A man who died following a suspected allergic reaction during a routine health check-up at the Royal Bolton Hospital waited 17 minutes for 'crash team' to arrive an inquest has heard.

David Horsman died on Monday, March 28, 2022, following a routine CT scan, just one month after his 25th wedding anniversary.

The first day of an inquest into his death was held on Wednesday, May 22 at Bolton Coroners' Court.

This is coverage of day one of the inquest. Coverage from day two can be found here.  Coverage from day three can be found here. Coverage from the final day can be found here. Transcripts and recordings of the emergency calls can be found here.

The 65-year-old, who lived in Westhoughton, was an internationally recognised electrical engineer who had retired in 2019, the court heard.

According to wife Jane Horsman, the proud granddad was diagnosed with stage 3 bowel cancer – with a tumour ‘the size of a satsuma’ – after discovering blood in his stool just two weeks after he retired.

After having his tumour surgically removed, Mr Horsman was invited to attend annual health check-ups at the Royal Bolton Hospital to check that the condition had not returned.

David left for his check-up, scheduled for 2.40pm, on Sunday, March 27, 2022.

Just over four hours after David’s appointment was due to start, at 6.50pm, wife Jane received what she described as the ‘worst phone call of her life’.

A doctor from the hospital informed Jane that David had suffered a suspected allergic reaction during his check-up, and that the hospital had ‘lost him and then got him back’.

After rushing to hospital with the help of a neighbour, Jane was told that a non-resuscitation order had been put in place if David were to collapse again – but she was convinced he would survive.

In court, Jane said: “He was completely fit and well, even though I was still shocked at what was going on and couldn’t believe it and couldn’t take it in.

“I was half confident David was going to beat it anyway. He’d beat the cancer so he could beat this, he was a strong-willed man.

“I wasn’t that worried in some ways because I knew he could get through.”

After a sleepless night, she returned to hospital the next day, where she was met by five doctors.

Jane added: “They were trying to say it in a very nice way and it wasn’t landing very well, I asked in practical terms what they were saying and they said he wasn’t going to survive.”

The scan was carried out in a van in the Royal Bolton’s car park by a team employed private healthcare company InHealth – billed as ‘the UK’s largest specialist provider of diagnostic and healthcare solutions’ on its website.

During such scans, patients are injected with a ‘contrast dye,’ used to help highlight areas of the body that are being scanned.

However, following the scan, David began to cough and started to feel hot, developing a redness on his skin, as a result of a suspected allergic reaction to the dye.

As his condition started to deteriorate, CT radiographer Idongesit Okon, employed by InHealth, tried to call the hospital’s radiography department from the van, but there was no answer.

He then tried to call the hospital’s crash team on the internal emergency number: 2222.

However, the script for such a call wasn’t followed.

Instead of saying ‘adult cardiac arrest, mobile scanner outside A block,’ Mr Okon said there was an ‘emergency at the CT van, the patient reacted to contrast’.

Mr Okon said he was ‘truly thrown off balance’ as it was the first time he’d witnessed a patient suffering anaphylactic shock.

Despite saying that it was a ‘man’ who needed help, the hospital’s emergency ‘crash team’ were sent to block E5, on the hospital’s children’s ward, rather than to the van in the car park.

Located on the hospital’s second floor – the error led, in part, to a delay of 17 minutes before the team arrived at the correct location as hospital staff searched for someone in need of help.

During the wait, Mr Okon made repeated calls to the emergency number and got a nurse, Derrick ‘Andy’ Newton, from the hospital.

After David stopped breathing, Mr Okon was eventually put through to 999.

Despite this, a defibrillator wasn’t used, which Mr Okon said was due to ‘tension’.

Coroner John Pollard said: “Forgive me for being so blunt, but you are health professionals – you are supposed to be able to deal with situations like this, I appreciate it’s shocking for you to see it, but it’s no excuse.”

The van had no EpiPens, something Mr Okon and his colleague, radiographer Shazia Hanif, had been trained to use – instead having adrenaline ampoules, which they had not been trained to use.

Just two days after the incident, the Trust provided EpiPens and a new emergency flowchart to the van.

After trying to run towards the hospital’s A&E department, Hanif eventually found the hospital’s crash team in the car park, and directed them to the van.

Andy Newton told the court that he was continuing compressions with a colleague from another MRI van, who found the CT van’s defibrillator – but that the pair could not get it to work.

He said: “Within minutes, he didn’t have a pulse.

“I just continued compressions, I just didn’t want him to pass away to be honest, I just carried on and carried on shouting for help.”

The inquest continues tomorrow.

If you have a story, I cover the whole borough of Bolton. Please get in touch at jack.fifield@newsquest.co.uk.