The sister of a woman who died of complications from constipation has said she wants answers over her death.
Sally Lewis, 55, from Bromsgrove in Worcestershire, who had learning difficulties, died after faeces blocked her bowel in 2017.
Her sister Julie Bennett said the condition was so bad Sally had faeces in her throat at the time of her death.
Her family said they wanted to make sure “nothing like this happens to anyone else again”.
A number of actions were taken following Ms Lewis’s death and care provider Dimensions, of which she was a resident, said it had “co-operated fully” with investigations and would consider any new findings that may come to light during the inquest.
What happened to Sally Lewis?
With a passion for music and the rock’n’roll CDs bought for her by her father, Sally Lewis was beloved by her family.
“We all loved Sally,” said her sister. “She would give you the best bear hugs.”
Ms Lewis developed learning disabilities after treatment for jaundice as a baby and spent almost her entire life supported by the care system.
But growing up “Sundays were Sally’s day”, her sister said. “We would go and fetch Sally and either go to an auntie’s or out for the day.”
For 20 years, Dimensions provided care for Ms Lewis and at the time of her death she was in supported living accommodation.
On the evening of 26 October 2017 Ms Lewis, who had a long-standing history of constipation, became unwell.
“They thought she was coming down with a tummy bug,” said Mrs Bennett. “She was wobbly and unsteady on her feet. She refused to drink which was unheard of with our Sal.”
That night Ms Lewis slept on the sofa. The next morning, she was dead.
A post-mortem examination found her large bowel was “grossly distended” and the cause of death was recorded as large bowel obstruction due to faecal impaction.
Her death was considered to be from natural causes.
What does her family say?
The family said Ms Lewis’s death was “totally preventable” and they wanted to make sure “nothing like this happens to anyone else again”.
As it was classed as natural causes, there was no initial inquest. The family fought for a hearing and a pre-inquest review took place in September, with a full inquest provisionally listed for July next year.
They said they hoped the proceedings would investigate all of the care in the lead-up to Ms Lewis’s death, including the administering of a laxative she was prescribed and how her bowel movements were monitored.
“I want answers,” said Mrs Bennett, who works as a florist. “I feel like I can’t grieve, I’m just eaten up with anger.”
“They all had proper bowel training,” she said.
“Every time they took her to the doctors for constipation the doctor used to provide lots of laxatives to clear her out but nothing was ever followed up again.”
The family has been awaiting a decision from the coroner as to whether the inquest would be held in accordance with Article 2 of the European Convention on Human Rights – the right to life – in which case they would be entitled to legal aid.
But in the meantime they have launched a CrowdJustice page, aiming to raise £15,000 to cover legal costs.
Mrs Bennett said: “She died of constipation in supported living and Sally isn’t the only one, it’s happening all the time with people with learning difficulties and nothing ever gets done about it. It’s like they don’t matter.”
“We absolutely adored her,” she added. “I’m on a mission, I won’t give up.”
What has happened since Ms Lewis’s death?
The BBC has seen documents that showed a number of reviews were carried out following Ms Lewis’s death.
A Learning Disabilities Mortality Review (LeDeR) stated Ms Lewis had not taken the Laxido laxative for nine months before her death.
The review said there was a lack of awareness from staff as to when it should be administered.
In addition, a safeguarding inquiry carried out by Worcestershire County Council found there was “no plan in place by Dimensions to monitor and manage Sally’s chronic constipation”.
Recording on a bowel monitoring chart was also said to be “poor and inconsistent”.
A number of actions were taken following Ms Lewis’s death, including the implementation of an action plan by Dimensions.
The supported living accommodation was visited by the council’s safeguarding team to review the remaining residents’ health action plans and support plans.
What does Dimensions say?
In a blog post in 2018, Steve Scown, chief executive of Dimensions, said the company “could and should have done better”.
And in a letter to Mrs Bennett sent in December 2017, seen by the BBC, the company said its investigation “determined that the staff supporting Sally did not document the monitoring of her constipation as they should have done”.
It added: “We are dissatisfied that, in Sally’s case, the procedures in place were not followed.”
In its latest statement the company said Ms Lewis’s death had had “a profound effect across our organisation, and particularly on the colleagues who supported her for 20 years”.
It said it was committed to raising awareness of the dangers of constipation and improving colleagues’ ability to spot the signs.
“The circumstances surrounding Sally’s death have previously been investigated by various authorities and we have co-operated fully with these. If new information comes to light during this inquest, we will carefully consider any new findings,” it added.