A PENSIONER'S six-hour wait for an ambulance after she fell and broke her hip was unlikely to have contributed to her death, an inquest heard.
Resuming a previous inquest hearing, coroner for North East Wales and Central John Gittins said the death of Daphne Edith Williams, aged 78, was accidental.
The inquest heard that on September 23, 2016, Mrs Williams, a retired housekeeper, had been pegging out washing in the yard of her home in Glendower Place in Hanmer, when she slipped and fell – fracturing her left femur.
According to a statement provided to the coroner by Mrs Williams’ daughter Jane Davis, an ambulance was called for and a number of family members arrived at the scene to wait with Mrs Williams, who remained on the concrete floor of her yard.
However it was not until 9.33pm that a paramedic arrived on the scene to assess Mrs Williams’ injury and make a request for an ambulance, which arrived after 10pm to take her to Wrexham Maelor Hospital.
The inquest heard an operation on the fractured femur was initially set to take place the following day but was delayed in order to properly medicate Mrs Williams and ‘optimise’ the conditions of the procedure.
Following the operation, Wrexham Maelor consultant physician Dr Sara Gerrie told the hearing, Mrs Williams became unwell and developed a ‘pseudo obstruction’ – which affected her bowel and presented a risk of chest infection – following which she became acutely unwell.
The coroner concluded that the cause of her death at Wrexham Maelor Hospital on September 26 was accidental, caused by renal and cardio failure with bronchio-pneumonia as a result of the fracture caused by her fall.
There were also contributory effects of a number of pre-existing medical conditions including type 2 diabetes and chronic kidney disease, for which she was taking a number of medications.
Dr Gerrie told the inquest: “It had been a very difficult balance when she was well, but then having a significant injury – that can be enough to tip the balance.
“It is not the level of service we would like to provide and if her family were here, I’d like to apologise to them."
The inquest also heard from Gill Plemming of the Welsh Ambulance Service, who explained the initial call at 4.22pm reporting Mrs Williams' injury had been classified as a ‘green two’ – which meant it was not life threatening – and the service had to respond to higher priority calls before hers.
She also said the service had received a number of calls from family members in the time between the initial call and the ambulance deployment, which were responded to with welfare calls to keep a check on Mrs Williams’ condition.
She said: “Unfortunately if we have a red or amber one or two call, they will always be diverted to the higher priority.
“There were other incidents on the stack which were a higher priority.
“It is not the quality of service we would like to give and if Mrs Williams’ family were here I would like to pass on my apologies."
Ms Plemming added the case was escalated to an amber two priority at 8.37pm after further contact with those at at the scene.
In relation to whether the long wait for an ambulance had contributed to Mrs Williams' death, Mr Gittins agreed with the statements of both Dr Gerrie and Dr Singh of Wrexham Maelor in that on the balance of probability it had not.
But he did express concern over the issue and concluded he would be issuing a regulation 28 report to both Betsi Cadwaladr University Health Board and the Welsh Ambulance Service over the matter, stating the experience Mrs Williams and her family had been through was ‘unacceptable’.
He added: “Other families in these crises must not be allowed to suffer as this family did.
“I can only hope that some answers will come to light to alleviate some of the difficulties that people in this area experience at the moment.”