NHS Staff Too Slow To Deal With Man Who Called 999 From Hospital Bed, By Coroner’s Rules | NHS


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A patient with a sickle cell crisis who called 999 from his hospital bed after being denied oxygen would not have died if medical staff recognized his symptoms and treated him sooner, concluded a coroner.

Evan Nathan Smith, 21, from Walthamstow in east London, died in April 2019 in hospital after developing sepsis after surgery to remove a gallbladder stent a week earlier.

Smith had inherited sickle cell anemia, when the red blood cells become crescent-shaped, which can lead to health problems. The sepsis has triggered a sickle cell crisis, which occurs when blood vessels in certain parts of the body become blocked. The disease is most common in people of African or Caribbean descent.

Smith, a football statistics analyst, called the London ambulance service in the early hours of April 23, 2019 while being held in a “tenant” bed, which is a bed added to a room for capacity extra because no bed was available, and did not have access to piped oxygen. However, the operator decided not to send paramedics.

When Smith was seen by a hematologist later that day, despite being prescribed oxygen, he was already in the early stages of a sickle cell crisis. Smith did not receive an exchange blood transfusion until late April 24 and suffered a series of cardiac arrests the same night.

It was confirmed that he died in the early hours of April 25. The pathologist discovered that his cause of death was a dysfunction of several organs resulting from a sickle cell crisis caused by sepsis.

Coroner Dr. Andrew Walker concluded that Smith’s cause of death was his delay in treating him with “a timely exchange transfusion.”

Smith's parents, Charles and Betty Smith, in Barnet Coroner's Court Tuesday.  They said they would ask the hospital to investigate their son's death.
Smith’s parents, Charles and Betty Smith, in Barnet Coroner’s Court Tuesday. They said they would ask the hospital to investigate their son’s death. Photograph: Tess De La Mere / PA

He added that this was made more difficult “by a lack of understanding of sickle cell disease among the doctors and nurses caring for Mr. Smith”. This was despite the hospital where Smith was treated, North Middlesex Hospital in Edmonton, north London, serving an area with a large African-Caribbean community. Walker added that “those caring for Mr. Smith at the time did not appreciate the importance of these symptoms.”

Despite the omissions of the medical staff, the coroner did not find negligence.

Barnet Coroner’s Court has heard that since Smith’s death, North Middlesex Hospital now has a dedicated ward for sickle cell patients and that staff at the wider hospital are receiving additional training.

Smith’s parents, Charles and Betty Smith, were present throughout the investigation. In a statement, Charles Smith said they are struggling with the loss of their only child.

“The death of someone you love is always sad, but the tragic way Evan died is something we will live with for the rest of our lives,” he said.

The couple said they would call for a “full and transparent” investigation into their son’s death by the hospital and hoped that lessons could be learned.

“We hope that no other family will ever have to go through what Betty and I have, to see our only child walk past us so unexpectedly, into the hands of those who were supposed to take care of him,” they said. .

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