75-year-old fed wrong food chokes to death

Cheng Wong

A 75-year-old male patient choked to death at Caritas Medical Centre after being given the wrong food by staff due to a suspected communication error.

Cluster chief executive of Kowloon West Alexander Law Chun-bon said the patient choked while having lunch on March 3. He died at around 1.30pm despite efforts to save him.

Law expressed apologies to the patient's family for the "deeply unfortunate" incident.

Hospital chief executive of Caritas Gladys Kwan Wai-man said the patient, who had a history of hypertension and cognitive impairment and was on a pureed diet, was admitted on February 28 for abdominal bloating.

Kwan said he was on a fasting regimen upon admission. After his condition improved, doctors wrote "DAT" - or diet as tolerated - in his medical records, which indicated he could resume his usual diet, which in this case was pureed diet.

However, a fifth-year nursing student misunderstood this to mean the patient could consume regular meals containing solid foods and proceeded to feed him.

Kwan said the nursing student fed the patient bite by bite to ensure he swallowed properly, only to find later that he had choked and initiated immediate resuscitation efforts.

During intubation, the emergency team found food remnants in his throat. But despite efforts to clear the obstruction, resuscitation proved unsuccessful.

Kwan said the feeding instructions were issued by a colleague of the nurse in charge who had four years of experience.

At the time, the nursing student was solely responsible for feeding the patient, with a supporting nursing team present in the ward.

The staff involved are currently on leave. Kwan said whether the staff involved will face criminal prosecution depends on the investigation's findings. The case will be referred to the Coroner's Court.

It is understood that meal distribution is managed by the ward nurse, who directs which patient receives what kinds of meals. The ward assistant then delivers the meal to the patient and it is fed to the patient by the nurse or nursing student.

Former emergency physician Lee Fook-kay said patients with cognitive disorders are more susceptible to choking on food due to weakened neural reflexes.

"Typically, when a healthy person chokes on food, their throat has a neural reflex that helps expel the object, while those with cognitive decline have diminished reflexes, so the likelihood of food entering the airway is increased," Lee said.

Using "DAT" to indicate resuming food intake is common practice, said Association of Hong Kong Nursing Staff chairman Tse Kin-keung.

The case follows the death of a 79-year-old eye patient due to staff negligence in failing to turn on an oxygen valve.

cheng.wong@singtaonewscorp.com