Angela Jackson
26 Sept 2018 · Coroner Alan Walsh · Manchester (West)
The coroner's concerns
1. inappropriate referral of patients with aortic aneurysms
“i. The treatment of an aortic aneurysm depends on the position of the aneurysm. In general terms aneurysms above the diaphragm are referred to as thoracic aneurysms and should be treated by cardiothoracic surgeons and aneurysms below the diaphragm are referred to as abdominal aneurysms and should be treated by vascular surgeons. The treatment of a thoracic aneurysm by a Cardiothoracic Surgeon may also depend on the position of the aneurysm above the diaphragm. An ascending thoracic aneurysm could”
2. absence of documented pathways for aortic aneurysm treatment
“There are no written protocols or pathways in relation to the treatment of aortic aneurysms in Greater Manchester or the North West of England, although the Preston Hospital has started to prepare a written Acute Aortic Syndrome Pathway. However, the Acute Aortic Syndrome Path is only in draft form, which has not been approved and which is not in existence.”
3. lack of clear urgent referral pathways for aortic aneurysms
“The referral of patients for the treatment of aortic aneurysm, in many cases, requires an urgent referral and emergency treatment and to consider clear and unequivocal pathways for the referral of patients requiring such treatment.”
4. national guidance on aortic aneurysm referral pathways
“I request the Secretary of State for Health to review guidance and direction given to all vascular surgery and cardiothoracic surgery departments in the United Kingdom in relation to the referral and treatment of patients with aortic aneurysms, with particular reference to clear and unequivocal documented pathways as referred to above.”