Football data analyst, 21, who died in hospital could have been saved, hears an inquest

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Evan Smith, 21, was forced to call 999 from his temporary bed in a hospital hallway

Evan Smith, 21, was forced to call 999 from his temporary bed in a hospital hallway

A football data analyst was forced to call 999 from his temporary bed in a hospital hallway after being denied oxygen despite the failure of his organs, an inquest has heard.

Evan Smith was admitted to North Middlesex University Hospital with jaundice in April 2019.

He later complained of hip pain and showed low blood oxygen levels classified as “severe” – but he was not given oxygen by medical personnel.

Mr Smith then called the London Ambulance Service from his hospital bed to ask if they would take him to the emergency room.

Staff discussed providing oxygen, but it could not be administered as he was still in a ‘guest bed’ that provided sleeping facilities but had no access to oxygen ports.

An inquest at the North London Coroner’s Court today learned that Mr Smith of Walthamstow, North East London, had a history of sickle cell disease.

A coroner heard his organs fail after an infection in his bile duct caused his blood cells to sickle – meaning they change shape, take in much less oxygen, and pose a risk of blocking his blood vessels – preventing his body from getting enough oxygen administer to his brain.

A post-mortem study found that his cause of death was ‘multiple organ dysfunction syndrome due to cerebral infarction and sickle cell crisis due to biliary septicemia’.

One of the hospital’s blood specialists, Dr. Arne De Kreuk, said today that he may have been present and given a potentially life-saving blood transfusion if he received a call.

North Middlesex University Hospital staff (pictured) discussed providing oxygen, but it could not be administered as Mr. Smith was in a 'guest bed'

North Middlesex University Hospital staff (pictured) discussed providing oxygen, but it could not be administered as Mr. Smith was in a 'guest bed'

North Middlesex University Hospital staff (pictured) discussed providing oxygen, but it could not be administered as Mr. Smith was in a ‘guest bed’

Mr. Smith was initially discharged from North Middlesex University Hospital after undergoing surgery to remove a stent from his bile duct – which had been installed after a previous gallstone removal.

But about 24 hours later, on April 18, 2019, he was admitted again with jaundice.

Five days later, on April 23, he complained of hip pain and showed low blood oxygen levels classified as “severe” – but he was not given oxygen and was later referred to as paramedics himself.

Doctors then considered giving oxygen, but the plan was discontinued because his temporary bed, which was set up in a hallway, was not built to house “oxygen ports.”

His condition worsened, and despite doctors ordering a blood transfusion around 11 a.m. the next day, “significant delays” meant that he did not receive it until later.

What Is Sickle Cell Disease?

Sickle cell disease is the umbrella term for a group of hereditary conditions that seriously affect red blood cells.

About 15,000 people in the UK suffer from it and it is especially common among people of African or Caribbean descent.

Healthy red blood cells – produced by stem cells in the bone marrow – are biconcaved discs that bend and bend easily.

However, in people with sickle cell disease, defective stem cells produce red blood cells that are crescent-shaped.

They are rigid, cannot be forced through smaller blood vessels, and are prone to blockages that deprive parts of the body of oxygen.

Patients are not expected to live beyond the age of 60 and treatment is mainly aimed at relieving symptoms, such as pain and infections, by means of blood transfusions and painkillers.

Mr. Smith then tragically died on April 25 at 5:55 am.

Coroner Andrew Walker QC said: “On the night of April 23, Mr. Smith complained of hip pain and was assessed by the attending physician.

The oxygen concentrations were 94 percent.

He was not given oxygen by medical personnel.

Smith had then called the London Ambulance Service to take him to the ER.

They discussed his request for oxygen, but this could not be provided as he was in a guest bed, a bed that turned out to be amenities for sleeping, but no access for oxygen ports.

He had developed sickle cell pain.

So on the night of April 23, it is likely that a sickling process had started.

And that would explain the symptoms and lower the oxygen levels. Something Mr. Smith himself would recognize from previous episodes of shekels.

“What was going on, Mr. Smith knew very well that was happening.”

One of the hospital’s blood specialists, Dr. Arne De Kreuk, said today that he may have been present and given a potentially life-saving blood transfusion if he received a call.

He said, ‘Unfortunately I was not informed and neither was my colleague, who was on call, so the physician assistant assessed the patient and made his own decision and the situation did not escalate.

If I had had the call at that point with a 94 percent saturation and an increase in pain, I probably would have started the transfusion process.

“I do think that by the time the transfusion was complete, the damage had already occurred. And so if we had started the transfusion in the early morning hours, we might have been able to control the damage better. ‘

When asked directly if it could have saved Mr. Smith’s life, he added, “Based on the probability, I would say yes.”

The court also heard that he was not tested for infection after the stent was removed, as guidelines did not recommend them in cases where there were no symptoms.

Dr. Base Mujamadar, who performed the stent removal, told the court, “It’s easy to see because you can see the color of the bile coming, the granulation of the tissue. There are many things we see during stent removal that would indicate infection – it was not present here. ‘

Coroner Andrew Walker QC added that there was “incoherent communication” between the hematology department.

The study also found that the area the hospital covers has a large population of Afro-Caribbean residents, who are most susceptible to sickle cell, but lacked a specialized unit that doctors say could have made a difference.

Such a department has now been set up and is staffed by specially trained nurses, the coroner was told.

Dr. De Kreuk added: ‘I have a very strong opinion on that, North Middlesex has been appointed as a specialist hemoglobin center – one of 24 in England – and in my opinion that implies that you have the expertise on board to take care of these. patients, so I strongly believe that a hospital like ours would have a dedicated unit. ‘

The judicial investigation continues.