Coroner orders report to shine spotlight on Northampton's overcrowded A&E's after inquest 85-year-old man's death

Overstretched emergency departments are far from a local issue - but a coroner wants a Northampton patient's death to be recognised by central government.
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The death of an 85-year-old man who spent nine hours waiting in Northampton's A&E will be used to demonstrate the stress faced by overcrowded emergency departments.

Northampton General Hospital was dealing with one of its busiest days on record when Mohan Archaya arrived at 4pm on March 7, 2018.Nine hours later, the 85-year-old passed away from cardiac arrest after only just getting a bed in the emergency department. He spent much of his stay in a chair waiting for a bed to become available.

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During his nine-hour wait, lapses in care by overstretched staff meant observations were missed or not completed. He was not given a recommended blood transfusion, he was not given pain medication despite a prescription and he did not receive an initial assessment by a doctor for nearly an hour-and-a-half after his arrival.

The death of a man in a Northampton's A&E during on a day with "unprecedented" pressure will be used in a report sent to central government.The death of a man in a Northampton's A&E during on a day with "unprecedented" pressure will be used in a report sent to central government.
The death of a man in a Northampton's A&E during on a day with "unprecedented" pressure will be used in a report sent to central government.

At the end of a two-day inquest yesterday (February 27), coroner Hassan Shah ruled none of these lapses played a major role in Mr Archaya's death - but ordered for a "preventing future deaths" report to be written about the case and sent to the secretary of state for health.

Mr Shah said: "If I think action should be taken to help prevent future harm then it should be reported.

"Although locally the hospital is doing as much as it can to find creative ways of managing the problem, I'm concerned other A&E's nationally could also learn."

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At least 500 people died as a result of overcrowded A&Es in 2017, according to the Royal College of Emergency Medicine.

On the day Mr Archaya arrived complaining of chest pains, NGH's A&E saw an "unprecedented" 450 patients attend for treatment - compared to 300 on the same day a year before.

The inquest heard how Mr Archaya died of cardiac arrest brought on by pneumonia in his lungs, which doctors misdiagnosed as a heart condition. Several experts said the 85-year-old showed "none of the usual symptoms" of the infection, and "any reasonable clinician" could also have mistaken it for a heart condition, leading to the condition growing quickly worse.

But the inquest heard from the hospital's clinical director, Matt Metcalfe, arrived at the department after the 85-year-old's death to find staff "in a state of distress" over the death.

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And, shortly after Mr Archaya's death, a nurse reportedly "broke down" in front of one of his family members and said: "We could have done more".

Although it was ruled the pressure on the department did not directly lead to the 85-year-old's death, it paints a picture of the stress faced by healthcare staff working in dangerously overcrowded A&Es.

The hospital's CEO Deborah Needham told the coroner several plans had been put in place since My Archaya's death to take the pressure off A&E.

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