A diabetes patient who died of dehydration was let down by a “cascade” of failures and neglect by medical staff, it has been revealed.
Kane Gorny, 22, a keen sportsman from Balham, south London, died at St George’s Hospital, in Tooting in May 2009. He suffered from diabetes insipidus, a rare form of the disease that stops the kidneys from conserving water.
An inquest into his death revealed that hospital staff failed to give him his vital medication to help him retain body fluid and ignored his desperate requests for a drink. The resulting dehydration caused his condition to deteriorate and ultimately lead to his death.
The senior staff nurse on the night he died told the inquest she did not take observations or ensure Mr Gorny took his diabetes medication.
It was also revealed that his death came just hours after police were turned away from his bedside after responding to his 999 call for water, with hospital staff telling them that he had a history of erratic behaviour.
Deputy coroner Dr Shirley Radcliffe told the hearing at Westminster Coroners’ Court that “a cascade of individual failures had led to an incredibly tragic outcome”, adding that Kane was let down “by incompetence of staff, poor communicatio, lack of leadership, both medical and nursing, and a culture of assumption”.
After the inquest, James Stevenso, the solicitor for Mr Gorny’s family, said they were devastated to hear of the number of “missed opportunities” to prevent the death of heir so, who was “well-liked and adored” as a so, brother and friend.
The coroner’s verdict of neglect was accepted by St George’s Healthcare NHS Trust, who also admitted civil liability for the failures in care, for which they were “profoundly sorry”.

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