A&E 'should have been warned' by paramedics about seriously ill 21-year-old with sepsis
A&E 'should have been warned' by paramedics about seriously ill 21-year-old with sepsis
.'Caring' Bethan Amy James was admitted to hospital by ambulance and died the next day
Bethan James was just 21 when she died
Paramedics 'should have' alerted A&E staff that the seriously ill daughter of a former cricket star was on her way to hospital, an inquest has heard. 'Caring' and 'beautiful' Bethan Amy James was admitted to hospital on February 8, 2020 and died the next day.
An ongoing inquest into her death, which began on Tuesday, heard that her death was caused by a combination of sepsis, pneumonia and Crohn's disease. Budding journalist Bethan was the daughter of former Glamorgan and England cricketer Steve James.
A highly respected sports journalist himself, Mr James was away covering Wales' Six Nations match in Ireland when his daughter was taken seriously ill.
Heartbreakingly due to weather delays he was unable to get home and see her before she died. In the lead up to Bethan's death, her family say she was 'dismissed' by multiple medics and that 'her life could have been saved'.
During the second day of Bethan's inquest on Wednesday it was heard how there was an apparent 'insufficient urgency' when paramedics arrived at Bethan's home in St Mellons, Cardiff, that evening.
Giving evidence, paramedic Laura Wilson accepted that she should have 'pre-alerted' the University Hospital of Wales in Cardiff of Bethan's arrival. However, she did not.
Article continues below
She said her experience with Bethan has informed her practice as a paramedic as well as her understanding of sepsis.
Speaking to coroner Patricia Morgan, Ms Wilson said: 'It was a long time ago. My practice is completely different now than it was then.
'At the time, on reflection, I should have pre-alerted and taken that phone call to the hospital. I was aware Bethan was very poorly and we needed to get her to hospital.'
She added that at the time she wasn't fully aware of the 'nature of decline' associated with sepsis.
Emergency medical technician Aaron Hook - who drove the ambulance and accompanied Ms Wilson - agreed that a pre-alert 'definitely' should have happened.
The inquest heard evidence that blue lights were not activated during the journey from Bethan's home to the hospital.
Ms Wilson accepted this was her decision but said activating the lights may not have been appropriate.
'The purpose is to make progress to [the destination] and alert other road users of your presence,' she told the inquest. 'Their use wouldn't have achieved [this] any quicker and my thought process was using sirens and lights would have only served to add to Bethan's stress.'
She noted that Bethan looked 'very poorly' and that she was 'very upset and distressed'.
Bethan was the daughter of Glamorgan and England cricket star Steve James
The inquest heard how the ambulance was on the scene for 29 minutes in total, which Ms Wilson said was 'not unreasonable'.
Although she did not pre-alert the hospital she told the inquest that the University Hospital of Wales is 'prompt' and 'the best' in the area at offloading patients from ambulances.
She estimated that it took around five or 10 minutes for Bethan to get into hospital, adding there was 'no major delay'.
However the inquest heard further evidence that Mr Hook rushed into the hospital to find a bed for Bethan in resus.
It was heard that the nurse in charge of resus that day, Carys Williams, told Mr Hook that the ward was at full capacity, but that she was aware of a 'buffer bed' - which is used when no beds are available - in the nearby 'majors' department.
It is understood that resus is the highest-intensity department at a hospital where those with life-threatening conditions are treated, whereas majors is a step down from this; where patients requiring close observation and treatment are seen.
It was heard how Bethan was taken to the buffer bed at the majors department when she first entered the hospital shortly after 7.45pm. She later went down to resus at 9.15pm, before she fell into cardiac arrest at around 9.35pm, it was previously heard.
Ms Williams said if staff had been pre-alerted it would have 'rung alarm bells' and triggered a discussion with the consultant.
It may have given medics time to select and transfer a current resus patient to the majors buffer bed, she explained.
Ms Williams told the inquest how when Mr Hook spoke to her on Bethan's arrival she only recalls him describing Bethan as 'unwell'.
When probed by Welsh Ambulance Service Trust Advocate Jack Scott on why she didn't ask Mr Hook for more information, she reiterated that she had no capacity and it could have delayed matters at that point to take a medical history.
The family's advocate, Richard Booth, put to Ms Williams an FOI obtained by the family detailing how many beds were available in resus that day, which suggested a bed may have been available.
Ms Williams reiterated that she was at full capacity for adults and that the availability likely referred to a free paediatric bay, adding: 'I don't recall any children coming in on that day.'
Mr Booth further asked Ms Williams to confirm if she later referred to Bethan's deceased body as 'it'. Ms Williams said she did not and would not have said this.
The inquest heard evidence from consultant Bethan Morgan who took charge of Bethan's care less than an hour before she died. Shortly before she passed it was heard how Bethan suffered a cardiac arrest.
Mr Booth asked Dr Morgan if she agreed that the cardiac arrest could have been prevented if Bethan had been promptly transferred to the hospital and arrived at resus.
In response she said: 'My opinion is I think Bethan would have died of this illness regardless.'
She added that it was difficult to say for definite since she had not seen Bethan at the time paramedics first attended her home. She described Bethan's deterioration as 'atypical'.
