On Tuesday 18 June 2019 Richard was away from the couple’s home, working in York and suffered a sudden onset of chest pain and pain in the left side of his neck and face, which caused him to fall to the floor. He was taken by ambulance to the York Hospital but was discharged later that day having had little in the way of investigation and with a working diagnosis of costochondritis (inflammation of the connective tissue in the ribs). Richard returned to London by train. The next day, concerned and still suffering from symptoms, he attended his GP surgery in London and was told to attend A&E if the pain persisted.
That afternoon, Richard then returned to his flat in Brighton, which he shared with Joe and went to bed around 11pm. In the early hours of the morning of 20 June, Joe woke to hear Richard gasping for air. Richard quickly fell unconscious. Joe phoned 999 and performed CPR until an ambulance crew arrived. Richard had to be lifted out of the flat by the fire brigade via a third-floor window, as there was concern that he had a blood clot. He was rushed to Brighton’s Royal Sussex County Hospital but sadly the medical team were unable to resuscitate him.
Sue Prior commented:
“The post-mortem concluded that Richard had died of an Aortic Dissection. Pain is the main symptom of this, but ECG, chest x-ray, ultrasound and blood tests can all appear normal (as was the case with Richard). When an Aorta ruptures, immediate severe pain is usually felt but this pain can then ease. Given Richard’s symptoms of head and chest pain and weakness, he should have had additional senior review and further investigation which, on the balance of probabilities, would have led to a diagnosis. Urgent cardiothoracic surgery would have meant his death could have been avoided.”
A Serious Untoward Incident (SUI) investigation was instigated at York Hospital, which concluded that Richard should have had those further investigations when first admitted. It was also evident from the SUI investigation that the Emergency Department had received recent training in the diagnosis of Aortic Dissection. Indeed, literature had been distributed via email and posters promoting the “Think Aorta” campaign by Heart Research UK were displayed. Sadly, despite all the specific training the Trust provided for diagnosing Aortic Dissection and the in-house awareness campaign, and despite Richard’s symptoms fitting the diagnosis of Aortic Dissection, the opportunity for diagnosis was missed, with fatal consequences.
Pictured above: Richard Tredgett (left) and Joe Paxton (right).
Disclaimer
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024