"The damage done was to my wife...it could have been the whole block of flats"

Thursday 11 May 2017

Carers in Jersey are being reminded about the dangers of people smoking while using a medical oxygen supply.

This week an inquest into the death of 64-year-old Diane Noel heard how she died of a heart attack after accidentally igniting her own oxygen supply, while lighting a small pipe.

She hadn't told her carers that she smoked. 

The inquest heard that Mrs Noel was in her bed when she tried to light a pipe, but the flame from the lighter ignited the oxygen around her face. The sudden fire caused burns to the side of her face and hair. It is believed that she attempted to go to the bathroom to get water on her face, but as the fire reached the oxygen cylinder, a  safety valve cut off the supply so suddenly it caused a heart attack. Firefighters, who had been alerted by a neighbour, were unable to revive her. 

Mrs Noel had been using the oxygen for a number of years to deal with Chronic Obstructive Pulmonary Disease (COPD). The cylinder was kept in the kitchen with the tubes reaching her bedroom. Due to her condition she had been warned not to smoke but her husband said "...she simply couldn't do it."

It emerged that two years ago she had had a scare while smoking a cigarette as she was using her oxygen. Her husband said: "She was unhurt but shocked. She wouldn't tell me exactly what she had done but I told her off as whatever she did was dangerous. I thought she had been scared enough not to do it again."

After the incident her husband had bought her a small women's pipe which she was trying to use before she died.

Paul McGrath, who was the fire investigation officer, said that the death was a preventable one and issued recommendations for future cases. He said that carers should receive training on the hazards associated with smoking for patients who use oxygen. However, Mrs Noel's husband admitted that it wasn't as simple as the carers knowing what to do, as his wife, whom he described as very independent, didn't tell her carers she was smoking, and might not have listened to their advice anyway: "They had no idea, it was all hidden away."

Mr McGrath noted that Gentle Care Ltd, whose carers frequently visited Mrs Noel, had no policy in place for patients who smoke. Anne Ruth, the owner of the company told Express they are working on it: "It was an unfortunate accident that could have been avoided. We have never cared for smokers and we were never aware that Mrs Noel was smoking. Our managers are working on new policies that we want to bring it as this case has highlighted how important it is.

"Had we been aware of Mrs Noel's smoking we would have done a big risk assessment and would have had a discussion with her. But it is difficult, we can only advise patients and state the risks, they have their own lives and make their own choices."

There was no suggestion that Gentle Care were at fault. 

Another recommendation from Mr McGrath was for carers to be aware of the effects of increasing the oxygen flow. Mrs Noel's condenser was set to deliver at least 4L of oxygen per minute at a concentration of 90%, despite being advised not to use it as such a high level, and the inquest heard that her carer had declined to turn it up to that point. 

Her husband said: "If it hadn't been set on 4 maybe the volume of oxygen wouldn't have been sufficient to cause a fire. There is a great danger there! We have been lucky in the sense that the only damage done was to my wife but it could have been the whole block of flats."

Before concluding his inquest, Advocate Cyril Whelan, who acted as relief coroner, said: "I think everybody is aware of the risks of smoking when using oxygen but this case puts in light the need for everybody to refresh themselves about the dangers."