A healthcare trust has apologised and changed its guidelines after a 97-year-old patient, Jacqueline Frehe, died having been given food when she was nil-by-mouth. The incident occurred at Yeovil District Hospital in Somerset.
An inquest heard that when Ms Frehe was transferred from A&E to another ward, staff were not informed of her nil-by-mouth status. Her family also raised concerns about her status, but this was not documented by ward staff.
Ms Frehe was given food and drink on 25 August 2025, which led to her vomiting and her condition deteriorating significantly before she died the same day. Following the inquest, the Coroner for Somerset, Vanessa McKinlay, issued a prevention of future deaths report.
Somerset NHS Foundation Trust has extended its "deepest sympathies" to Ms Frehe's family and stated it is taking action on the coroner's findings. The trust plans to improve the standardisation of emergency department-to-ward handovers, how staff document and act on family concerns, and strengthen education and training for clinical staff regarding dysphagia and aspiration risk.