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Fred Pring died while ambulances queued outside Wrexham hospital Fred Pring died while ambulances queued outside Wrexham hospital
(about 4 hours later)
While a man lay dying at home waiting for paramedics, an ambulance was outside a hospital for nearly five hours until it could drop off a patient, an inquest has heard. A man lay dying at home waiting for paramedics as an ambulance waited outside a hospital for nearly five hours to drop off a patient, an inquest has heard.
Despite a fully-staffed ambulance service, Fred Pring, 74, from Mynydd Isa, Flintshire, died 42 minutes after his wife had first called 999. Despite a fully-staffed ambulance service Fred Pring, 74, from Mynydd Isa, Flintshire, died 42 minutes after his wife, Joyce, had first called 999.
She had rung four times but there was not an ambulance available. Mrs Pring wants the ambulance service to review its policies on 999 calls.
Mr Pring was categorised as a lower priority, the inquest in Ruthin heard. The coroner John Gittins will present his conclusions on Monday.
He died in March 2013 at his home and had been receiving treatment for chronic obstructive pulmonary disease. The inquest in Ruthin heard that Mr Pring, who had been receiving treatment for chronic obstructive pulmonary disease, had been categorised as a lower priority by the ambulance service.
On Friday, Gill Pleming, from the Welsh Ambulance Service, said on the day Mr Pring died there were seven ambulances and one rapid response vehicle to cover Flintshire and Wrexham. On Friday, Gill Pleming of the Welsh Ambulance Service said on the day Mr Pring died in March 2013 there were seven ambulances and one rapid response vehicle to cover Flintshire and Wrexham.
But, she said, at the time of Mrs Pring's first call, there were no ambulances available. But, she said, at the time of Mrs Pring's first call there were no ambulances available.
Coroner John Gittins asked: "Presumably the caller isn't told that? They're not told 'Sorry, we haven't got one available'?"Coroner John Gittins asked: "Presumably the caller isn't told that? They're not told 'Sorry, we haven't got one available'?"
Miss Pleming replied: "No."Miss Pleming replied: "No."
The court was told one ambulance had spent nearly five hours (287 minutes) waiting at Wrexham Maelor Hospital to drop off a patient.The court was told one ambulance had spent nearly five hours (287 minutes) waiting at Wrexham Maelor Hospital to drop off a patient.
Another ambulance had been at the same hospital for more than an hour and a half.Another ambulance had been at the same hospital for more than an hour and a half.
"In a nutshell, six vehicles waiting to transfer patients into Wrexham Maelor Hospital, three waiting to transfer patients into Glan Clwyd - all experiencing delays significantly beyond the 15 minute target handover," the coroner said."In a nutshell, six vehicles waiting to transfer patients into Wrexham Maelor Hospital, three waiting to transfer patients into Glan Clwyd - all experiencing delays significantly beyond the 15 minute target handover," the coroner said.
'Red two''Red two'
Mr Pring's case had been classified by the ambulance service as 'red two', which is a lower priority than 'red one' which means an immediate threat to life, but Miss Pleming said the aim was to arrive within eight minutes for either classification.Mr Pring's case had been classified by the ambulance service as 'red two', which is a lower priority than 'red one' which means an immediate threat to life, but Miss Pleming said the aim was to arrive within eight minutes for either classification.
Mr Gittins asked whether the call would be upgraded to a higher priority if there was a delay in sending an ambulance.Mr Gittins asked whether the call would be upgraded to a higher priority if there was a delay in sending an ambulance.
"No," Miss Pleming replied."No," Miss Pleming replied.
Mr Gittins said: "The truth of the system is that members of the public could cause chaos - if you want to get an ambulance there, you just tell them that he's dead."Mr Gittins said: "The truth of the system is that members of the public could cause chaos - if you want to get an ambulance there, you just tell them that he's dead."
Earlier a Home Office pathologist said it was extremely difficult to answer whether Mr Pring's life would have been saved if an ambulance had arrived sooner.Earlier a Home Office pathologist said it was extremely difficult to answer whether Mr Pring's life would have been saved if an ambulance had arrived sooner.
Dr Brian Rogers said the cause of death was heart disease and chronic lung disease.Dr Brian Rogers said the cause of death was heart disease and chronic lung disease.
He told the inquest Mr Pring's already compromised arteries struggled to cope with added pressure from weakened lungs. The chief executive of the Welsh Ambulance Service, Elwyn Price Morris, told the hearing it was not unusual for the ambulance service and the NHS to experience severe pressure such as happened on the night Mr Pring died.
'Too late' He added it did not happen on a daily basis, but hinted there might have been similar incidents in the past and that there was no easy solution to ambulances being stuck outside hospitals.
"His heart had been failing, he had chest pain because his heart was struggling and his lungs weren't functioning properly," Dr Rogers said. Matthew Makin, medical director of the Betsi Cadwaladr University Health Board, said the health board and ambulance service had been working together at the time of Mr Pring's death to try to minimise the amount of time ambulances spent waiting outside hospitals.
"Whether or not earlier intervention would have altered the outcome is impossible to say from the pathology evidence. It's possible it would, it's possible it wouldn't." Mr Pring's cardiologist told the hearing on Thursday if the ambulance had arrived after the first 999 call he would have survived.
But Mr Pring's cardiologist told the hearing on Thursday if the ambulance had arrived after the first 999 he would have survived.
The consultant told the coroner he would have expected the ambulance to have arrived in six minutes.The consultant told the coroner he would have expected the ambulance to have arrived in six minutes.
Mr Pring's widow Joyce called 999 three times for an ambulance for her husband but was told the service was "very busy" in her area. In a statement issued outside the hearing through her solicitor, Mrs Pring said she believed the ambulance service needed to review its policies in view of what had happened to her husband.
She called a fourth time to say they were "too late" and that her husband had passed away. "[It should] review the questions asked by the 999 operators, perhaps using a flowchart so that a person is never asked again if their relative is breathing when they have been told that the person has died," she said.
The statement also called for the ambulance service to review its policy of sending two ambulances to a 'red one' call.