Tube was inside his lung

PHOTO: Tube was inside his lung

SINGAPORE - He could not swallow properly, so he had to be fed via a tube, which was inserted through his left nostril.

But Mr Ang Thiam Chye had a habit of pulling out the tube. As a result, with the permission of his family, his hands were tied to the side of his hospital bed and he had to wear mittens.

Even so, Mr Ang, 76, still managed to pull the tube out by bending forward towards his hands or by raising his knees to his head.

On Oct 26 last year, a staff nurse at Tan Tock Seng Hospital found that the tube was not in his stomach but in his right lung instead.

Fluid ended up accumulating in Mr Ang's lungs and he died from inflammation of the lungs a day later.

At a coroner's inquiry into his death yesterday, State Coroner Victor Yeo concluded that the wrong placement of the feeding tube could have been the result of an accident, or that it had been dislodged.

The court was told that Mr Ang had been living at Ju Eng Home in Jalan Kayu since Sept 24, 2005.

His family members admitted him there as they were unable to give him the care he needed.

Mr Ang required assistance in daily activities, nursing and medical care, and fell frequently. He suffered a stroke previously, and was also stricken with dementia and hypertension, among other illnesses.

When he was observed to have difficulty in swallowing whole foods, Mr Ang was put on a blended diet.

In July 2009, it was noticed that he could not swallow properly and he had to be fed through a nasogastric tube, which was inserted into his stomach through his left nostril.

After inserting the tube, checks were done to ensure that the tube was in his stomach and not his lungs.

But on Oct 3, 2010, his family sent him to a hospital at the recommendation of a doctor as Mr Ang was losing weight and the home could not find out why, even though they had increased his number of feeds.

Mr Ang was taken to Tan Tock Seng Hospital (TTSH) and warded at Ren Ci Hospital. While he was warded, Mr Ang constantly pulled the tube out and had to have his hands restrained.

The court was told that on the night of Oct 25, 2010, a staff nurse noticed that Mr Ang's feeding tube had been removed.

As Mr Ang was not scheduled to be fed until the next morning, he did not insert the tube.

The next day, at around 5.30am, the same staff nurse inserted the feeding tube into Mr Ang. After performing the checks to ensure the tube was inserted correctly, he left to prepare Mr Ang's food.

Before feeding him at 6am, the staff nurse performed the same checks.

Tube inserted correctly

Tube inserted correctly

He handed over the ward to another staff nurse at about 7am, and ended his shift an hour later.

The nurse also checked that Mr Ang's feeding tube was inserted correctly when she took over the ward.

It was about 9am when a medical officer checked the placement of the tube and realised that something was wrong.

At the suggestion of a doctor, a chest X-ray was performed at about 11am and it showed that the tube was inside Mr Ang's right lung.

Checks also showed that Mr Ang's blood pressure and oxygen saturation were low. He was then transferred to the main TTSH building but died the following day.

Ms Angie Ang, 42, an educator and Mr Ang's second daughter, was at the inquiry yesterday.

She teared as she told The New Paper about the last time she saw her father. "I remember that it was raining very heavily that night. My father's condition seemed stable so I went home for a shower and to get a sweater at about 4am.

"Then I got a call from the nurse telling me that he had died without anyone by his side."

Mr Ang's wife and their six other children had visited him earlier that night.

This article was first published in The New Paper.