Mr Booth acknowledged that medics at the time were 'trying to piece together' what was causing Bethan's presentation that day, and that it was not known that the cause of Bethan's sepsis was 'viral'.
Dr Morgan said: 'I think we assumed it was bacterial at the time of seeing her.'
During the first day of the inquest on Tuesday it was heard how Bethan was 'dismissed' by a number of medics in the weeks that led up to her death.
Speaking on Tuesday her heartbroken mother Jane James described Bethan as a 'caring' and 'beautiful' person who always put others before herself.
Diagnosed with Crohn's disease in 2019 at the age of 20, Bethan documented her experience of the condition through a vlog and had hopes of becoming a journalist.
Article continues below
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.' The inquest continues
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Independent
2 hours ago
- The Independent
Labour pledges to lower A&E waiting times and end NHS ‘corridor care'
The government has pledged to drastically reduce the number of patients facing long waits in A&E, with plans also set out to end "corridor care". According to the Department of Health and NHS England, almost £450 million will be invested in creating better care and more facilities, with an emphasis on caring for people closer to their homes. The new Urgent and Emergency Care Plan for England states that more needs to be done to drive down long waits, cut delayed discharges, and improve care for patients. An earlier version of the document said NHS trusts would need to show how, by this winter, systems will "improve flow through hospitals, with a particular focus on patients waiting over 12 hours, and eliminate corridor care". The later version does not commit to a timescale for ending corridor care, instead stating that systems must "improve flow through hospitals, with a particular focus on reducing patients waiting over 12 hours and making progress on eliminating corridor care". Ministers have also set an ambition for a minimum of 78% of patients who attend A&E to be admitted, transferred, or discharged within four hours, up from the current 75%, meaning "over 800,000 people a month will receive more timely care". There will also be a focus on seeing more children. The Government wants to slash the number of patients waiting more than 12 hours for a hospital bed – or to be discharged from A&E – so this occurs 'less than 10% of the time', according to the new document. Around 1.7 million attendances at A&E every year currently exceed this time frame. Further measures in the plan are intended to drive down delayed discharges from hospital, which occur when people are medically fit to leave but care in their homes or community has not yet been put in place. Local performance targets will be set to improve patient discharge times, and 'eliminate internal discharge delays of more than 48 hours in all settings', the plan said. Experts said A&E 'league tables' will be published to drive up performance. Those patients who need an overnight emergency admission will also have their overall stay reduced where appropriate – the average is 'currently nearly a day longer than in 2019'. The plan further sets out how ambulance waiting times for category 2 patients – such as those suffering stroke, heart attack, sepsis or major trauma – will be cut by more than 14%, from 35 to 30 minutes. A previous target of 18 minutes has been repeatedly missed. In the document, there is an aim to 'eradicate' last winter's lengthy ambulance handover delays by meeting a maximum 45-minute target for patients to be handed over to A&E. This should help 'get 550,000 more ambulances back on the road for patients', it says. According to the document, around 40 new same day emergency care and urgent treatment centres will also be established to treat and discharge patients the same day, avoiding unnecessary admissions to hospital. Almost 500 new ambulances will also be rolled out across the country by March 2026. The plan details 15 mental health crisis assessment centres, which are designed to ensure mentally ill people do not have to wait in A&E for hours for care. It comes after the NHS experienced a crisis over winter, with patients waiting hours for beds and regularly being treated in corridors – so-called corridor care. A&E waiting time targets have not been met for more than a decade, while the 18-minute target for category 2 ambulance calls has never been hit outside the pandemic. Health Secretary Wes Streeting said: 'No patient should ever be left waiting for hours in hospital corridors or for an ambulance which ought to arrive in minutes. 'We can't fix more than a decade of underinvestment and neglect overnight. 'But through the measures we're setting out today, we will deliver faster and more convenient care for patients in emergencies. 'Far too many patients are ending up in A&E who don't need or want to be there, because there isn't anywhere else available. 'Because patients can't get a GP appointment, which costs the NHS £40, they end up in A&E, which costs around £400 – worse for patients and more expensive for the taxpayer. 'The package of investment and reforms we are announcing today will help the NHS treat more patients in the community, so they don't end up stuck on trolleys in A&E.' Under the plans, paramedics will play a bigger role in the community, with patients given 'more effective treatment at the scene of an accident or in their own homes from ambulance crews'. More patients will also be seen by urgent community response teams in their own homes to try to avoid hospital admission. The NHS is also pledging better use of virtual wards, where patients are monitored by hospital staff from their home, and there are plans to drive up vaccination rates among NHS staff to help protect patients. The Liberal Democrats claimed the Government had listened to their calls to end corridor care, but called on ministers to follow through on their promises. Lib Dem health spokesperson Helen Morgan MP said: 'Patients have heard these kinds of promises before only to be led up the garden path. 'We can't bear any more of the shameful neglect and failed delivery that we saw for a decade under the Conservatives. 'It's good to see ministers finally listen to Liberal Democrat demands to end corridor care but the misery in our A&Es will only be prolonged if they continue to move at a snail's pace on social care. 'Until they grasp this nettle, millions are at risk of dangerously long waits in A&E. 'They must see sense and conclude their review into social care by the end of this year.'
