Graham Flindle · Prevention of Future Deaths report

On 11th May 2022 I commenced an investigation into the death of Graham Flindle. The investigation concluded on the 17th October 2022 and the conclusion was one of Narrative: Died from complications of necessary surgery. The medical cause of death was 1a) Pneumonia; 1b) Right hemicolectomy; 1c) Cecal cancer; and 2) Chronic obstructive pulmonary disease

Graham Flindle had rectal bleeding and a low haemoglobin in November 2021. A sigmoidoscopy suggested the cause was haemorrhoids and they were treated. He was discharged from Tameside General Hospital. Following an outpatients review he was discharged from secondary care. His haemoglobin level did not improve significantly. On 5th April his haemoglobin was 77g/L and he was admitted to Tameside General Hospital .On 6th April 2022 a malignant tumour was identified by CT scan. An operation was required. On 20th April 2022 he was operated on. Post operatively he subsequently developed complications with his breathing. He deteriorated and died at Tameside General Hospital on 6thMay 2022.

1. The inquest heard that FIT tests were very effective at identifying bowel cancers at an early stage. GPs and other community health care providers, the inquest heard, have a key role in promoting the use of them where there is rectal bleeding/unexplained weight loss and other symptoms that may be consistent with bowel cancer. Use of FIT tests allows far more effective identification of patients who need to be fast tracked onto the cancer pathway. An understanding of just how effective FIT tests are was not always widely understood and promotion of them amongst all community health professionals was, the inquest was told, crucial in reducing deaths from bowel cancer;

2. The inquest was told that interpretation of haemoglobin test results and prompt referral back into secondary care if they were abnormal and remained low despite treatment was important to effective and potentially lifesaving treatment. The volume of blood results that GPs were regularly having to consider was significant and made it difficult to always identify cases that were concerning. Prompts in relation to haemoglobin test may be effective in assisting GPs juggling a large volume of results.