Inquest into death of Evan Nathan Smith at North Middlesex Hospital

Evan Nathan Smith, from Walthamstow, has concluded that his death was the consequence of a sickle cell crisis in a patient with biliary infection.

Evan died on April 25, 2019, at North Middlesex Hospital in Edmonton.

At one point while being treated at the hospital Evan was so desperate for help that he rang 999 from his mobile phone to ask for oxygen because he was refused this by a nurse on his ward, the inquest heard.

He was having difficulty breathing and he later told his family he felt calling 999 was the only way he could get help.

The coroner said there was a failure to appreciate the significance of Evan’s sickle cell crisis symptoms by those looking after him.

Evan Smith died at North Middlesex Hospital.

He said there was a mindset in those looking after Mr Smith which distracted the treatment away from the need for an urgent exchange transfer to treat the sickle cell symptoms in favour of seeking to perform a procedure to look again at clearing the biliary tree from a stone or other obstruction.

He was not recognised to be developing sickle cell symptoms until 3.20am, April 23, five days after his admission with the diagnosis of a bile duct infection, when he was attended by a doctor from the haematology department.

The inquest at Barnet Coroner's Court heard that Evan’s life could have been saved if he had been given a blood transfusion sooner to manage his sickle cell crisis. The inquest also heard that the hospital’s haematology team were not made aware that he had been admitted until two days after he arrived at the hospital.

“Evan was an intelligent and caring young man with a very bright future ahead of him,” said Evan’s parents Charles and Betty Smith.

“He was an exceptionally conscientious and hardworking individual who treasured his family and friends and was always keen to help anyone who needed it. We continue to be devastated by his death and the shocking way his life was cut short so quickly.”

Suzanne White, solicitor at law firm Leigh Day who represented the Smith family, added: “Betty and Charles Smith had to fight for the inquest into their only son’s death to be held. The evidence presented to the coroner about the failures in Evan’s care has been very difficult for Betty and Charles to hear. We have heard that if the haematology team had been alerted sooner, then Evan may not have died two years ago.

“Evan was a young man with the potential for a hugely fulfilling life . . . he was intelligent and gifted, caring and the very centre of his parents’ lives. Betty and Charles will now take some time to consider their options.”

Dr Emma Whicher, medical director at North Middlesex University Hospital NHS Trust, said: “We want to offer our sincere condolences and apologies to Mr Smith’s family.

“In 2019, we carried out a thorough internal investigation into the care and treatment Mr Smith received at North Mid, and recognise that this could and should have been better. 

"We have worked hard to learn lessons and have introduced a specialist sickle cell area on one of our wards, extra training for staff around the disease as well as ongoing engagement with the local community about how we can make our care better, as we know that this devastating disease disproportionately impacts some of our local communities."

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