Wales Online
3 hours ago
- Wales Online
Dying dad denied treatment that will give him more time with kids
Dying dad denied treatment that will give him more time with kids Former Welsh Rugby Union commercial director Craig Maxwell was first diagnosed with incurable lung cancer in September 2022 and has raised £1.6m for charity since Craig Maxwell with his children Zach and Isla after rowing 72 miles from Tenby to Cardiff (Image: Mark Lewis ) A terminally ill former Welsh Rugby Union commercial director has had his request for a potentially life-extending drug turned down in the midst of his latest fundraising efforts. Craig Maxwell, who was diagnosed with incurable and inoperable lung cancer back in September 2022, has been undergoing chemotherapy alongside using amivantamab - a drug not yet approved in the UK, but one that Maxwell says could give him an extra "invaluable" six months with his family. Having previously been turned down for funding, Maxwell had to pay for the first quarter of his treatment himself - recently telling WalesOnline it cost him nearly £22,000. The treatment is approved in the US and some parts of Europe but is not yet freely available in the UK - with it currently going through the NHS approval process. Prior to applying to a Individual Patient Funding Request panel, Maxwell said that the costs of continuing on the drug would be around £100,000. Since his diagnosis, Maxwell, who also previously worked for the Six Nations, has completed the London Marathon, cycled from Cardiff to Paris and, last year, he walked the entire 780-mile Wales Coastal Path in just 26 days, delivering the match ball ahead of Wales' Six Nations clash with France. In doing so, he has raised around £1.6m for charities and will not use any of that money for his own treatment. Article continues below Most recently, he rowed from Tenby to Cardiff ahead of the Champions Cup final at the Principality Stadium. It was during this latest challenge when he discovered his request for funding had not been successful, despite the fact that his latest results show that his cancer is "stable and has stopped growing". "They feel it's not making a considerable benefit to my quality of life versus the cost," he told BBC Radio Wales Breakfast. "I've found that hard to accept, because in my position, six to nine months is invaluable. "There's no cost you can put on that, to have six or nine months with my family." Maxwell told the BBC that some private donors had offered help, but, as he faces having to continue paying for the drug himself, he is planning to go through the appeals process to overturn the decision. "The IPFR panel exists to support patients like me in Wales," he added. "I understand the drug is very expensive. "But it is the best thing for me at the moment and it was recommended to me by multiple professionals." He added that his his family are trying to enjoy their time together, as he recognises that "staying close is important". "There have been some amazing moments and experiences throughout this journey and I have to savour them," he said. Cardiff and Vale University Health Board told the BBC it had "worked extensively" with Maxwell to raise awareness of his condition. Article continues below "We are unable to comment further on individual patient cases," the health board added.
Rhyl Journal
4 hours ago
- Rhyl Journal
Stark inequalities in cancer rates across Wales revealed
The report by Public Health Wales' Welsh Cancer Intelligence and Surveillance Unit (WCISU) found that people's housing, job, and ethnicity impact cancer incidence rates. To conduct the study, researchers linked all-Wales cancer registry data to Census data, using anonymising techniques to maintain confidentiality. The researchers then analysed the data to determine how cancer rates differed across the Welsh population based on ethnicity, housing type, and job. They found that people living in overcrowded housing had a cancer rate seven times higher than those with two or more spare rooms. Similarly, residents living in social housing had cancer rates nearly three times higher than those owning their homes outright. The study also revealed variances in cancer rates among different ethnic groups. The White population showed the highest overall cancer rates, partly due to the older age of this group. However, people from Mixed ethnic backgrounds were generally diagnosed at a later stage, which could potentially hinder cancer survival. The study also showed that Black men and Asian women were more likely to be diagnosed with prostate and breast cancer, respectively. The study shed light on the type of jobs and their connection with cancer incidence. People in lower-paid and manual jobs, such as process, plant, and machine operatives, had the highest cancer rates. They were also more likely to receive a late-stage cancer diagnosis compared to those in professional roles. Professor Dyfed Wyn Huws, director of the Welsh Cancer Intelligence and Surveillance Unit, said: "This is the first time we've been able to look at unfair inequalities in cancer rates through this level of detail using individual data across the whole of the Welsh population. "It's a major step forward in understanding and reducing cancer inequalities in our society. "It has enabled us to get a much greater level of detail of the socio-demographic factors at play, by looking at individual or household measures of inequality, rather than area-level analysis. "It's a strong baseline for future work and a clear call to action to focus on where cancer and other health inequalities start." Professor Huws added that in many parts of Wales, elements crucial to health and well-being, such as healthy homes, good jobs, sufficient income, community connections, education and skills, and safe, clean environments, are either lacking or inadequate. He said: "Up to four in 10 cases of cancer are potentially preventable amongst the population of Wales as a whole. "Preventing cancer and achieving earlier diagnosis is a priority for everyone in the system." The study used linked data from the Welsh Cancer Intelligence and Surveillance Unit's national cancer registry and the 2011 Census, via Swansea University's SAIL Databank.
