Area coroner Catherine Cundy wrote to the chief executive of the York and Scarborough Teaching Hospitals NHS Foundation Trust following the two unrelated deaths at York Hospital last year.
A trust spokesperson told The Press it takes the coroner’s findings “extremely seriously” and is “committed to act wherever necessary to improve patient safety”.
Ms Cundy prepared the two reports following inquests held into the deaths of Janet Seddon, 79, on February 9, 2023, and Stephen Dulling, 69, on September 4, 2023.
Mrs Seddon died as a consequence of naturally occurring disease contributed to by a delay in correctly identifying her abdominal pathology, an inquest concluded.
Ms Cundy, in her report, said Mrs Seddon underwent a CT scan on January 30, 2023. Eight days later, the images from the scan were re-reviewed and found that her bowel could become obstructed due to her condition.
The same day (February 7, 2023), Mrs Seddon was surgically assessed and consented to an operation to examine her abdominal organs.
She was stable immediately after the operation but her condition “steadily deteriorated with signs of developing sepsis”, the report said.
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