Former cricket star's 'beautiful' 21-year-old daughter was 'dismissed multiple times' by medics before her death
Former cricket star's 'beautiful' 21-year-old daughter was 'dismissed multiple times' by medics before her death
Bethan James' devastated mother told an inquest that her daughter was 'dismissed' by multiple medics and that 'her life could have been saved'
Bethan James pictured celebrating her 21st birthday
A former cricket star's 21-year-old daughter was 'dismissed' multiple times by doctors before she died in hospital, an inquest has heard. Bethan Amy James was admitted to hospital on February 8, 2020 and died on February 9.
Bethan, the daughter of former Glamorgan and England cricketer Steve James, was just 21 when she died. Mr James, a highly respected sports journalist, was away covering Wales' Six Nations match in Ireland when his daughter was taken seriously ill, and due to weather delays was unable to get home and see her before she died.
The first day of an inquest into Ms James' death opened on Tuesday at Pontypridd coroner's court. It heard how Bethan had visited hospital on several occasions prior to February 8.
Her doting mother, Jane James, told the inquest that her daughter was 'dismissed' by multiple medics and that 'her life could have been saved'.
Speaking in person at the inquest Jane James described Bethan as a 'caring' and 'beautiful' person who always put others before herself.
She explained that Bethan had suffered with gastrointestinal issues throughout most of her life, before she was diagnosed with Crohn's disease in 2019 at the age of 20. Mrs James said her daughter took her diagnosis with 'great maturity'.
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Prior to her death Mrs James said Bethan had been studying journalism at the University of South Wales and dreamed of being a voice for those with Crohn's and related illnesses.
It was heard how Bethan had started a vlog account where she documented her experience of the condition, before she became involved in a BBC documentary with Amy Dowden, who is also diagnosed with the condition.
The documentary sadly aired after Bethan's death, and the programme was dedicated to her memory.
Paying tribute to her daughter Mrs James said: 'As a person she never moaned, she never made a fuss. She was very caring. She was just beautiful.
'She put people before herself. She was more interested in other people and their stories and I think that's why she would have made a brilliant journalist.'
Bethan was the daughter of Glamorgan and England cricket star Steve James
Mrs James told the inquest about the heartbreaking events that led up to her daughter's death.
She explained how on Saturday, January 25, 2020 her daughter had been out in town with a friend when she complained of feeling tired and having shortness of breath.
Mrs James said they decided to book her daughter in for an emergency appointment with her GP on Monday, January 27.
The inquest heard that her GP, Dr Jonathan Carnell, was concerned about Bethan and set up an urgent referral at Llandough hospital for her respiratory symptoms to be investigated.
It was heard that discharge summary notes from the appointment on January 28 read that Bethan was likely suffering from 'community acquired pneumonia'.
She was given antibiotics and discharged. However, Mrs James said this diagnosis was not verbally relayed to her or her daughter by medics at the hospital.
She said: "They didn't tell her 'community acquired pneumonia'. We sat in the waiting area and they said they think she may have a chest infection and that she should take antibiotics as a precaution."
She added that if the word 'pneumonia' had been used it would have struck the family as more sinister in that early stage of her illness developing.
The following day, on Tuesday, Mrs James said her daughter was determined to go to university to deliver a presentation that was important to her.
Bethan was well enough to drive herself to university, but was 'absolutely exhausted' by the time she got home, it was heard.
She developed numbness in her right arm and continued feeling short of breath, the inquest was told.
Over the next few days Bethan developed more symptoms including involuntary movements in her right arm and difficulties using her right arm and hand.
It was heard how she struggled to hold a cup and had problems holding her arm above her head.
In addition it was heard how Bethan was suffering abdominal pain and nausea to the point of being unable to 'tolerate food'.
'On Tuesday she could drive, and by Sunday she couldn't hold a cup in her hand,' Mrs James told the inquest.
Why we cover inquests – and why it's so important that we do
As painful as these proceedings are for those who have lost a loved one the lessons that can be learned from inquests can go a long way to saving others' lives.
