Do not resuscitate order 'twice added without consent'

A bereaved husband has begun a legal action over "do not resuscitate" orders placed on his wife's medical notes.

David Tracey says two DNR notices were included in Janet Tracey's records at Addenbrooke's Hospital, Cambridge, without her knowledge or consent.

Mrs Tracey, a 63-year-old care home manager and mother of four, died in March last year following a transfer to Addenbrooke's after she fractured her neck in a car crash on February 19 - two weeks after being diagnosed with terminal lung cancer.

The first notice, on February 27, was cancelled on March 2 after Mrs Tracey and her daughter found out about it and objected, while a second was placed on March 5, two days before she died.

Mr Tracey claims Cambridge University Hospitals NHS Foundation Trust acted unlawfully.

The trust, which strongly disputes the family's claims, says a doctor did seek Mrs Tracey's informed consent.

Mrs Justice Nicola Davies is hearing evidence in the High Court to determine issues of fact before a full judicial review in February.

That will seek to clarify whether there is a legal duty to inform patients with capacity whether a DNR has been placed on their notes and whether they have any right to be consulted about it.

The family's QC, Philip Havers, told the High Court that the case raised "real issues of real public importance".

Giving evidence at the start of the 10-day hearing, Mr Tracey, a 65-year-old retired engineer, said that after his wife's cancer diagnosis there was talk of chemotherapy and a drug trial.

Even while his wife was intubated after the road accident, he lived in hope.

He was told by a doctor that if there were problems with ventilation being withdrawn, they would let her "slip away" but he was not aware of the first DNR notice until after it had been cancelled.

Although known as DNR notices, they are officially termed 'Do not attempt cardio-pulmonary resuscitation' forms.

Mr Tracey looked up cardio-pulmonary resuscitation (CPR) but did not think it was relevant in his wife's case as she did not have a heart condition, and he did not speak to the doctors about it.

"At one point, she did say they were trying to get rid of her, and I didn't believe her. I just said, 'don't be so silly', which proved to be a mistake."

He reassured his shocked wife, who was in tears, that neither he nor their daughters agreed to the notice.

He said his wife was being "badgered" about making a resuscitation decision, but didn't want to discuss it any more.

"She just didn't want that to happen to her. I had rather they hadn't kept badgering her all the time. They told her she had a one per cent chance of leaving the hospital. What kind of thing is that to say to someone in hospital?"

Despite his wife's condition, he thought she might come through and the family wanted her moved to a hospice closer to home where they felt she would get better care.

Mr Tracey said that, two days before his wife died, he discussed her future with doctors but did not think her death was imminent. There was no detailed discussion about a DNR and he did not agree to one.

"My wife was a very clear-thinking woman. There was nothing wrong with her mind.

"It was my wife's wish, she did not want a DNR. She was quite clear, and it was not my decision to make, it was hers. It was her life."

The hearing was adjourned until Tuesday.