Systemic Hospital Failures Contributed to Young Man's Death After Delayed Heart Operation
A 26-year-old man described by his family as a 'loveable rogue' died following heart surgery that had been repeatedly postponed for months, with an inquest hearing how his case was allowed to 'fall through the cracks' of the hospital system. James Poots, a dryliner from Heywood who previously enjoyed good health through gym workouts and five-a-side football, passed away at Wythenshawe Hospital on April 2 last year, just one week after his 26th birthday.
Steady Decline from Fitness to Critical Condition
The proceedings at Rochdale Coroners' Court revealed that Mr Poots had rarely required medical attention until he began experiencing chest pains in 2023. His GP, Dr Imran Ghafoor of Peterloo Medical Centre, told the court that the previously healthy young man became a frequent visitor to the practice, appearing increasingly unwell. Blood tests arranged as part of investigations led to a diagnosis of pericardial effusion by October 2023, resulting in his first admission to Royal Oldham Hospital.
Dr Ghafoor described James as a well-liked figure at the medical centre, affectionately regarded as a 'loveable rogue'. By December 2023, his condition had progressed to the considerably rarer and more severe constricted pericarditis, prompting arrangements for an MR scan at Wythenshawe Hospital.
Repeated Surgical Delays and System Failures
Consultant cardiologist Dr Jonathan Swan informed the court that despite treatment with steroids, anti-inflammatories and intravenous diuretics, he could observe the patient was 'definitely not getting better'. Dr Swan explained he had arranged a multidisciplinary meeting for May 2024 to discuss surgical intervention, but revealed that surgeons were initially 'reluctant', describing the procedure as 'not a great treatment' for the condition due to its dangerous nature and high complication and mortality rates.
The inquest discovered that when Dr Swan requested another multidisciplinary meeting in July 2024 to revisit the possibility of surgery, this meeting never occurred. James' sister, Emma Walsh, tearfully challenged Dr Swan during proceedings, asking: 'He was a 25-year-old boy. How was he falling into the cracks so much under your care?'
Family's Frustration with Unanswered Calls
Ms Walsh recounted how she had been provided with a contact number to escalate James' case at the hospital, but her calls went unanswered until someone finally explained it was 'just a phone in a corridor and nobody answers it'. She also mentioned that attempts to reach Dr Swan's office went unreturned. Arena coroner Catherine McKenna acknowledged that the hospital trust admitted there was a 'gap in the system', stating: 'That's not acceptable at all. I don't think there's anybody in this court who thinks that's acceptable.'
Final Hospital Admission and Fatal Operation
Following another consultation with his GP, James was referred to North Manchester General Hospital, where he was admitted on January 24, 2025, remaining for eight weeks. Consultant cardiologist Dr Mita Kale examined him upon arrival, noting he was 'quite limited in terms of what he could do because of breathlessness' and displayed significant fluid buildup and heart failure signs. After a subsequent multidisciplinary assessment in January 2025, James was transferred to Wythenshawe Hospital in March for additional treatment.
On his 26th birthday, he underwent a pericardiectomy - a procedure to excise portions of the membrane encasing the heart. He passed away on April 2, with the certified medical cause of death recorded as 'multi-organ failure'.
Internal Review Reveals Systemic Shortcomings
Dr Timothy Gray, a consultant cardiologist with the Northern Care Alliance NHS Trust who conducted an immediate learning review, informed the inquest about systemic shortcomings regarding multidisciplinary team meetings. He confirmed that Dr Swan had advocated for surgery at a May 2024 meeting, but this was rejected by a senior surgeon at Wythenshawe Hospital. The requested July 2024 review never occurred, with the MDT coordinator not remembering the request and 'not understanding why'.
Dr Gray noted there was also a failure to consider the case the following week or when Dr Swan, who worked part-time, was available. The surgeon who initially dismissed the surgery idea, Dr Venkat, did not provide evidence as he has relocated to the USA, with Dr Gray noting that 'most' of the cardio department at Wythenshawe had moved to America.
Broader Implications and System Changes
The witness confirmed an 'another incident' where another patient had been let down by the trust's MDT process, though no additional details were provided. Dr Gray spoke about the large number of patients the trust manages, revealing that Dr Swan's waiting list for a consultation currently extends back 12 months. When questioned by the family if a similar incident could occur again, he conceded it was 'possible'.
Dr Gray responded to relatives' calls for change by stating: 'I echo those thoughts. I'm very passionate about patient safety which is why I do this particular aspect of my job. I will do everything in my power to change processes and keep everyone safe.' He concurred with the coroner's assessment that James' survival odds from the operation would have been 'much higher' had it been performed six to eight months earlier. A new system has now been implemented to track patients' progress through the MDT process.
