A CORONER is to write to hospital bosses concerned the full range of back-up services is not available to medics at night and at weekends.
It follows evidence at an inquest where it was revealed doctors had to have very good reasons to request a scan outside normal working hours.
The hearing at Ruthin, into the death of 59-year-old Ronald Perry, who collapsed at home only a few hours after being discharged from Glan Clwyd Hospital, revealed he was rushed back to the hospital – just a few hundred yards from his home in Maes Owen, Bodelwyddan – but despite an hour-long effort to resuscitate him was certified dead.
A post-mortem showed he died of a “ballooning” of the main blood vessel in the abdomen – and consultant pathologist Dr Andrew Dalton said it had caused “catastrophic haemorrhaging”.
Mr Perry also had “significantly” diseased arteries.
The inquest heard Mr Perry went to the A&E department on January 17 complaining of abdominal pain and remained there for several hours.
He said he may have twisted something while working, and an X-ray was carried out because it was thought he might have kidney stones.
Nothing was found and doctors concluded it may have been a muscular problem.
Mr Perry returned home and went to bed at about 11pm but his wife Kathleen claimed he remained agitated, and at 1.30am collapsed in the toilet.
Mrs Perry and her granddaughter attempted resuscitation and paramedics continued as he was returned to hospital, where he died.
Dr Ahmed Mohammed, a trainee in vascular surgery, said there was no definitive diagnosis during Mr Perry’s first visit but he would have expected a scan, had it been carried out, to have revealed an aneurysm.
However, he said, scans would be requested “out of hours” only if a life-threatening condition was suspected, and that was not the case with Mr Perry, who had no chest pains.
John Gittins, coroner for North Wales East and Central, asked the doctor: “If a scan had been done would it have been more likely than not that it would have been spotted?”
Dr Mohammed replied: “Yes.”
He said it was “probable” that a scan would have been requested had Mr Perry been at the hospital in the daytime.
Recording a conclusion of death from natural causes, the coroner said he was concerned at the different processes by which scans were taken during working hours and out-of-hours.
“The evidence is that had a scan been undertaken the diagnosis would have been made, but that is not to say he would have survived,” he said.
He said he would be sending a report to the Betsi Cadwaladr University Health Board.