Investigation and inquest
Mr Marriott elected to undergo a haemorrhoidal artery ligation with mucopexy surgery following consultations with his surgeon.
He underwent a pre-assessment for the surgery on 30 March 2024 which was conduced by telephone using the assessment on the Surrey and Sussex Healthcare NHS Trust Cerner system. During the assessment he was asked about his family medical history and his own history of haematological conditions. He was not asked about his family history of haematological conditions directly as this is not required by the system. The evidence to the Court was that the clinicians relied upon the patient's response to their family medical history question to ascertain this.
The evidence was that Mr Marriott was aware of his significant family history of blood clotting disorders. The evidence from clinicians who assessed him was that this was not disclosed to them. The family believe that he did make this known but there is no evidence which indicates when, where or to whom this was made. The evidence was that he had not been directly asked about this and it was not stated on his notes or GP documentation.
On 12 April 2025 he underwent the haemorrhoidal artery ligation with mucopexy surgery as a day patient. He was given compression stockings as per the Trust guidance as well as mechanical calf compression during the procedure which was above what the guidance required.
On 15 April 2024 he sadly died at home. A post mortem found he died due to a Pulmonary embolism which on the evidence was a result of the surgery.
Circumstances of the death
This section is present but empty in the published report.
Coroner’s concerns
The evidence was that the system which is used for assessment of patients prior to day surgery does not (a) directly require a question to be asked about their haematological family history or (b) record negative answers to the questions related to the patient's own haematological history