission', and was given medication to take twice a day.
However, between this and her third admission, her husband said she had started to deteriorate after around a week out of hospital.
Her third admission to hospital came after another fall, and her sodium levels decreased for several days before a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH), which causes sodium levels to be lower.
Dr Aye Nyunt, a consultant in general surgery, said Mrs Sellwood's sodium levels increased on December 3 and 4, and she was discharged again and prescribed Tolvaptan, which treats low sodium in the blood.
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Despite there being no plan to discharge her on December 1 (a Friday), Mrs Sellwood was moved to a different ward by December 4 in anticipation of her discharge.
Dr Nyunt described Mrs Sellwood as 'mobilising independently, eating and drinking' on December 4, and was not aware of the family's concerns regarding the decision to discharge her at the time.
She said Mrs Sellwood's sodium levels were 'safe enough' to be discharged, with her GP to monitor these levels weekly.
Her husband Paul said the family 'disagreed on a number of occasions when told she was good to go home' and were 'given medication and not told how to use it', which he told the inquest was 'very upsetting'.
Her behaviour became 'more erratic' after the third discharge from hospital, and she fell at home in the intervening period – her son Paul described her eating habits as 'really abnormal' and 'like she was starving'.
He said she was not 'sound of mind' at that time, and that he felt they 'should have taken her back' to Glan Clwyd again.
On December 8, she had blood tests done at her GP surgery, but the results, which show low sodium levels, did not come back until the following Monday (December 11).
Later that day, Mrs Sellwood fell against a worktop at home and was 'screaming in absolute agony', and in the early hours of December 9 was re-admitted to Ysbyty Glan Clwyd.
A CT scan was done on December 10, which showed rib fractures to her right side, but despite further monitoring and investigation, she died on December 14.
Dr Huyam Abdalsalam, a consultant pathologist at Ysbyty Glan Clwyd, said Mrs Sellwood showed signs of cardiac disease and pneumonia, with the latter considered the terminal event.
Her medical cause of death was pneumonia with contributing rib fractures and underlying smoking and heart disease.
Mr Gittins gave a narrative conclusion, and confirmed a medical cause of death of pneumonia as a result of a fall with rib fractures and chronic pulmonary disease and contributing pulmonary heart disease.
He said: 'On December 8 dec the deceased had a blood test at her GP surgery.
'When analysed, neither she nor her family were made aware of the results.
'That evening, she collapsed in her bedroom and sustained rib injuries which resulted in her death on December 14.
Mr Gittins said that there were 'concerns that need addressing', with the health board set to investigate and conduct enquiries into how GP test results were conveyed between departments.
Addressing Mrs Sellwood's family, he expressed his condolences on the 'loss of a lady who is hugely missed'.
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