The final witness on Day 1 of David’s inquest was Dr James Bailey.
The coroner had already indicated that he struggled to see what he could ask of this witness and that his two page statement, dated 8 February 2023, was quite self-explanatory.
So it was straight to Ms Bartlam for questions from David’s family. She said that her first question was about Dr Bailey’s statement.
CB: You say, in my opinion the laboratory standard operating procedure for a high haemoglobin was correctly followed by the duty biomedical scientist and a blood film was made. This was reported at 22:19 on 15 January 2022. Was that reported after David died?
JB: Yes, that data is taken from the laboratory system that has an audit trail of everything that happened. Blood sample landed in the laboratory on 21:16 on the 12th, run through the analyser, certain parameters trigger different actions with different timescales.
A blood sample with certain flags for gross abnormality might trigger blood screen made immediately… if thought required my colleagues to act differently as urgent would be flagged, for something like this minor discrepancy that would go through as routine blood film. It will take several hours to be made and sit in queue waiting to be reported.
CB: I put to Dr Young result from analyser 21:47 on same day showed elevated haemoglobin … in terms of other blood results, all of those would have been available on the night to the Emergency Department?
JB: Yes that’s right, full blood count, only certain elements if grossly abnormal would be criteria to look at urgently. Set of bloods like this looked at very urgently, hence half hour for receive in laboratory and being released.
Other blood tests take a little longer for how to run for release in laboratory.
CB: You wouldn’t be able to say today?
JB: I could log onto our systems and find out?
CB: I don’t think its contentious, thank you. In terms of results if take you to Hull records, start at page 70. You see there on p70 elevated neutrophil count?
JB: Yes
CB: If you go over the page, the haemoglobin described in your statement as well as haematocrit, but also elevated white blood count would you agree?
JB: Marginally
CB: If go few pages to 76
JB: Yes
CB: Can see elevated C reactive protein is that right?
JB: Correct
CB: Next page, elevated urea is that right?
JB: That is correct
CB: And next page is elevated ART?
JB: That’s correct, yes
CB: Would you agree that in terms of the blood results, obviously the polycythaemia was noted, acute kidney injury risk noted, would you agree on basis of these results an infection could also be the possible basis?
JB: On the basis of early results hard to give opinion, reference ranges quoted 95% confidence intervals, 5% of people healthy will lie outside the range, a white count of 12 is as near as normal wouldn’t be particular concern to me in my own clinical practice, similarly CRP of 28 is only marginally elevated, CRP in someone with a rip roaring infection would be in 3 figures
CB: Would you agree the urea is very significantly elevated?
JB: It is elevated, consistent with dehydration as discussed
CB: Would you agree could also be associated with community acquired pneumonia?
JB: It could be, it’s not on basis of those results particularly alarming, can all be explained by a long lie and significant dehydration
CB: Thank you, no further questions.
There were no questions from Ms Lyle for Hulls University Teaching Hospitals NHS Trust.
The witness was released at 5pm on Day 1 of David’s inquest.