Woman, 48, died at Blackpool Victoria Hospital after delays in spotting her rare condition

A 48-year-old woman with a rare condition who died at Blackpool Victoria Hospital was kept waiting in an ambulance for three hours before being admitted to the emergency department.

Further delays in her most suitable treatment meant it was some 24 hours after arrival before Rebecca Holden’s rare condition was recognised, despite it being pointed out by her partner, and she died several hours later, an inquest at Blackpool Town Hall heard.

Rebecca, with a history of asthma, had been diagnosed in 2020 with pulmonary arterial hypertension, which affects fewer than 10,000 people in the UK.

It requires several medications, notably an intravenous infusion pump proving constant treatment and Rebecca, from Blackpool, was under the care of specialists in the condition at Sheffield.

On December 9 last year, she called an ambulance because she had shortness of breath. The ambulance arrived at Blackpool Victoria shortly after noon but it was 3.20pm before she was admitted to the emergency department as it was so busy.

Emergency department triage was briefed by ambulance staff regarding Rebecca straight after the ambulance’s arrival and her condition remained fairly constant while waiting to be admitted.

But she had signs of a fever and after a check on arrival in the hospital, it was feared she might have sepsis and was put on anti-biotics, paracetamol and a nebuliser.

Her condition remained constant overnight but the following day, she deteriorated and was transferred to the Medical Enhanced Care Unit.

There, consultant respiratory physician Dr Thomas Bongers examined her that afternoon and recognised her rare condition but medics at Sheffield were not consulted.

Within a few hours, however, Rebecca suffered a cardiac arrest and died that evening.

Pathologist Dr Richard Shepherd confirmed her cause of death as bronchial pneumonia, with contributing factors pulmonary arterial hypertension, which can lead to an enlarged heart, and her previous diagnosis of asthma.

Dr Tarek Saba, respiratory consultant at Victoria Hospital, who had previously seen Rebecca, told the inquest that the pneumonia with her rare condition meant it was likely she would have died anyway.

But Blackpool and Fylde chief coroner Alan Wilson, concluding that Rebecca died of natural causes said he was pleased that new measures had been brought in at Victoria Hospital which he hoped would help prevent a repeat of Rebecca’s circumstances.

A new Medical Treatment Centre, which has helped take some of the pressure off the emergency department, a target of admitting patients arriving by ambulance within 45 minutes, and faster escalation to consultation by a senior clinician in such circumstances are all welcome developments, said the coroner.