Rhyl man died after ambulance delays left first responder ‘helpless’

Howard Kenneth Tucker died aged 65 at his home on November 5, 2022.

Following a full inquest into his death, held in Ruthin today (April 8), Kate Robertson, assistant coroner for North Wales East and Central, recorded a narrative conclusion.

Mr Tucker’s medical cause of death was noted as chronic obstructive pulmonary disease (emphysema) with pneumonia, contributed to by liver cirrhosis and ischemic heart disease.

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The inquest heard that Mr Tucker had suffered from emphysema for more than a decade prior to his death, but that he had largely found this condition “manageable”.

But an accident which saw a car wheel dropped on his left foot, as well as an incident involving a relative’s dog jumping on him while he lay on a sofa, had caused his health to deteriorate.

Mr Tucker, who had been diagnosed with a hernia earlier in 2022, complained of “a lot of pain” in his chest and stomach on November 5, which led to his partner phoning 111 at about 3.35pm.

Michael Keith Jones, a volunteer with the Welsh Ambulance Services Trust (WAST), arrived at Mr Tucker’s home within roughly 10 minutes of this call, and began administering oxygen to him.

Coroner's Court, Ruthin (Image: Newsquest)

Though Mr Jones requested an ambulance, it did not arrive at Mr Tucker’s home until several hours later.

By 6.30pm, the oxygen in the cylinder which Mr Jones brought had ran out, so he again told WAST’s clinical contact centre that more was needed urgently.

He said Mr Tucker was struggling to breathe and talk by then, before later going into cardiac arrest.

Mr Jones agreed with Ms Robertson’s assertion that he must have felt “helpless”.

Having travelled to Mr Tucker’s home in his own vehicle, which was not suitable for transferring him to hospital, Mr Jones said he was only allowed to carry one oxygen cylinder in it for insurance reasons.

Paramedics arrived at Mr Tucker’s home shortly after 7pm, but despite cardiopulmonary resuscitation taking place, he was pronounced dead later that evening.

Since Mr Tucker’s death, Mr Jones said he can now contact a “clinical support desk”, from whom he can request a call back from an advanced paramedic or nurse as soon as possible.

Neil Stanley, a WAST paramedic who also attended Mr Tucker’s home, said he could not recall another incident in his many years with the trust where a patient has been “left without anything”.

Gill Pleming, WAST service manager, said Mr Jones should not have needed to ask for backup because, as a community first responder, it should have been automatically allocated to him.

There were more than 10 calls for an emergency ambulance ahead of Mr Tucker at the time an initial request was made, she added.

Having investigated Mr Tucker’s case, she found there were “no missed opportunities” to allocate resources to him sooner, primarily due to “significant handover delays” and exacerbated by “operational shortfalls”.

She said there is a “significant amount of work” ongoing to reduce such delays, including the new Cymru High Acuity Response Unit, which seeks to improve outcomes for people who have suffered cardiac arrest.

The trust is also placing greater onus on the use of advance paramedic practitioners and prescribers to support patients during their ambulance waits, meanwhile.

Concluding, Ms Robertson said she acknowledged that those who saw to Mr Tucker on November 5 “clearly did their very best” in “incredibly difficult” circumstances.

She said she was satisfied that first responders such as Mr Jones now have a “direct line” to escalate concerns so that there is “at least the best opportunity of finding an available resource”.

Likewise, Mr Tucker’s partner expressed her gratitude for the “amazing” efforts of Mr Jones and his colleagues.