Investigation and inquest
On 19th February 2020 I commenced an investigation into the death of Brian Richard Murphy. The investigation concluded on the 24th July 2020 and the conclusion was one of Narrative: Died from the recognised complications of congestive cardiac failure and a myocardial infarction whilst awaiting a cardiology appointment.
The medical cause of death was 1a) Pulmonary oedema; 1b) Myocardial infarction on a background of Congestive cardiac failure; 1c) Coronary artery disease; ii) Idiopathic pulmonary fibrosis, Community acquired pneumonia, Chronic obstructive pulmonary disease.
Circumstances of the death
Brian Richard Murphy was a long-term smoker and had diabetes. He saw a GP with shortness of breath. A chest x-ray and blood tests were arranged and showed signs of congestive cardiac failure. An Echocardiogram was requested. A CT scan showed significant coronary artery narrowing. The results of the Echocardiogram were reported, and he was referred on 6th February by his GP to the cardiology clinic. On 12th February he deteriorated suddenly. He was admitted to Stepping Hill Hospital. He had an acute myocardial infarction. He deteriorated further. On 17th February 2020 he died at Stepping Hill Hospital.
Coroner’s concerns
The inquest heard that the system for referrals for cardiology tests meant that there were delays in tests being carried out which led to delays in patients being referred to the cardiology clinic to see a cardiologist.