THE sad death of Stourbridge community champion Dorothy Clarke, who passed away after a fall at her care home, was accidental - a coroner has concluded.
Retired admin manager Dorothy, aged 92, who was awarded the MBE for services to the elderly for the popular senior citizens clubs that she ran in Pedmore and Halesowen, died on December 17 at Russells Hall Hospital having failed to recover from surgery following a fall at Oriel Care Home.
An inquest into her death concluded at Black Country Coroner's Court at Oldbury today (Tuesday March 2), having been opened on January 4.
Joanne Lees, area coroner for the Black Country, told the court the medical cause of death was bronchopneumonia, caused by a broken hip, caused by a fall and contributed to by ischemic heart disease and old age.
The inquest was told Dorothy, who had Alzheimer's, had been taken by ambulance to Russells Hall hospital on December 10 with swelling in her feet and suspected DVT (deep vein thrombosis) but after assessment she was discharged back to the care home.
Her daughter Catherine Marshall had driven her back to the home in Hagley Road and dropped her off at the door five minutes before midnight. Dorothy then had a sandwich and cup of tea in the dining room before going to her room for bed.
She reportedly told staff she'd been on an adventure with her daughter - having been unable to see her for months due to the Covid pandemic.
In the early hours though, at around 3am, a loud bang was heard.
Care home manager Kerry Turner said staff went to check the rooms and "they found Dorothy on the floor so they called paramedics".
Great-grandmother Dorothy, a widow, was then taken back to Russells Hall where an X ray revealed she had broken her hip.
She also had Alzheimer's, thyroid disease and ischemic heart disease - the court was told.
A dynamic hip screw surgical repair was carried out but post surgery she developed pneumonia and and failed to respond to treatment. Her condition deteriorated and she died on December 17.
The coroner, Mrs Lees, said there was a direct causal link between the fall at Oriel and Dorothy's death - the fall resulted in injury that required a surgical procedure and inevitably that was followed by a period of immobility - and she added: "Given her age and ischemic heart disease she was susceptible to respiratory infection. She was treated but sadly passed away."
Dorothy's daughter Catherine questioned what measures had been taken to protect her mother from falls in the home that evening - having dropped her off with severely swollen feet and unable to walk unaided.
The coroner said she was satisfied an appropriate risk assessment had been carried out when Dorothy moved into the home in late 2019 and that there were regular reviews of the risk assessment and she said there was no evidence to suggest the fall could have been prevented with a pressure mat in the bedroom.
She said no further risk assessment had been carried out on Dorothy's return from hospital on the 10th as it had been late at night and she had not suffered a fall which would have triggered the need for another risk assessment.
She offered her sincere condolences to Dorothy's family as she concluded her death was accidental and she said: "Not all falls can be prevented."
The coroner did, however, say she would write to Oriel Care Home in six months time to see what improvements had been made as a result of a safeguarding investigation by Dudley Council.
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here