Ex-England cricketer’s daughter would have survived with quicker care – coroner

The daughter of a former England cricket star would not have died from sepsis had she received more prompt urgent medical care, a coroner has ruled.

Bethan James, 21, the daughter of former Glamorgan and England batter Steve James, died on February 8 2020 just a few hours after being admitted to hospital.

A post-mortem examination found she died of sepsis and pneumonia, with complications caused by Crohn’s disease.

Journalism student

An inquest in Pontypridd heard Ms James, a journalism student at the University of South Wales, died while being treated at the University Hospital of Wales (UHW) in Cardiff.

She had suffered with gastrointestinal issues for most of her life and had been diagnosed with Crohn’s disease in 2019.

Following complaints of being short of breath, Ms James was given antibiotics for community-acquired pneumonia in late January.

Her condition continued to decline, and she was taken to Llandough hospital twice before she was admitted to UHW on the evening of February 8, the inquest was told.

Patricia Morgan, area coroner for South Wales Central, said there were delays in the treatment to Ms James after she arrived at the hospital.

Pre-alert

In recording a narrative conclusion, she said the ambulance crew had failed to issue a pre-alert to the hospital of how sick she was, which would have resulted in her immediate admittance to the resuscitation area of the emergency department.

“I find that the lack of pre-alert to recess resulted in a lack of advanced knowledge of Bethan’s condition and consequently no efforts made to secure a bed for her in the resus area,” she said.

“There’s no clinical staff waiting for Bethan when she arrived in the way that would have occurred had a pre-alert been issued.

“It resulted in an unwillingness of the recess lead nurse to become involved in the initial decision making, instead directing them to the major assessment nurse in line with admission procedure for those not deemed to meet the issues criteria for resus.

“It resulted in time being taken to triage back then and a further handover being provided to hospital staff in the majors area.

“It’s all been a delay, which in my view, would not have been the case had the pre-alert been issued, critically resulting in a delay of approximately one hour in obtaining the lactate reading for Bethan.”

Expert witness

The coroner said she had heard evidence from doctors working at the UHW, as well as expert witness Dr Chris Danbury, and said she was “more persuaded” by his evidence.

“Dr Danbury expressed a strong view that the outcome would have been different for Bethan if she had been subject to a pre-alert and admitted into resus immediately,” she said.

“I am therefore more persuaded by Dr Danbury’s opinion on treatment options and whether earlier treatment would have made a difference.

“I find that if earlier recognition and prompt action in response to Bethan’s condition upon attendance by ambulance services had occurred, this would have resulted in a pre-alert to the emergency department.

“This would have resulted in direct admission into resus, with clinical staff waiting for her, quicker triage process, and earlier treatment would have and ought to have commenced.

“Earlier lactate treatments would have been available, and the involvement of the specialists would have and ought to have occurred at an earlier stage.

“The cognitive bias towards resus patients would have been directed in Bethan’s favour at the time of her arrival rather than once the lactate result was available.

“On balance I find that had this direct admission to resus and prompter recognition and treatment occurred, then cardiac arrest would not have occurred when it did, which would have enabled more time for other specialities to become involved in Bethan’s care.

“On balance I find that Bethan would not have died.”

Addressing her parents, the coroner said: “It’s been five years plus since Bethan passed away and I don’t doubt that the pain is still as strong as it was back then.

“I’m sure the evidence in relation to Bethan’s passing will have resurrected a lot of your sad memories so I just want to express my condolences on behalf of myself and the coroner’s service.”