And? Tony Chambers wasn't in full possession of the facts.
Quote from the article
"I said to him 'well it's not for you to find the cause, you have unexpected and unexplained collapses and deaths of patients and even one of those is a cause of concern"
Chambers was more concerned with protecting the reputation of the hospital. Obviously he wasn't qualified to determine the cause.
And another quote from today
>“\[Stephen Brearey and I\] spent three hours going through the timeline, both clinically and non-clinically, of everything that had happened.
>“I discovered clinical histories of patients who were doing well, who were expected to go home, perhaps even on the day they were due to go home, suddenly having a cardiorespiratory collapse.
>“Even with adults, on an intensive care unit you have a watchlist of patients who are at risk of deterioration, or whose clinical condition is fragile, and if they deteriorate it’s not like flicking a switch, it’s a gradual worsening of their vital signs.
>“What Dr Brearey was describing to me was something I had never, ever, seen or heard of in my clinical practice.
>“Just one of those, for me, would have been enough as a medical director or a director of nursing, to absolutely want to get to the bottom of what is happening here
So Susan Gilby immediately knew there was something not right and she knew action needed to be taken.
<modsnip - personalizing>