A RETIRED lorry driver from Colwyn Bay who died in hospital would have had a “good chance” of surviving surgery had a more appropriate initial diagnosis been made, an inquest heard.

Barry Edwards died aged 84 at Ysbyty Glan Clwyd, Bodelwyddan after collapsing early on January 11, 2021 at his home on Dolwen Road.

At a full inquest into his death, held in Ruthin on August 15, John Gittins, senior coroner for North Wales East and Central, gave a conclusion of death arising from natural causes.

A medical cause of death of ruptured abdominal aortic aneurysm was provided.

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Joanne Brown, Mr Edwards's daughter, told the inquest that, prior to his death, her father had been in "very good health".

Following his collapse in his bathroom, three 999 calls were made to the Welsh Ambulance Services Trust (WAST) between 3.21am and 4.43am.

They were initially categorised as “Amber Two” but later upgraded to “Amber One”.

No WAST resources were available until 4.54am when an emergency ambulance was diverted to Mr Edwards’ home some 10 minutes later.

Mr Edwards was taken to Glan Clwyd at 6.16am and his care was passed on to nursing staff at 6.52am.

Paramedic Ceri Jones, who attended Mr Edwards’ home, said she was concerned he was suffering from gastrointestinal bleeding or an abdominal aortic aneurysm.

She deemed Mr Edwards a “time-critical” patient, transferring him directly to Glan Clwyd’s resuscitation area.

He was then triaged in the category of gastrointestinal bleed, and bracketed in the most serious category of “red”.

Dr Mathiyalagan Paramalingam said he first saw to Mr Edwards at about 7am that morning; an hour before he was due to finish his evening shift.

He said Mr Edwards initially appeared “fully conscious", but he was unsure if he was in a stable condition, given his blood pressure was “borderline”.

The doctor admitted he "should have taken a CT scan earlier" before carrying out a verbal handover prior to finishing his shift.

Mr Paramalingam denied having "one eye on the clock" when asked by Mr Gittins.

Dr Warzala received the handover notes when she started work at 8am.

But it wasn't until 9.20am, about two-and-a-half hours after his admission to hospital, that she saw him, due to receiving a "pre-alert" about another patient.

She suspected he had an abdominal aortic aneurysm due to his collapse, low blood pressure, and history of abdominal pain.

Following CT scans carried out at 11.22am, Dr Warzala said her suspicions were correct and Mr Edwards required urgent surgical intervention.

Vascular consultant Wanniarachige Fonseka said that Mr Edwards lost consciousness while enroute to an operating theatre.

It was agreed, at that time, that Mr Edwards may not benefit from surgery, or even survive a general anaesthetic.

Mr Edwards was pronounced dead in the early hours of January 12.

Independent expert Barbara Phillips, professor in intensive care medicine at Brighton and Sussex Medical School, believed Mr Edwards would have had “just over 50 per cent chance of survival” had he been taken to theatre earlier.

Likewise, an immediate diagnosis of ruptured abdominal aortic aneurysm would also have left Mr Edwards likelier to have survived surgery, she said.

The initial assessment made in his case was, professor Phillips said, “too reliant” on the opinions of the ambulance crew and his triage diagnosis.

As a result, she said, not only was his initial examination “poor”, but the severity of his illness was “underestimated”.

Aidas Raudonaitis, a vascular surgeon, said there was “too long” between the onset of Mr Edwards’ symptoms and the proposed commencing of surgery; the “gold standard” for which is 90 minutes.

He labelled Mr Edwards’ transfer time “not acceptable”, and found there to be “lots of room for improvement” in terms of patient handover and prioritisation.

Emergency department doctors at Glan Clwyd should have called for surgical specialists immediately, he said, given “all signs pointed to an acute abdominal emergency”.

Balasundaram Ramesh, medical director at Glan Clwyd, said Mr Edwards’ case presented a “diagnostic dilemma” to staff and acted as a “learning experience for the whole hospital”.

Betsi Cadwaladr University Health Board (BCUHB) carried out its own investigation into the circumstances surrounding Mr Edwards’ death.

The hospital now has more “screening programmes” for abdominal aortic aneurysms.

Dr Seramanperuman Sivaraman, a Glan Clwyd emergency department consultant, accepted there were “not enough” doctors working night shifts at the hospital at the time.

Since then, two additional registrars and senior house officers have been appointed and the hospital now has three ultrasound machines, compared to just one in January 2021.

Concluding, Mr Gittins accepted the improvements the health board has endeavoured to make, even if it may be "too little, too late" for Mr Edwards.

He refrained from issuing a Prevention of Future Deaths Report, but described the care provided to Mr Edwards as “suboptimal”.

The two-and-a-half-year period between Mr Edwards’ death and yesterday’s full inquest had, he said, left his loved ones with an “open wound”.

Offering his family his condolences, Mr Gittins told them: “What you’ve had to endure in this instance is about two-and-a-half years of the death not being fully closed.

“You have my very sincere apologies for the length of time it’s taken.”