THE death of a 53-year-old patient at a Dewsbury hospital might have been prevented had mistakes not been made following his cancer surgery, an inquest has heard.
The Huddersfield hearing was also told that one of the people involved in treating Mr John Wynn was surgeon Abdul Mohammed Basheer – criticised for his work in two inquests last month.
And in his findings, Coroner Paul Marks recorded a verdict of misadventure aggravated by neglect. He criticised delays in treating Mr Wynn when problems arose.
Mr Marks said: “Expert medical evidence suggests that basic medical attention would have involved taking Mr Wynn to theatre within the hour, which of course did not happen.
“This represented a gross failure and there is a clear and direct causal link between these factors and the death”.
Ex-miner Mr Wynn – landlord at the Hope and Anchor pub in Pontefract – died in Dewsbury And District Hospital in May 2006, 10 days after surgery to remove cancer from his oesophagus.
The inquest heard Mr Wynn suffered massive blood loss caused by a tear to the aorta which may have been brought on by an untreated leak at the site of the surgery.
The family’s barrister, Claire Watson, told the hearing delays in treating the blood loss led directly to Mr Wynn’s death and argued that the hospital trust was, therefore, guilty of neglect.
Expert witness Professor Derek Alderson – a consultant surgeon – said mistakes were made in Mr Wynn’s post-operative care including a delay in getting him into operating theatre when the blood loss became apparent 10 days after the initial surgery.
Prof Alderson said a man aged around 50 would not have succumbed had surgeons intervened earlier and repaired the damage to the aorta.
He also said use of a certain type of oxygen mask during Mr Wynn’s recovery went against common sense and was “illogical” as its pumping action had a tendency to “blow up” the work the surgeon had carried out.
Mr Wynn was eventually taken to theatre, but Miss Watson claimed vital hours were wasted and by the time the leak was found it was too late to save his life. Prof Alderson said Mr Wynn “would likely” have survived had he been taken to theatre earlier.
The hearing was told consultant surgeon Abdul Mohammed Basheer, who carried out the original cancer surgery with colleague Clive White, delayed taking Mr Wynn to theatre to determine the blood loss because the correct type of blood was not immediately available and because he believed Mr Wynn’s condition had stabilised.
But Prof Alderson said tests could and should have been done to try to discover the cause of the blood loss. And, he added, O negative blood could have been used in an emergency.
Mr Basheer told the hearing Mr Wynn had been progressing well after the cancer surgery, but had been given assisted ventilation to help his breathing.
Mr Basheer said had he operated immediately and found the torn aorta there would not have been the blood available for a transfusion and Mr Wynn would have died. He claimed he was told there wasn’t enough O negative blood in the hospital and requested six units of Mr Wynn’s blood type to be brought straight away. A delay was caused because the patient’s blood was found to contain problematic antibodies.
After the case the Trust insisted they had robust systems in place to examine concerns and said the practice of all surgeons was monitored.
A spokesman said they had every confidence in Mr Basheer.