Intensive care transfer for woman occurred too late, inquest hears

An inquest has determined that a 79-year-old woman, Gwynneth Exall of Swansea, who passed away from complications after hip surgery, ought to have been transferred to intensive care several hours sooner. Ms. Exall suffered a fatal cardiac arrest on 28 April 2022, the day after undergoing a hip replacement operation at Nuffield Health Vale Hospital. Ms. Exall had opted for private medical care to bypass the waiting times associated with an NHS operation. However, the inquest revealed that her blood pressure and urine output were low following the surgery on 27 April, preceding a decline in her condition on 28 April. During the second day of the proceedings in Pontypridd, the inquest received testimony from expert witness Dr Mark Raper, an intensive care consultant affiliated with the University Hospital of Wales, Cardiff. While Ms. Exall’s medical records showed pre-existing low blood pressure, Dr. Raper stated that a subsequent minor decrease in the hours immediately following surgery would not be considered “uncommon”. Ms. Exall received fluids and medication for hypotension; however, by 08:00 GMT on 28 April, her blood pressure remained in the low 60s. Dr. Raper conveyed his concern to the inquest, stating, “That sort of blood pressure would worry me,” and further noted that “The trend [was] either not improving, or going downwards.” When questioned whether the hospital ought to have summoned an ambulance at that juncture to transport Ms. Exall to an intensive care unit, Dr. Raper responded that such action would have been “entirely appropriate”. He further indicated that the diminished urine output suggested fluid was being “redistributed to the tissue or the lungs,” potentially contributing to cardiac problems. The ambulance service was ultimately contacted in the afternoon, and Ms. Exall was subsequently transferred to the University Hospital of Wales (UHW); however, she passed away later that same evening. Helen Pipe, a nurse employed at Nuffield Health Vale Hospital, informed the inquest that she had conferred with Dr. Subramanian Balachandran, the anaesthetist on duty on 28 April, regarding Ms. Exall’s low blood pressure. Ms. Pipe further stated that as Ms. Exall’s condition worsened around 14:00, “she needed immediate treatment, which we could do on site.” She explained, “She was too poorly at that stage to transfer out,” adding, “We were treating her.” Subsequently, Ms. Pipe contacted the ambulance service, which provided treatment to Ms. Exall prior to her transportation to UHW. Coroner Patricia Morgan additionally presented a statement from another nurse, Teresa Stow, who reported that Ms. Exall had been conversational and exhibited no indications of distress the preceding evening. Ms. Stow’s statement included the remark, “I didn’t feel that Gwynneth was so unwell overnight that she needed to be transferred.” The inquest proceedings are ongoing. Copyright 2024 BBC. All rights reserved. The BBC bears no responsibility for the material found on external websites. Information regarding our policy on external linking is available.