Rachel Johnston: Probe into death after all teeth removed

Rachel Johnston was of a "happy disposition" when discharged from hospital

A "happy and alert" disabled woman died after having all her teeth removed due to severe decay, an inquest heard.

Rachel Johnston, 49, began bleeding after being discharged from hospital and was "slumped" in bed at her care home the next day, her mother said.

There was a "significant delay" by NHS 111 practitioners in getting information to carers that evening, the hearing in Worcestershire was told.

Ms Johnston died just over two weeks later of a hypoxic brain injury.

Diana Johnston, Rachel's mother, said she accompanied her daughter to Kidderminster Hospital for the operation on 26 October 2018.

In a statement, Dr Sarah Foy, a special care dentist, said severe tooth decay had led to a "hopeless prognosis" and all needed to be removed because Ms Johnston was at risk of pain and infection.

Four hours after the procedure, she was considered to be of a "happy disposition" and discharged to Pirton Grange Care Home near Worcester.

Mrs Johnston, of Evesham, said in a statement her daughter was singing during the journey but fell asleep 10 minutes before arrival.

"I said 'Mummy will see you first thing tomorrow'," she said in a statement. "I left her thinking she was in safe hands."

Diana Johnston accompanied her daughter to Kidderminster Hospital for the operation

The next day staff said the 49-year-old had been bleeding in her mouth, and when Mrs Johnston arrived at the care home, her daughter was "slumped to one side and had funny, heavy breathing and her tongue swollen".

"It seemed wrong to me and asked them to call a doctor. They said they would but it would be a little while."

'Wasn't my Rachel'

Instead, they phoned NHS' 111 service that evening at 19:00. It was not until 20:34 they received a call back from out of hours provider Care UK.

Nurse practitioner Alison Trueman said she assessed the situation and told the carer to call back if Ms Johnston's condition worsened.

She said she was not aware of her deteriorating condition, adding "she did not detect urgency" in the caller's voice.

"Do I wish I'd made a full assessment of her consciousness and breathing difficulties? Yes, of course I do," said Ms Trueman.

"I wish I'd done things differently but at the time I went with the information given."

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The following day, worried carers called an ambulance to take Ms Johnston to hospital.

"It was like she wasn't my Rachel any more and she was fighting for her life," Mrs Johnston said.

Her life support was switched off on 2 November and she died 10 days later with her mother beside her.

The hearing continues.