The press has a legal right to attend inquests and has a responsibility to report on them as part of their duty to uphold the principle of open justice.
It's a journalist's duty to make sure the public understands the reasons why someone has died and to make sure their deaths are not kept secret. An inquest report can also clear up any rumours or suspicion surrounding a person's death.
But, most importantly of all, an inquest report can draw attention to circumstances which may stop further deaths from happening.
Should journalists shy away from attending inquests then an entire arm of the judicial system is not held to account.
Inquests can often prompt a wider discussion on serious issues, the most recent of these being mental health and suicide.
Editors actively ask and encourage reporters to speak to the family and friends of a person who is the subject of an inquest. Their contributions help us create a clearer picture of the person who died and also provides the opportunity to pay tribute to their loved one.
Often families do not wish to speak to the press and of course that decision has to be respected. However, as has been seen by many powerful media campaigns, the input of a person's family and friends can make all the difference in helping to save others.
Without the attendance of the press at inquests questions will remain unanswered and lives will be lost.
Due to her worsening symptoms Mrs James said she took her daughter to accident and emergency (A&E) at the University Hospital of Wales in Cardiff on Sunday, February 2.
Mrs James said she clearly remembers the day, including telling the triage nurse about the previous appointment in Llandough. In response, she said the nurse was 'abrupt' which upset her daughter.
She explained how Bethan was seen by one particular doctor who was 'dismissive' of her chest symptoms. She said he did not think it was of 'any significance'. She said he spoke to A&E consultant Dr Chen Wen Ngua for advice as well as to neurology registrar Dr Mark Willis.
It was heard how the outcome of this hospital trip was that Bethan's symptoms were likely the result of a hemiplegic migraine. Mrs James said: 'I don't feel on the 2nd that they fully assessed her.'
Mrs James became emotional when she described how on Monday, February 3, her daughter had collapsed because she was 'so exhausted' from being at hospital.
Following this Mrs James said an ambulance was called and although paramedics arrived her daughter said she did not want to go to hospital, having felt dismissed by various medics and exhausted by the hours of waiting around she had already endured.
It was heard how paramedics noted that Bethan's heart rate was high, but that she couldn't be forced to go to hospital.
Two days later, on Wednesday, February 5, Bethan's symptoms persisted in her right arm, and she had also developed numbness and issues with her right leg.
'Myself and my husband knew we needed to do something to try and find out what was going on,' Mrs James told the inquest. She said they took her back to A&E at the University Hospital of Wales.
During this visit Mrs James said they encountered Dr Ngua for the second time.
She described him as "very, very dismissive" of her daughter and recalled that he told her daughter words to the effect of: 'You again! You were here on Sunday.'
What is Crohn's disease?
Crohn's disease causes inflammation of the digestive system's lining - from the mouth to the back passage - and is a long-term condition.
The exact cause of the disease is not known, but factors can include genetics, immune system problems, previous infections and environmental factors.
There is no cure.
Common symptoms can include: Diarrhoea
Abdominal pain
Fatigue
Unintended weight loss
Blood and mucus in faeces
About 115,000 people in the UK currently have the condition.
This was despite the fact that Bethan was advised to come back to hospital if her symptoms continued or worsened, which they had.
Speaking during the inquest Dr Ngua said he "did not mean to be dismissive" when he made that comment.
He said on reflection Bethan's high heart rate could have been investigated further.
Mrs James said while in the hospital waiting area a medic came and did an observation of her daughter.
During this, she explained how her heart rate appeared unusually high.
Mrs James said the medic assumed that the machine was broken, but that the family believe it was more likely that Bethan was being dismissed and that her heart rate really was that high.
Coroner Patricia Morgan asked Mrs James whether she thinks her daughter should have been admitted at this point.
'Definitely,' she said. 'She was so unwell. They didn't appreciate how unwell she was.'
Mrs James added that it was only when she threatened to contact health board seniors that medics agreed to arrange a follow up appointment with neurology. Meanwhile, Bethan could 'barely walk out of the hospital,' she said.
The family was advised to return to the hospital the following morning for the neurology referral, Mrs James said.
