Father says Martha’s rule would have saved life of son who died at London hospital

A 30-year-old man who died last month at one of the UK’s leading hospitals would still be alive if “Martha’s rule”, giving the right to a second opinion, had been in place, his father has said.

Balram Patel, who was described by his father as “happiness personified” died at St Thomas’ hospital on 9 August. Balram had multiple disabilities and was developmentally delayed, so behaved more like an eight-year-old. Jay Patel, 58, claimed that when his son fell ill, he was given unsuitable treatment, which had not previously worked on him, and he was refused a second opinion. As a consequence, he said Balram’s lungs became fatally flooded.

To make matters worse, pulmonary oedema (build-up of fluid in the lungs) was not initially mentioned as the cause of death and was recorded as such only after Patel intervened with the coroner’s office.

The coroner’s office has told him it is opening “an investigation in regard to care and delay of treatment given”.

Patel said: “I love my NHS, Balram was here for 30 years because of the NHS. Unfortunately he passed away in pain, before his time, suffering in a very inappropriate manner because of the very same NHS.

“I am mortified at losing my baby. I couldn’t do what was needed to turn it around and I tried literally absolutely everything.”

Patel said his son, “who was born with half a functioning heart” was initially treated with oral diuretics (which reduce build-up of fluid in the body) at St Thomas’ after falling ill but, because they did not work, medics switched to intravenous (IV) diuretics.

After a Covid outbreak, it was decided Balram would be transferred home due to his vulnerabilities but district nurses could not be found to administer the IV diuretics at home.

As a result, it was agreed that the diuretics could be administered through an alternative method using a syringe pump to diffuse through the tissue rather than directly through the bloodstream, as is the case with IV.

Patel said he found a bariatric surgeon, who was a close family friend, who was willing to administer this alternative method at home but he was never contacted, and a nursing agency, which was not taken up either.

Related: Martha’s rule should be a last resort for when other safety systems have failed

Instead, doctors decided that Balram would be discharged with oral diuretics despite Patel’s opposition given his son’s previous experience with them. He said he asked for a second opinion but this was denied.

“If Martha’s law had been put in place and in a way that there could be a swift response to the second opinion requested, I’m sure Balram would not have died when he did,” he said.

Days after Balram was discharged he began retaining fluid and on 7 August, Patel called the hospital several times. He said his pleas that the oral diuretics were not working were ignored and while a nurse told told him a consultant would call back, they never did.

When, on 8 August, he took his son to St Thomas’ A&E he said an X-ray, taken shortly before 7pm, showed that his son’s lungs were flooded. However, Patel said that despite his multiple requests, the IV diuretic was not initiated till about 1am. Balram stopped breathing at about 4am and was declared dead about 40 minutes later.

Patel has set up a group called Patients Lives Matter in memory of Balram and to help others.

The government has said it is committed to bringing in Martha’s rule after a campaign by the parents of 13-year-old Martha Mills, who died in hospital after developing sepsis.

A spokesperson for Guy’s and St Thomas’ NHS foundation trust said: “We wish to extend our deepest sympathies to Balram’s family. Balram had incredibly complex health needs and had been under our care throughout his life, during which he was cared for by an extensive multidisciplinary team. Any concerns the family have will be fully investigated.”