An inquest has heard how Paul Gage entered the Whittington’s emergency department at 7pm but was not seen until four hours later
Published: 19 August, 2016
by WILLIAM McLENNAN
A PATIENT suffered a “catastrophic” internal bleed after lying on a trolley in pain waiting to see a doctor for four hours at an “overcrowded” A&E department, an inquest has heard.
Paul Gage entered the Whittington Hospital’s emergency department at 7pm but, despite being marked as needing assessment within 10 minutes, he was not seen until four hours later.
At 11pm, the 59-year-old from Muswell Hill was diagnosed with a suspected aneurysm – a swelling of an artery – in his stomach. The aneurysm ruptured at around midnight as he waited for a scan to confirm his condition and he was rushed to the nearby Royal Free Hospital for surgery. He died on the operating table, St Pancras Coroner’s Court was told on Friday.
The emergency department of the hospital in Magdala Avenue had been severely overcrowded and did not have enough resources to deal with the number of patients arriving on March 17 this year, the inquest heard.
The hearing was halted after it became clear that a surgeon, who had not been called to attend court, was required to give evidence to determine if the delays had contributed to Mr Gage’s death.
Stephen Moore, head nurse at the Whittington, said: “The department was under a great deal of pressure. [It] had more patients than it had capacity for at the time.”
The hospital launched a review of the events leading up to the death and medical consultant Ben Killingley, who led the investigation, told the court that had Mr Gage been assessed quicker it was “possible, but by no means certain, the outcome could have been different”.
He said: “I think the rupture already happened before, but the body was able to contain that with clots.” Barrister Samantha Presland, a clinical negligence specialist representing Mr Gage’s family, questioned the assessment that the rupture had taken place before he arrived at the hospital.
Coroner Richard Brittain agreed to adjourn the hearing until the surgeon who operated on Mr Gage could attend and give evidence.
Leena Savjani, a specialist medical negligence lawyer at Irwin Mitchell, representing the family, said after the hearing: “The family has been absolutely devastated by Paul’s death and hope that the inquest will provide answers to the questions and concerns they have regarding his treatment at the Whittington Hospital’s emergency department.”
Before the hearing was adjourned, Dr Killingley told the court that the hospital had introduced a number of changes in the wake of Mr Gage’s death.
He said: “Emergency department staffing, nationally, is difficult. In this case it’s evidenced by having four locum doctors there overnight.”
He said that he had no concerns over the competence of these doctors. This week the hospital launched a new recruitment drive to boost emergency department staffing, he said.
The court had heard that a doctor was called to see Mr Gage at 10pm, but difficulty in finding the patient notes caused additional delays. Dr Killingley said: “I’m not sure it had any direct affect on the outcome of the case...but strengthening and recording better nursing notes is something we want to try and do going forward.”
A spokesman for the Whittington said: “In the days following Mr Gage’s death, we conducted a full investigation into the circumstances surrounding his visit to our emergency department. We have been in regular contact with Mr Gage’s family to keep them informed and have been working closely with the staff involved to put a clear action plan in place to make sure we learn from the important issues identified.”