### Inquest Hears of Tragedy as Cardiff Man Dies After Prolonged Wait for Specialist Care
An inquest has been told of the tragic case of Damien Bedford, a 39-year-old man from Ely, Cardiff, whose death in 2022 has raised serious concerns about the timely delivery of specialist medical care. Mr Bedford passed away at University Hospital of Wales (UHW), weighing just over eight stone, after days waiting for treatment whilst his condition rapidly deteriorated.
Proceedings at Pontypridd Coroners’ Court revealed that Mr Bedford had been reporting severe abdominal pain, unexplained weight loss, and persistent diarrhoea to his GP as far back as July 2022. Despite these warnings, he spent more than 48 hours in the hospital’s overcrowded emergency department before being seen by specialists.
Expert testimony suggested that Mr Bedford’s fatal condition—a rare instance of acute mesenteric ischaemia, where blood supply to the small intestine is drastically reduced—was exceedingly unlikely in someone of his age. Such a diagnosis has less than a 0.1% incidence rate among individuals under 40.
Specialists strongly suspected that undiagnosed Crohn’s disease might have been the underlying issue. However, the cause behind the escalation of his condition remained unclear. Crucially, by the time he arrived on the gastroenterology ward, Mr Bedford was deemed too physically weak to undergo a colonoscopy—a key diagnostic procedure for Crohn’s disease. The required bowel preparation and laxatives would have been intolerable in his fragile state, doctors told the court.
Dr Emily Watkin, who saw Mr Bedford at Ely Bridge Surgery, recalled being alarmed by his appearance when she met him in person on 7 September. At that point, Mr Bedford weighed just 53.8 kg and appeared extremely unwell. He was sent directly to A&E, where he remained on a trolley behind a curtain due to lack of available beds. Despite days in hospital and a CT scan that suggested possible Crohn’s disease, no firm diagnosis was made as there were no clear signs of bowel perforation at that stage.
Gastroenterology consultant Dr Dharmaraj Durai explained the difficulties faced by the medical team. “With such profound weight loss, performing a colonoscopy is fraught with risk. Normally, we’d wait for symptoms to stabilise and support the patient with fluids before proceeding, unless there’s a life-threatening emergency like heavy bleeding,” Dr Durai said. Plans to re-assess the possibility of a colonoscopy the following week were rendered moot as Mr Bedford’s health sharply declined.
The post-mortem, conducted by pathologist Dr Thomas Hockey, confirmed death was due to a perforated ischaemic bowel. However, no definitive underlying cause could be found, with the pathologist noting that loss of blood flow to the bowel leads to tissue death and fatal perforations.
Professor Julie Cornish, consultant colorectal surgeon at UHW, told the inquest that Mr Bedford became so critically ill that even radical surgery, such as a bowel transplant, would not have been an option. His blood pressure was perilously low despite powerful medication, and he had entered multi-organ failure. Professor Cornish remarked that she had never seen mesenteric ischaemia in someone as young as Mr Bedford.
Radiologist Dr Rwth Ellis Owen provided further insight, stating that scans repeatedly showed narrowing of the bowel’s blood vessels, but without clear blockages amenable to surgical intervention. “All three major vessels feeding the bowel looked abnormal, so normal collateral circulation could not develop,” she explained. The scans did not suggest a simple solution, such as placing a stent, would have been feasible.
Questions have been raised by Mr Bedford’s family over the timeliness and seriousness with which his symptoms were treated. His partner, Charlotte, recounted how he appeared emaciated and suffered greatly in the days before his death. She expressed concerns that his condition was not sufficiently prioritised by both primary care and emergency staff.
In the wake of this tragedy, Cardiff and Vale University Health Board has implemented a “zero tolerance policy” to ensure no patient remains in a state of limbo in A&E for more than 24 hours. The inquest is set to resume next week, when a final verdict on the circumstances surrounding Mr Bedford’s death is expected.
The case serves as a stark reminder of the critical importance of rapid specialist intervention, especially in complex cases where initial test results are inconclusive and diagnostic uncertainty prevails.