Rhyl man was ‘deprived’ of treatment due to 12-hour ambulance delay

But the coroner concluded that it was the fall that resulted in his death - not the 999 delay.

George Howell died aged 78 at the Bodelwyddan hospital on August 2, 2022, after suffering a fall at his home in Rhyl.

At a full inquest held in Ruthin today (July 19), Kate Robertson, assistant senior coroner for North Wales East and Central, gave a conclusion of death arising from natural causes due to traumatic injury from the fall.

Mr Howell’s medical cause of death was recorded as heart failure due to ischemic heart disease, and chronic obstructive pulmonary disease with cor pulmonale (enlargement of right side of heart) contributed to by spinal fracture.

The inquest heard that Mr Howell suffered a fall from his bed when reaching for a glass of water in the early hours of August 1, and was stuck on the floor in pain and unable to get up.

A call was made by his daughter Valerie Tromans at 3.44am, which was correctly coded and designated an Amber Two case by Welsh Ambulance Service, which is ‘serious but not life-threatening’.

At the time, they were given an estimated time of arrival of an ambulance of five to seven hours, based on demand and the ability to respond.

Ms Tromans said that at 11.25am, parts of her father’s nose and ears were blue, and he was in considerable pain.

A second call was made by a district nurse at approximately 1.37pm, where the case was upgraded to Amber One, considered life-threatening – because Mr Howell was breathing and conscious this could not be upgraded further.

The estimated time of arrival at this stage was two to four hours.

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A third call to emergency services was made at 3.38pm, where despite consciousness there was an “indication that there was a deterioration”.

An estimated time of arrival of two to five hours was given on the call.

Paramedics arrived at the property at around 4.30pm, whereby a backup ambulance was called for support – Mr Howell had waited just under 12 hours and 46 minutes since the first call was made.

The nearest backup ambulance arrived a little more than two hours after being called, and an ambulance took Mr Howell to Ysbyty Glan Clwyd at 7.21pm, arriving at 7.35pm.

Mr Howell remained in the back of an ambulance at the hospital for six hours and thirty-five minutes, but had received a CT scan upon arrival.

The scan implied fluid in the tissue surrounding the lungs, and showed evidence of fluid in the sacks around the heart, and also showed a spinal injury.

He was visited by Dr Eduardas Subkovas, a consultant interventional cardiologist, at 3.20am, who said that had an assessment been done earlier, they could have done a full heart scan and this “might have altered the outcome if we had more time to treat him aggressively”.

At this point, Dr Subkovas observed that he was “more unwell than we initially thought” and that the possibility he could have survived was “quite low”.

He was given pain relief while in the ambulance bay, and was transferred to a ward, but was uncomfortable and pleaded for more pain relief, complaining of pain in his back.

He told his daughters to ask for painkillers, but said “something was changing” before never speaking again, and passed away at 6pm, August 2.

Reaching a narrative conclusion, Ms Robertson said: “Mr Howell died due to natural causes contributed by a fall out of bed causing traumatic injury.

“He was deprived of the opportunity for further extensive medical investigation for further treatment due to the long lie and wait."

Addressing Mr Howell’s family, Ms Robertson added: “I can’t see anymore that could have been done at the time, you were between a rock and a hard place as to what could be done.

“You gave him the best possible opportunity – my very best wishes to all of you.”