However, upon their arrival she said there was 'no record' of the referral appointment and that medics had 'no idea' why they were there. She described this as 'appalling'.
Mrs James said: 'Again her heart rate was off the scale and they said the machine was not working - it probably was just her heart rate and it was dismissed again.'
Mrs James added that throughout the assessment, which was with Dr Willis, her daughter's respiratory symptoms were not investigated.
She noted a comment made by Mr Willis that she found inappropriate during the assessment.
She said: 'He said he had seen a 17-year-old girl with similar symptoms and that she is now symptom free and fine. I have no idea how he could say this to Bethan without diagnosing her.'
She said Dr Willis did organise for blood tests to happen that day, but that Bethan was so dehydrated by the time that these came about that medics could not draw blood.
Bethan was advised to get these done at her GP instead. Mrs James added: 'I felt they just wanted Bethan out of there as soon as possible.'
Speaking during the inquest Dr Willis said he made the comment in an attempt to show compassion and reassure Mrs James. He added: 'I'm sorry to hear Mrs James feels she wasn't listened to.'
Answering questions from the family's advocate, Richard Booth, Dr Willis said it was unusual for neurology assessments to result in hospital admission. He said when examining Bethan he found only mild weakness in her right arm.
He addressed that neurological symptoms of the nature experienced by Bethan were rare in cases of sepsis.
On Saturday, February 8, Mrs James said her daughter had been in bed all afternoon. By the afternoon she said she was watching rugby with her daughter and trying to encourage her to eat.
By 4pm Mrs James said her daughter 'looked dreadful' with bags under her eyes and nails so pale she thought she was wearing white nail polish.
On a number of occasions Mrs James recalled asking if she could call for an ambulance, but in response her daughter reiterated that Dr Willis said she would soon be fine. However, she called 999 that evening.
The first person to arrive was a rapid response paramedic named Paul Humphries. Mrs James said Mr Humphries could not record Bethan's blood pressure properly.
In hindsight Mrs James said she now knows this is a sign of sepsis. She said the 'signs' of sepsis were 'right in front' of Mr Humphries.
The inquest heard how initially Mr Humphries called for a P3 ambulance response, which refers to a low priority. He later escalated this to a P2.
Mrs James said: 'I don't know why someone doesn't get a P1 when they are so unwell.'
Speaking during the inquest Mr Humphries said in hindsight he believes he dealt with Bethan appropriately, adding: 'I didn't come away from that incident thinking I did a bad job.'
When the ambulance turned up Mrs James said she didn't sense any 'rush' to get her daughter to hospital. She finally arrived at 7.45pm following a 12 minute journey, it was heard.
Mrs James described that on arrival at the University Hospital of Wales they had to wait in the ambulance outside the hospital for some time.
She said they 'now know' there was a bed available, claiming her daughter wasn't 'deemed unwell enough' to have it.
At 8.10pm Ms James was triaged before she went down to resus at 9.15pm.
Mrs James said it occurred to her that her daughter was only at this point going down to where she needed to be to receive help, some three hours after the ambulance had been called.
She described there being 'chaos' at the hospital as medics struggled to administer a line into Bethan, and with nobody clearly in charge of her care.
Mrs James said she believes it should have been administered in her daughter's neck instead for easier access, or that she should have been taken down to intensive care.
All the while this was ongoing Mrs James said her daughter was awake, could 'hardly breathe' and was 'so scared'.
After some time Mrs James said an anaesthetist came down and Bethan was put to sleep. Mrs James said she felt that with that her daughter's body lost its ability to fight.
She said she was asked to leave the room at around 9.25pm before she was told that her daughter had a cardiac arrest a short time later.
Mrs James recalled being told that medics were working on her daughter and asked if she wanted to be with Bethan as she passed away.
'As soon as I walked in, I knew she was dead,' Mrs James said.
She commented that a sepsis protocol should have been put in place early on and that her daughter 'should have had the right care straight away'.
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She added: 'It's heartbreaking as a mum to know that her life could have been saved. They didn't know what they were doing.'
The inquest continues.
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