A man died of natural causes while waiting for an ambulance after falling and hitting his head at home in Northumberland.
Derrin Trent Cozart died at his home in Beadnell some time after calling an ambulance after falling over and hitting his head on November 14, 2019. The 55-year-old had woken up on the floor in the early hours of the morning and called for an ambulance, explaining he had an injury to his head. But by the time an ambulance crew arrived at the scene almost an hour and a half later, Derrin had already passed away.
An inquest held at Northumberland Coroner's Court in Morpeth on Friday heard that Derrin, who was from Canada, had battled alcoholism, was in poor health and had suffered from a massive internal bleed at the time of his death, likely a result of cirrhosis of the liver. His death was down to natural causes, the inquest found.
The inquest was told Derrin, who was an alcoholic and had suffered from depression, called an ambulance at around 2.50am and explained he had "just come around" after fainting and hitting his head. He said he could not remember falling but was unable to get up and was bleeding.
A North East Ambulance Service (NEAS) health advisor who answered Derrin's call went through a series of questions which he answered and logged the call as a category three - which means an ambulance is targeted to generally arrive on scene within 120 minutes. Andy Bell, a dispatch manager for NEAS gave evidence at the inquest and said there were only nine resources covering the area at the time due to a "shortage" and that there was usually 11.
Mr Bell said that there were 75 patients awaiting an ambulance on that day, 54 of which were emergency calls. There were also 178 delayed handovers.
An ambulance was assigned to Derrin at around 3am, but that crew was soon diverted to a higher priority category one call. At 3.22am, a call was made to Derrin, but there was no answer, so NEAS upgraded it to a category two case, with an ambulance crew arriving at his home at 4.25am. Sadly, when paramedics entered his home, Derrin was found dead in the bedroom.
During the inquest, Dr Clive Bloxham, who carried out Derrin's post-mortem, said he had a laceration to the back of his head, but no other external injuries. Dr Bloxham said Derrin's medical cause of death was due to extensive gastrointestinal haemorrhage likely as a result of cirrhosis of the liver, which was consistent with his alcohol consumption.
Unbeknownst to Derrin, he also had an enlarged heart which brings a risk of sudden death, Dr Bloxham said, and Derrin's health was in a "dire state" and he was in a "particularly precarious situation". Dr Bloxham added that is was "likely" Derrin had already died or was dying when the ambulance service called him back at 3.22am and he failed to answer.
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Mark Richardson, a section manager for call handling at NEAS said the health advisor followed HNS Pathway guidelines and asked all relevant questions to determine the seriousness of Derrin's call and that they were "relying on what they were being told" by him. Mr Richardson said that Derrin's reason for calling was a head injury, and based on that information, it was the "appropriate outcome" to assign the call as category three. He added there has been additional "learning" for the health advisor since.
The inquest heard that since Derrin's death, NEAS has received extra funding which is being used to secure additional learning and staffing. There is also an extra ambulance crew based in Alnwick now serving the area. NHS Pathways will also be requested to look into how they ask questions to callers who may be suffering from shock and if anything can be improved, after concerns were raised by Derrin's family.
In his conclusion, Senior Coroner Andrew Hetherington, said at the time of his death, Derrin had a "massive gastrointestinal haemorrhage, likely the result of cirrhosis of the liver" and that it was "unlikely the outcome would have been any different in any event". He concluded that Derrin's death was due to natural causes.
Speaking after the inquest, Derrin's partner of 20 years, Mark Mitchell, 54, said he was glad to hear that changes could potentially be made to NEAS Pathways processes in regards to how health advisors ask questions to patients who are in shock - as Derrin likely was. He said: "If you are in a state of shock, how can you properly answer these questions?" Mark, who lives in Newcastle, explained that the inquest had also confirmed what he believed, that even if a category one ambulance was sent, it was still unlikely Derrin would have survived.
Mark also looked back on his relationship with Derrin, explaining that they had met in Canada and moved to Northumberland briefly, while Mark was working in the oil and gas industry in Norway. Mark, who was working in Singapore at the time of Derrin's death, said: "He grew up in Saskatchewan and was very outdoorsy. We used to ski and he enjoyed camping. He then moved to Vancouver as he enjoyed the laid-back work ethic and the social scene there."
Derrin worked in the IT sector, but due to his health issues and alcoholism, he had not worked for several years before his death. Mark said: "We moved to Northumberland when I got a job in Norway. I'd spend a week there and a week in Beadnell. I think he liked the countryside here but I do think he found it difficult to form a network of friends and we were talking about moving back to Canada in 2020." Mark added that during his time in Northumberland, Derrin greatly enjoyed walking their dog Lily along the beach and had met up with Mark's mum, Heather Cairns, in Seahouses for a bonfire event only a day before his passing.
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