Urgent warning issued over cardiac death risk

A coroner has issued an urgent warning that the failure to implement an emergency cardiac pathway could result in more deaths.

Malcolm Budd, aged 65, was admitted to Royal Derby Hospital, part of University Hospitals of Derby and Burton Trust, in February with a suspected aortic dissection.

This is a medical emergency in which a tear happens in the inner layer of the aorta, the body’s main artery. For a severe ‘Type A’ dissection – which requires emergency surgery – mortality increases by up to 2 per cent each hour without treatment.

However, Mr Budd was not transferred to the specialist cardiac centre at Glenfield Hospital, part of University Hospitals of Leicester Trust, until almost 8.30pm, eight hours after he was first admitted to Royal Derby.

NHS England published a Standard Operating Procedure and a toolkit which aimed to standardise and improve aortic dissection pathways in 2022. This has been implemented in other parts of the country but not the East Midlands.

Dianne Hocking, assistant coroner for Leicester City and South Leicestershire, has now issued a Prevention of Future Deaths (PFD) notice in relation to this issue. The PFD was issued before the inquest into Mr Budd’s death begins next month due to the urgency of the coroner’s concerns.

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Source: HSJ, 28 September 2026