Man died from multi-organ failure after hospital failed to admit him to Intensive Care Unit

A man died from multiple organ failures after being neglected at Tameside Hospital, a coroner has reported.

Twenty five-year-old Jordan Howarth was in good health when admitted to the hospital in April 2023 after feeling unwell with a deteriorating condition, Alison Mutch, senior coroner for Manchester South, said.

Within three days he was dead, following a catalogue of missed opportunities at the hospital, a prevention of future deaths report prepared by the coroner revealed.

On his admission, tests showed no evidence Mr Howarth was suffering an infection and it was suspected he might be suffering an auto immune reaction.

However, the report says: "There was no co-ordinated approach between specialists to identify the cause of his deterioration."

The patient was not prescribed antibiotics to help deal with an infection.

The day after arriving at the hospital, the patient should have been for a critical care review, according the the policy of the Tameside and Glossop Integrated Care trust, but this did not happen.

He was moved to another ward and by the following morning his condition had worsened.

A review at 12.35pm highlighted he needed to be transferred to the intensive care unit (ICU) for his condition to be reviewed by and ICU consultant.

By this time Mr Howarth's body was 'shutting down and going into shock'.

However, the consultant decided not to carry out a review and not admit him to ICU despite his 'declining clinical picture'.

Ms Mutch said in her report: "Earlier admission to ICU would have prevented such a rapid deterioration and allowed for earlier support to have been provided to his organs."

When he was eventually admitted to ICU his organs had started to fail and he suffered a fatal heart attack at 3.30am on April 6 - just three days after his arrival at the hospital.

The report concluded: "On the balance of probabilities, had he been reviewed and admitted to ICU following the first review by the critical care outreach team, he would have not died when he did."

The original inquest verdict was that Mr Howarth had 'died from the complications of a severe inflammatory response contributed to by neglect."

His cause of death was given as multi organ failure.

Now Ms Mutch has given the hospital until June 26, to answer a series of concerns to avoid future deaths.

The concerns include:

- There was not a joint approach to the patient's care and no detailed discussion about a decision to withhold antibiotics. The report says: "The decision was made by the microbiology team and as a consequence, antibiotics were withheld without further alternative treatments being put in place despite how unwell he was and despite the case the cause of his deterioration was unclear.

- There was no documentation setting out the reason for declining to admit the patient to ICU and no evidence of discussions between the medical consultant and the ICU consultant in clinical notes.

- It was unclear who was responsible for the continuity of Mr Howarth's care.

The report has been sent to Tameside General Hospital and the Secretary of State for Health and Social Care.

Ms Mutch said: "In my opinion action should be taken to prevent future deaths a d I believe you have the power to take such actions."