Former cricket star's daughter 'would have survived' if medics acted sooner
Former cricket star's daughter 'would have survived' if medics acted sooner
There were a 'number of delays' in Bethan James' treatment that 'more than minimally contributed' to her death, a coroner said
Bethan James was just 21 when she died
The death of a cricket star's 'caring and beautiful' daughter could have been avoided, a coroner has concluded. Bethan Amy James was admitted to hospital on February 8, 2020 and died on February 9.
An inquest into her death previously heard that she died of sepsis and pneumonia, which was complicated by the immune suppressing effects of Crohn's disease. However during the inquest's conclusion on Tuesday coroner Patricia Morgan said that Bethan likely 'would not have died' if medics acted appropriately sooner.
The conclusion at Pontypridd Coroner's Court followed three days of evidence earlier this month. It included a statement from Bethan's mother, Jane, who detailed how she believed her daughter had been dismissed multiple times by hospital medics before her death. An expert witness had also shared that he believed Bethan's life could have been saved.
Summarising the relevant evidence that led to her decision, Ms Morgan said that Bethan had a history of Crohn's disease that she had been diagnosed with in 2019 at the age of 20.
Between January 27 and February 6, 2020, she said that Bethan, who was from St Mellons in Cardiff, had attended hospital four times due to feeling unwell.
This included an appointment at Llandough Hospital on January 27, following which Bethan was diagnosed with community acquired pneumonia, for which she was treated with oral antibiotics.
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Following this it was heard how Bethan developed a numbness in the right side of her body and began to feel physically sick, becoming unable to tolerate her antibiotics.
It was heard how an A&E appointment on February 5 focussed on Bethan's neurological symptoms, but there 'should have' been more focus on assessing the already diagnosed pneumonia, Ms Morgan said.
Ms Morgan said that by this point Bethan's interactions with medics made her 'reluctant' to return to hospital as she continued to deteriorate - it was something she was 'desperate to avoid',' Ms Morgan said.
Bethan James wanted to raise awareness of Crohn's and documented her diagnosis on YouTube
(Image: YouTube )
Previously it was heard how more than one doctor made comments towards Bethan that made her feel dismissed. Including one who said words to the effect of: 'You again! You were here on Sunday,' when she felt seriously unwell. It was also heard how another told her that he had seen a teenager with similar symptoms who was 'now symptom free and fine.'
On February 8 Ms Morgan detailed how further mistakes were made by medics that 'more than minimally' contributed to Bethan's death.
She recalled evidence that Bethan's mother called an ambulance for Bethan at around 6.12pm.
A rapid responder arrived by 6.23pm and identified that Bethan was very unwell and required an ambulance to take her to hospital. However, it was heard how the responder called for a P3 ambulance response, which refers to a low priority. He later escalated this to a P2.
Ms Morgan found that the P3 decision 'made no material difference' to the arrival time of the ambulance. However, she said it showed a "lack of urgency and appropriate response' when 'Bethan's condition warranted an emergency response'
Further, she said that ambulance paramedics did not pre-alert the University Hospital of Wales in Cardiff of Bethan's arrival.
Ms Morgan said that this meant medics were not prepared for Bethan, and that a bed was not secured for her in resus. She said: 'When Bethan arrived at hospital she was transferred to majors, when she should have been admitted directly to resus.'
She said this led to an 'unwillingness of the lead nurse [in resus] to become involved in decision making', adding that this resulted in time being used to triage Bethan.
It further contributed to a delay in recognising Bethan's critical condition, as well as delayed appropriate treatment, she said.
Regarding Bethan's outcome she noted conflicting evidence from the doctors involved in looking after her, and an expert witness who works in a different hospital.
Bethan's family called her 'caring and beautiful'
Dr Duncan Thomas, who treated Bethan at hospital, previously told the inquest how Bethan's rate of deterioration was 'a-typical'. He added that he believed Bethan would have died regardless of the medical treatment she received on February 8.
However expert witness Dr Chris Danbury disagreed, saying that Bethan's cardiac arrest could have been avoided. He said a pre-alert should have ensured Bethan a place in resus, and that 'cognitive bias' - where resus patients are regarded as priority - would have worked in Bethan's favour.
On Tuesday Ms Morgan said she was more persuaded by Dr Danbury's evidence, that with a pre-alert and appropriate treatment earlier on, Bethan's cardiac arrest would likely have not happened when it did. She said: 'On balance, I find that Bethan would not have died.'
Concluding the inquest Ms Morgan delivered a narrative conclusion. She told the inquest that Bethan died as a result of pneumonia which led to sepsis which led to septic shock.
She said there were a 'number of delays' in Bethan's treatment that 'more than minimally contributed' to her death.
Ms Morgan said she is still yet to make a Regulation 28 to prevent future deaths. She said the decision is pending further clarification from the University Hospital of Wales, which she has asked for by next week.
Addressing Bethan's family, Ms Morgan offered her condolences, adding: 'It has been five years plus since Bethan passed away. I don't doubt the pain still is as strong and difficult today as it was back then.'
She further apologised for the delay between Bethan's death and the inquest taking place.
Bethan's mother, Jane, previously paid tribute to her daughter during the first day of the inquest.
She described Bethan as a 'caring' and 'beautiful' person who always put others before herself.
Bethan was the daughter of Glamorgan and England cricket star Steve James
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.
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 - named Strictly Amy: Crohn's and Me - sadly aired after Bethan's death, and the programme was dedicated to her memory.
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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.'
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