A coroner has ruled Yusein Aliev died of natural causes after suffering a heart attack on his way to North Mid, reports Ben Lynch, Local Democracy Reporter

Ambulances (credit London Ambulance Service) — credit London Ambulance Service

An Edmonton man died of a brain injury in hospital days after travelling to A&E in a taxi because an ambulance took so long to arrive.

Yusein Ahmedov Aliev passed away on 12th May 2023 at St Bartholomew’s Hospital of hypoxic brain damage, having suffered a cardiac arrest several days prior.

Yusein, 63, collapsed in the car park of North Middlesex University Hospital on the morning of 6th May, having taken a taxi from his home after waiting two hours for an ambulance. He was subsequently transferred to St Bartholomew’s Hospital in the City of London, where he died six days later.

At City of London Coroner’s Court yesterday (Thursday 18th), coroner Alison Hewitt found Yusein had died of natural causes, and that it was impossible to say for sure whether the delayed ambulance had contributed to his death.

She also accepted the delay was due to a combination of high demand and limited resources at London Ambulance Service (LAS) on the morning concerned.

Yusein’s family rang 999 just after 4am on 6th May last year, explaining he had fainted and, though awake at the time of the call, was having difficulty breathing. At around 6am, Yusein’s family took him from his Edmonton home to North Middlesex University Hospital, via taxi, due to the ambulance still not arriving. But he collapsed before he made it to the entrance.

He underwent a series of treatments in the hospital in a bid to resuscitate him, including receiving ten electric shocks to the heart. He was then transferred to St Bartholomew’s later that morning, after achieving spontaneous circulation.

Dr Stephen Hamshere, who is based in the cardiology department at St Bartholomew’s, told the inquest Yusein underwent a procedure in which he had five stents installed. At that point, he believed Yusein had a chance of survival.

However, a CT scan the following day revealed the extent of the hypoxic brain damage, caused when the organ is deprived of oxygen, which Yusein suffered as a result of his cardiac arrest. He died at 6.10pm on 12th May.

When the family dialled 999 on 6th May just after 4am, they were told to expect an ambulance in 40-60 minutes. They were called back by LAS at 4.43am, to inform them the service was suffering from severe delays. An ambulance is recorded as arriving at Yusein’s Edmonton home around 6.25am, though by that point he and his family had called the taxi.

In her questions to Dr Hamshere, the coroner queried whether the long ambulance delay contributed to Yusein’s death. Dr Hamshere explained that his colleagues in the LAS are trained in life support, but they would have been unable to prevent Yusein going into cardiac arrest.

He conceded they may have been able to stave off the hypoxic brain damage, though was careful to caveat this by saying the number of variables involved made that impossible to confirm. The lack of an ECG scan prior to his cardiac arrest also meant it is unclear as to the condition of his heart at that point, he added.

Lyn Sugg, senior quality assurance manager at LAS, told the inquest that while the more than two-hour delay was longer than expected, on the morning of 6th May the service was suffering from high demand compounded by staffing issues, which was at 70-80% of what it should have been. “Our resources were not meeting what was needed,” she said.

Lyn explained the proper protocol had been followed in attempting to assist Yusein, and that since the incident, steps had been taken to improve response times, including recruiting more staff and reviewing its processes.

Announcing her findings, Hewitt said she found Yusein’s death to be by natural causes, and that she was satisfied the reason for the delayed service “was in effect a demand of ambulances beyond the resources available”.

On whether the paramedics arriving earlier could have prevented Yusein suffering hypoxic brain damage, Hewitt referred to Dr Hamshere’s earlier statements. While paramedics are trained in resuscitation, she told the inquest: “He said, being very careful about it, that nonetheless it is a big jump to say on the balance of probability it would have prevented the period of hypoxia […] not least because the success of it being highly dependent on a whole series of different factors.”

She added while “it is possible that an earlier arrival may have, could have, avoided Mr Aliev’s death, on the evidence, I certainly cannot ascertain whether it would have done or not”.

The coroner said she would be sending a prevention of future deaths report to the secretary of state, acknowledging response times are a national problem rather than LAS-specific.

Dr Fenella Wrigley, chief medical officer at the LAS, told the Local Democracy Reporting Service (LDRS): “On behalf of London Ambulance Service, I apologise for the delay in responding to Mr Aliev and offer my sincere condolences to his family and loved ones in this difficult time.

“Since the time of Mr Aliev’s death we have made a number of changes to improve our response times, including working to reduce hospital handover delays and recruiting more staff for our 999 control rooms and to go out on ambulances.”

No news is bad news

Independent news outlets like ours – reporting for the community without rich backers – are under threat of closure, turning British towns into news deserts.

The audiences they serve know less, understand less, and can do less.

If our coverage has helped you understand our community a little bit better, please consider supporting us with a monthly, yearly or one-off donation.

Choose the news. Don’t lose the news.

Monthly direct debit

Annual direct debit

£5 per month supporters get a digital copy of each month’s paper before anyone else, £10 per month supporters get a digital copy of each month’s paper before anyone else and a print copy posted to them each month. £50 annual supporters get a digital copy of each month's paper before anyone else.