THE family of a woman from Rhyl who died at Ysbyty Glan Clwyd say she was “failed” by the staff who treated her during her time at the Bodelwyddan hospital.
Laura Jade Rees died aged 33 of multi-organ failure, due to severe hypertension, due to undiagnosed pheochromocytoma (rare tumour of the adrenal glands), on April 24, 2021.
Ms Rees, of Rhyl Coast Road, had presented at the hospital on April 20 due to high blood pressure and low oxygen levels, but died after suffering a seizure which caused irreversible brain injury.
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At County Hall, Ruthin today (November 28), an inquest into her death resulted in coroner John Gittins recording a narrative conclusion, deeming a finding of neglect to be inappropriate.
Mr Gittins, senior coroner for North Wales (East and Central), said Ms Rees’ continued hypertension was “not recognised, and was not therefore effectively addressed”.
Though, he accepted that the finding that “more aggressive management” of Ms Rees’ high blood pressure may have changed the outcome could only be made “with the benefit of hindsight”.
The inquest heard that Ms Rees, a banker, attended Glan Clwyd on April 20, when she explained her symptoms, and that she had an unusual feeling in her abdomen when lying on her right side.
But in a statement, her parents said: “Despite our daughter detailing all of those symptoms, nothing was done by Glan Clwyd to explore what could be causing them.”
They added that hospital staff “seemed to have no understanding of how best to treat Laura”.
On April 21, Ms Rees was moved to Glan Clwyd’s acute medical unit, with staff then believing she had pneumonia.
Ms Rees’ parents said that, on this day, she asked for paracetamol five times before receiving it, and had “no response” when requesting assistance so that she could use the toilet.
She was later moved to the hospital’s coronary care unit, where she collapsed early on April 22, and then to intensive care.
Shortly before 5am on April 22, Ms Rees’ parents were informed to attend Glan Clwyd immediately – when her father and partner arrived, they found her “braindead”.
Her parents said they found this “highly distressing and traumatic”, and felt “little empathy or humanity” was shown by staff.
Requests to transfer her to the Walton Centre in Liverpool also proved unsuccessful, as she was considered too unstable by then to undergo this.
Ms Rees’ parents added: “The care at Glan Clwyd from entering had been inadequate. There was no urgency, and vital opportunities in saving her were ignored and resulted in her death.
“Everyone failed to act, and give her the due attention she deserved.
“Laura was a beautiful person inside and out; the kindest person anyone could have the fortune to meet. She was failed.”
Gavin Cox, her partner at the time, found it “baffling” that pheochromocytoma was not considered a possible diagnosis, and that it was “not mentioned on any of the doctors’ reports”.
Dr Aram Baghomian, on-call consultant at Glan Clwyd on the day Ms Rees arrived, said her heavy sweating was, in hindsight, a possible indicator of pheochromocytoma.
But Dr Baghomian, who said he had never come across a case of pheochromocytoma previously, admitted he did not suspect this to be the case at the time.
He was initially presented with a working diagnosis of a pulmonary embolism in Ms Rees’ case, but said he later felt she had “atypical pneumonia”.
A CT scan was not carried out for Ms Rees until the morning after she arrived, he said, because he first saw her at 7.37pm on April 20, and “not every test is available to you 24/7”.
Nor, Dr Baghomian said, did he consider there to be an urgent need for a CT scan on April 20, because she appeared to be improving that evening.
Dr Craig Beaton took over as the on-call consultant of the coronary care unit on the morning of April 22, when he was informed that Ms Rees had suffered a seizure and was unresponsive.
He also said he had never come across pheochromocytoma in his career, and offered his “condolences and apologies” to Ms Rees’ family for “how I may have come across” to them.
“I knew, all in likelihood, I didn’t have time to reach a diagnosis, and that Laura could slip away regardless of anything we could do,” Dr Beaton said.
“I felt there was a need to convey that message to the family.”
His colleague, Dr Andrew Evans, who first came across Ms Rees on April 23, deemed it likely that her brain stem herniated shortly after arriving in intensive care – after which “nothing could have been done to save her”.
Independent expert Barbara Phillips, professor of intensive care medicine at Brighton and Sussex Medical School, felt greater control of Ms Rees’ high blood pressure from the early hours of April 21 may have made a difference in her case.
She said it was a “shame” that Ms Rees’ CT scan did not happen sooner, though acknowledged it is “within guidelines” to wait overnight for this.
Professor Phillips said: “She was young and hypoxic, and I think it would have been reasonable to push for an immediate CT scan. That would have perhaps changed the dynamic of the thinking early.
“My only concern is that the very high blood pressures were not more aggressively managed. In a young person, it is very unusual to get those sorts of blood pressures.”
Concluding, Mr Gittins said Ms Rees’ pheochromocytoma would have been “difficult, though not impossible, to identify”.
To the clinicians involved in her care, he said: “I’m conscious that none of us live in a perfect world. I remain grateful for the efforts you continue to make, even though you can’t be perfect doctors, ultimately.”
Mr Gittins added to Ms Rees’ family: “The loss you have suffered is one that none of us can recognise, quantify, imagine or understand.
“You have my genuine and sincere condolences on her loss.”
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