Hillsborough Inquests: Victim Tony Bland 'should have been treated differently'

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The last of the 96 victims of the Hillsborough disaster should have been treated differently at hospital, according to a medical expert.

The new inquests have been focussing on the final movements of Tony Bland, who was left severely brain damaged by the 1989 crush but lived until March 1993.

He was left in a persistent vegetative state but his life supporting treatment was removed after a legal battle.

Mr Bland was 18 at the time of the disaster but 22 when he died.

He was caught up in a fatal crush at the Liverpool versus Nottingham Forest FA Cup semi-final in Sheffield on 15 April 1989.

The jury previously heard how a doctor and a policeman helped revive Mr Bland on the pitch before he was taken to hospital.

Prof David Menon, a Cambridge University anaesthesiology expert, said more should have been done to protect his airways and doctors should have monitored him more closely in the following hours.

Mr Bland's condition deteriorated twice while he was at hospital on the day of the disaster.

Prof Menon said he could not say whether those "events" contributed to Mr Bland's brain damage.

The inquests heard how, when he was first assessed at Northern General Hospital, Dr Rani Naidoo did not ask for a tube to be inserted down Mr Bland's windpipe to keep his airway open before being transferred to a ward.

Prof Menon said: "He should have been intubated and placed on a mechanical ventilator.

"Given that resources were available, I would have expected him to have been intubated."

Prof Menon also said medical guidelines from 1989 would have recommended intubation.

Doctors later found that Mr Bland had inhaled vomit. This is thought to have caused his breathing to deteriorate for a period of up to 10 minutes.

Prof Menon said the risk of this could have been "substantially reduced" had Mr Bland been intubated in A&E or shortly after arriving on a ward.

The jury heard how Dr Steven Hunter assessed Mr Bland on Ward 60 at about 17:00 BST, almost an hour after his arrival.

He noted Mr Bland needed neurological observations every 15 minutes.

Christina Lambert QC, for the coroner, asked: "How does that compare with reasonable standards in 1989?"

Prof Menon replied: "Not ideal."

He added that a "very close eye needed to be kept" on Mr Bland's breathing and blood pressure because there was a risk of "further damage to the brain".

"I would have expected closer observations, providing the resources were available," he said.

Doctors eventually transferred Mr Bland to the hospital's cardiac intensive care unit (CICU).

A nurse, Carol Barlow, recorded that at one stage he "suddenly became blue".

Both his lungs had collapsed and an emergency procedure was carried out to reinflate them.

Prof Menon said the collapse was diagnosed "promptly" and resolved "quickly".

Ms Lambert asked: "Given that there were these two events at hospital, one on ward 60 and the other on the CICU, are you able to tell us whether or not in your opinion, either of those two events contributed to Tony's brain injury and his ultimate condition?"

"The short answer is, I'm afraid not," Prof Menon said.

He went on to say that Mr Bland's medical notes "don't tell us clearly what the duration of these physiological insults were".

He also said it was unclear for how long Mr Bland had been unconscious and in cardiac arrest at the football stadium.

But he said the two "events" at the Northern General "could have" made "some material contribution to Tony's brain injury".

The court also heard how Mr Bland's family stayed by his bedside every day for nearly four years before his life support was removed.

Parts of a statement by Allan Bland, Mr Bland's father, were read to the court.

'Die with dignity'

He told how he and his wife Barbara lived in hospital accommodation and only returned home for fresh clothes.

Mr Bland said that after his son's transfer to Airedale Hospital, near their home in Keighley, West Yorkshire, he "couldn't accept that Tony wasn't totally without pain".

"I used to think that he pulled a face when his fingers were extended to have his nails cut, despite Dr [James] Howe's explanation that Tony could not possibly feel anything.

"I just wanted Tony back and I was looking for any signs that might mean he was improving."

The jury heard how Dr Howe and the hospital trust, supported by the Bland family, applied to the Family Court for permission to withdraw treatment.

Mr Bland said: "We are as sure as we can be that given a choice, he would have wanted to die with dignity, once every chance of recovery had disappeared."

The case went through the Court of Appeal and the House of Lords before permission was finally given in 1993.

Mr Bland continued: "When we viewed his body before the funeral, it was the first time that Tony had come back to us as he was before Hillsborough.

"It was the first time in four years that we saw Tony with no tube in his nose. For so long we had not seen him in any other way."

The inquests, in Warrington, Cheshire, are due to resume on Tuesday.

Who were the 96 victims?

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