Thomas Gibson, 40, passed away on 7th June 2023 from a sudden but preventable cardiac death at his home following his earlier attendance at Manchester University NHS Foundation Trust. The Trust has given a full admission of liability that they provided negligent medical care to Tom in the days before his death, which caused his sudden cardiac death.
Tragically, Tom passed away on the same morning that Rebecca Moss, Tom’s partner, gave birth to their first child, Harper, now 11 months old, and never got to meet his daughter.
Three weeks before Tom passed away, he contracted a stomach bug, which he was struggling to recover from. After failing to be seen in person by his GP (Delamere Medical Centre in Stretford) he contacted 111 and was told to present himself to Wythenshawe A&E due to the symptoms of the stomach bug.
While in A&E, Tom was given an electrocardiogram (ECG) test which displayed abnormal results. The ECG identified a complete heart block, also known as a third-degree heart block (the most serious type of heart block), and can lead to sudden cardiac death, which is sadly what happened in Tom’s case. The abnormality on the ECG was missed by the doctors in the A&E department and he was discharged for follow up care by his GP relating to his stomach bug.
At the time of Tom’s death, Rebecca was 39 weeks pregnant with their daughter Harper. Tragically, Rebecca was scheduled to have a planned caesarean section on the morning when she found Tom unresponsive at their home.
Rebecca called 999 and performed CPR but he had already passed away. Thankfully, and in spite of the horrific events that morning, Harper arrived safely but Tom never got to meet his first and only child.
Manchester University NHS Foundation Trust has admitted that Tom should have been admitted as an inpatient to cardiology and fitted with a pacemaker device. This would have likely prevented his death.
What does Rebecca Moss hope to learn from the inquest?
Rebecca wants a series of questions answered through the inquest, here are the most pertinent:
- Tom had 2 ECG’s during his admission. What lead to these being interpreted incorrectly?
- Is there an over-reliance on the automated ECG report that is produced – which was erroneous in this case?
- Did the A+E clinicians have sufficient training with regard to ECG interpretation and if they didn’t, did they recognise they required more senior/specialist input. Tom wasn’t reviewed by a specialist cardiologist during his admission. The Trust have provided expert evidence to say he should have had cardiac input after his first ECG.
- The Registrar who discharged Tom felt that there were no cardiovascular symptoms as Tom attended with gastrointestinal symptoms. There had in fact been several cardiovascular concerns during Tom’s admission. Is there an issue with communication within the Trust?
- Is there also complacency on behalf of the Registrar and in general when dealing with younger patients and failure to consider the patient as a whole and consider the full clinical picture?
- Why were antibiotics that were contraindicated in long QT syndrome proposed by the microbiologist at the Trust. Tom was subsequently prescribed these by his GP and had taken a dose the day before he died.
- Whether the Trust are now implementing changes to ensure that the clinicians have appropriate training to allow accurate interpretation of ECG and/or whether they recognise the limit of their knowledge and seek senior input when required. What is there escalation policy and was this adhered to? What have they put in place to make sure this doesn’t happen again.
Quote from the family’s solicitor – Charlotte Moore, CL Medilaw
“Tom’s tragic death is a result of a misinterpretation of a basic cardiac function test, for which we have received a full admission of liability for Tom’s partner, Rebecca. If the ECG had been properly interpreted as showed a complete heart block, Tom would have received a pacemaker, and his untimely death would have been avoided. For this to happen on the day that Harper was born adds to the pain and anger that Rebecca now endures in losing Tom, unnecessarily. Harper’s birthday, which should be a joyous occasion, will forever be tinged by sadness for Rebecca and Harper, due to the loss of their loving partner and father.”
Sudden Cardiac Death in the Young
According to the charity Cardiac Risk in the Young (CRY), every week in the UK, 12 apparently fit and healthy young aged 35 and under die from undiagnosed cardiac conditions.
Despite this shocking statistic, following a government review by the National Screening Committee in 2019, it was concluded that there should be no systematic population screening of people under the age of 39 for cardiac conditions associated with sudden cardiac death. The next review is due to be completed this year.
Statement from Cardiac Risk in the Young (CRY)
There is a crisis in the UK surrounding the lack of knowledge, training and awareness of heart health problems. The situation is at such a level that the charity Cardiac Risk in the Young (CRY) has established itself to tackle this head on and prevent more needless deaths such as Thomas Gibson’s.
CRY also offers subsidised cardiac screening (an ECG) to all young people between the ages of 14 & 35.
Chief Executive of the charity Cardiac Risk in the Young (CRY) Dr Steven Cox said:
“Every week, 12 apparently fitand healthy young (that is, aged 35 and under) people in the UK die suddenly from a previously undiagnosed heart condition. In 80% of these cases, there will have been no signs or symptoms of a heart defect until it is too late, which is why CRY believes screening is so vitally important (particularly for those involved in regular, physical activity). As such, CRY now tests around 27,000 young people each year, aged between 14 and 35.
“As CRY receives no government funding, our UK-wide screening programme is only possible because of the backing CRY receives from families - and their wider communities - who have been affected by the devastation of such a tragedy. This support allows us to provide this service free at the point of access to the general public. And, as a campaigning organisation, we are committed to lobbying for change and the development and implementation of a National Strategy for the Prevention of Sudden Cardiac Death in Young People.”
Interview availability
Rebecca Moss is open to pre-recorded interviews following the inquest conclusion, as too is her solicitor, Charlotte Moore of CL Medilaw.
A statement will be given following the end of the inquest to be read out to press present.
Scala
Scala’s PR Executive – Christian Abbott - will be in attendance on both days of the inquest (Tuesday 4th and Wednesday 5th June). We will be acting as point of contact for the press, fielding any questions they may have, scheduling requested interviews and managing the family’s and solicitors schedule for them.
For all enquiries regarding the inquest, interview availability, or just general information on the family’s story, please contact Scala.
