## Delays in Hospital Care ‘More Than Minimally Contributed’ to Bethan James’ Tragic Death, Coroner Finds
The life of Bethan James, daughter of former Glamorgan and England cricketer Steve James, could have been spared had medical professionals responded more urgently and effectively, a coroner has ruled. The 21-year-old from St Mellons, Cardiff, passed away at the University Hospital of Wales on 9 February 2020, just a day after her final admission for what was later determined to be sepsis and pneumonia—aspects made worse by her struggle with Crohn’s disease.
At the conclusion of a three-day inquest at Pontypridd Coroner’s Court, Patricia Morgan, senior coroner, determined that a series of delays and misjudgements throughout Bethan’s treatment played a significant role in her death. Ms Morgan said these shortcomings “more than minimally contributed” to the outcome, and remarked that “on balance, I find that Bethan would not have died” if appropriate action had been taken sooner.
Throughout the inquest, harrowing details emerged about Bethan’s repeated pleas for help and the missed opportunities to better diagnose her rapidly deteriorating condition. Bethan, who was diagnosed with Crohn’s disease in 2019, made several visits to hospital between late January and early February 2020. After an initial pneumonia diagnosis at Llandough Hospital on 27 January, for which she was prescribed antibiotics, her condition began to worsen: numbness, nausea, and a growing reluctance to return to hospital out of fear of being dismissed.
One contentious moment involved medical staff attributing Bethan’s concerns to anxiety or exaggeration, with one doctor reportedly greeting her with “You again! You were here on Sunday,” and another attempting to reassure her by comparing her case with a teenager who subsequently recovered—comments that left Bethan feeling belittled and hesitant to seek further help.
Evidence presented by Bethan’s mother, Jane James, painted a portrait of her daughter’s repeated unheeded requests for assistance. On 8 February, a rapid responder summoned to their home quickly identified that Bethan was seriously unwell. However, the call for an ambulance was initially classified as ‘P3’—a lower priority emergency response—which the coroner later criticised as failing to match the gravity of Bethan’s condition, though she noted this did not affect the actual ambulance arrival time.
Upon Bethan’s arrival at the University Hospital of Wales, paramedics failed to pre-alert staff, meaning team members were not prepared and a suitable bed in the resuscitation unit had not been secured for her. This oversight resulted in what Ms Morgan described as “lost time” during the triage process, further delaying urgently needed care and the diagnosis of Bethan’s septic condition. Expert witness Dr Chris Danbury, speaking at the inquest, asserted that the absence of a pre-alert and the resulting delays could very well have contributed to Bethan’s fatal cardiac arrest.
The complexities of Bethan’s condition were further discussed in court, with one attending doctor, Dr Duncan Thomas, suggesting her decline was “a-typical” and that a difference in hospital response may not have altered the outcome. However, Dr Danbury maintained that early intervention would almost certainly have given Bethan a greater chance of survival, an assessment with which the coroner ultimately agreed.
Following the inquest, Ms Morgan acknowledged her intention to consider a Regulation 28 report—to prevent future deaths—awaiting further clarification from the University Hospital of Wales as part of the ongoing review. She also expressed her deep sympathy to Bethan’s family, noting the enduring pain caused by the years-long wait for answers and accountability.
Bethan James was much more than a patient—her mother described her as “caring” and “beautiful”, someone who consistently prioritised others’ needs above her own. A journalism student at the University of South Wales with aspirations of amplifying awareness of Crohn’s disease, Bethan chronicled her experiences online, even contributing to a BBC documentary alongside fellow sufferer Amy Dowden. That programme, ‘Strictly Amy: Crohn’s and Me’, aired after Bethan’s passing and was dedicated to her memory.
This case, which has shone a harsh spotlight on the series of missteps in Bethan’s care, now serves as a stark reminder for hospitals and health professionals of the need for vigilance, patient-centred care, and timely intervention. The coming weeks will reveal what, if any, further steps the coroner will take to ensure lessons are learned in the wake of this avoidable tragedy.