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Who was Evan Smith? Man, 21, who died of sepsis rang ambulance after hospital denied him oxygen, inquest hears

'The delay in treating Mr Smith with a timely exchange transfusion was the cause of his death,' the coroner stated in his report

Evan Nathan Smith, a 21-year-old patient died on April 25, 2019, at a London hospital due to sepsis following a gall bladder stent removal procedure. However, a coroner has now said that Smith would not have died if the hospital staff had identified his symptoms of sickle cell crisis and offered blood transfusion sooner. 

From his hospital bed, the patient reportedly called 999 for emergency medical help after he was refused oxygen citing that his blood saturation was high enough, reported The Times UK. However, the operator decided not to send paramedics after having a word with the nurses about his latest medical observations. 

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Who was Evan Nathan Smith?

Smith was a 21-year-old soccer stats analyst from Walthamstow. He underwent a surgical procedure for gall bladder stent removal at the North Middlesex Hospital in Edmonton, North London. He was then kept for recovery in a 'lodger' bed as no beds were available in the facility and he did not have any access to piped oxygen or a call bell. Soon he developed sepsis from the procedure.

In the early hours of April 23, 2021, Smith experienced a sickle cell crisis due to sepsis, which causes red blood cells (RBCs) to become crescent-shaped. The cells then block the capillaries which can restrict blood flow to organs. The disease is common among individuals of African or Caribbean descent. However, the coroner Dr Andrew Walker now stated that the medical staff at North Middlesex University Hospital did not have specific training to manage sickle cell crisis. 

Feeling his own condition deteriorate, Smith requested oxygen from the hospital staff. But he was refused and told that his blood saturation was high enough. As a desperate measure, he called the London Ambulance Service at 999 to provide him with urgent medical attention. However, the operator spoke with his nurses about the latest observations and decided against sending paramedics. 

Later that day, a hematologist examined Smith and prescribed him oxygen but his sickle cell crisis had already set in by then. He did not receive a blood transfusion until late next day. On the night of April 24, 2019, Smith suffered a series of heart attacks and died on April 25 at 5:55 am. 

What did the coroner say? 

The cause of Smith's death was ruled by a pathologist to be multiple organ dysfunction and cerebral infarction, resulting from the sickle cell crisis due to sepsis. 

In his report, coroner Dr Walker said, "In the early morning of April 23, 2019, Mr. Smith is likely to have begun to show symptoms of a developing sickle cell crisis, this being precipitated by the ongoing biliary infection."

"This was made more difficult by a lack of understanding of sickle cell disease in the medical and nursing staff looking after Mr. Smith and the need for a consultant hematologist to be available in the early morning of April 23," he added. "The delay in treating Mr. Smith with a timely exchange transfusion was the cause of his death," Dr. Walker stated. 

Evan Smith's parents Charles and Betty Smith said that they would be appealing for a 'full and transparent' investigation about his death by the hospital.