A man died hours after ignoring his doctor's advice to go to hospital as a 999 call didn't see an ambulance crew arrive for an hour.
The 55-year-old collapsed at home just hours after his GP told him to go to hospital to get treatment for his serious breathing problems, despite his partner dialing 999 to call for an ambulance. His GP says he has now questioned whether the advice he gave was strong enough, while South West Ambulance bosses launched an investigation and found the call should have been given higher priority.
Mark Rowe, 55, died at his home in Leigham, Plymouth after he stopped breathing following a serious chest infection, reports plymouthherald. Despite attempts by his fiancé, Deborah Osborne, to resuscitate him, the former Naval Base worker, who was diabetic, morbidly obese and suffered with chronic obstructive pulmonary disease (COPD), was pronounced dead by paramedics in the early hours of January 7, 2016.
It was only the day before Mr Rowe's GP had advised him to go to Derriford Hospital after a medical examination revealed he had very low oxygen levels as a result of the chest infection, the inquest was told. But Doctor Timothy Alexander from Elm Surgery said his patient, who was a heavy smoker, declined his advice, and died about 15 hours later.
"He knew that he should go into hospital and he knew things could deteriorate," Dr Alexander told the inquest. "This was not a situation without risk, but [...] I did not think he would die before [his next appointment two days later]."
Mr Rowe's partner of 19 years, Ms Osborne, raised concerns at the inquest that the seriousness of his condition was not pressed upon them enough by the GP. She also questioned, had an ambulance arrived sooner on the night Mr Rowe died, if there would have been a higher survival rate.
In a statement read out at the inquest, Ms Osborne said: "At no time were we given any diagnosis, verbal or otherwise, or any other reason why the GP felt Mark should go to hospital." Mr Rowe, who previously worked as a health physics monitor at HMNB Devonport before medically retiring due to his deteriorating mental health, became ill over the Christmas period.
Noticing how unwell he was, Ms Osborne booked him an appointment with his GP on Wednesday, January 6, which Mr Rowe was reluctant to attend, the inquest was told. It was here, following an hour-long examination, Mr Alexander advised him the best option would be to go to hospital "that day", prescribing him antibiotics in the meantime.
Mr Alexander told the room: "I was very clear but I wanted to avoid having an aggressive approach which I felt would provoke a response that almost boxed himself into a corner, which meant he would not return for a review or seek a review if he deteriorated. I tried to keep it to some extent light-hearted, without avoiding the seriousness of the issue.
"I think any compassionate human being looks back and wonders whether one said enough, however there is a balance between giving due warning but maintaining a relationship that may allow continuing working with that person to persuade them to a different outcome."
It was in the early hours of the following morning Ms Osborne heard her fiancé fall onto the bedroom floor upstairs. In her statement read out at the inquest, Ms Osborne said she "legged it" to her partner, discovering him on his knees on the floor.
Getting him into bed, she dialled 999 at 3.18am to ask for an ambulance to come and take a set of Obs, which was arranged. But it was at about 4am that Mr Rowe stopped breathing, and another 999 call was made. Despite commencing CPR while waiting for the paramedics to arrive, with one paramedic taking over on arrival, Mr Rowe was pronounced dead at the scene.
The inquest heard an internal investigation was launched by South Western Ambulance Service NHS Foundation Trust (SWASft) following his death, which concluded the initial call made by Ms Osborne should have been given a higher priority and therefore arrived within a target time of eight minutes. However concluding, the coroner refused to accept neglect from either party – the GP practice or ambulance service – and recorded Mr Rowe died of natural causes, having accepted the pathologist's cause of death of 1A bronchopneumonia and ischaemic heart disease.
"I have listened to the evidence and have considered it likely Mr Rowe had suffered a sudden cardiac event at about 4am which caused his death," said Mr Bird. "Mr Rowe's death is essentially due to a natural disease process and a consequence of pre-existing medical conditions." A spokesperson from SWASft said after the inquest: "Our thoughts are with Mr Rowe's family and friends at this time. The coroner found that Mr Rowe died of natural causes and there were no formal recommendations for the ambulance service."
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