A RETIRED firefighter’s life was ‘wrecked’ in a botched operation nine years before he became critically ill with a bowel blockage and died in hospital.
Stephen Pagan, 61, of Maryport, died on October 2, 2023 at The Cumberland Infirmary in Carlisle following emergency surgery.
An inquest heard Mr Pagan had undergone endoscopic surgery to remove bowel polyps at the West Cumberland Hospital in 2014 but his bowel was perforated during the procedure.
There was extensive bleeding which couldn’t be stopped and Mr Pagan had to have emergency surgery. He was then given a stoma.
Mr Pagan’s daughter, Amelia Crayston, said his life had ‘changed dramatically’ after this. He had a number of health conditions including a large hernia and chronic pain.
He felt he would never be able to come to terms with the physical changes and found the stoma ‘very distressing’. He described feeling like his life had fallen apart, Cockermouth Coroners’ Court heard.
His part-time employment as a retained firefighter at Maryport Fire Station was terminated and he medically retired from his role as a firefighter at Sellafield in 2018. This left him feeling ‘like he had no purpose’.
In the days leading up to his death, Mr Pagan became ill and was ‘distressed’. He was being sick and had a pain.
He spoke to his wife, Julie, over the phone and she told him to ring her back if he got worse or to call an ambulance.
Mr Pagan then left her a voicemail to say he had called an ambulance. When his wife called back, a paramedic answered the phone and told her that Mr Pagan was being taken to the Cumberland Infirmary because he didn’t want to go to West Cumberland Hospital.
Mrs Pagan later called A&E and was told that Mr Pagan was still in the ambulance and had not yet seen a doctor. A short while later, she spoke to a doctor who she said seemed ‘quite blasé’.
At about 7pm, she received a call from an anesthetist who said Mr Pagan was critically unwell. His kidney function had dropped and he was not fit to be transferred.
Mr Pagan had an obstruction in the small bowel and emergency surgery was carried out. Mrs Pagan was told afterwards that her husband was ‘not out of the woods’.
A second operation was carried out on October 1 where two metres of bowel had to be removed. Gangrene had been found in Mr Pagan’s bowel.
His condition did not improve and he went into multiple organ failure. He passed away the following day.
His daughter said: “He died in the very room he learned his life had changed [in 2014] when this nightmare began. A cruel end to years of pain and suffering.”
Giving evidence, Ahmed Mortada, a general surgeon at the Cumberland Infirmary who performed the emergency procedures, said Mr Pagan had an obstruction in the small bowel, and this was within the scope of general surgery.
Mr Mortada said Mr Pagan was ‘critically unwell’ and there had been no plan to transfer him to a hospital in Newcastle because he may not have survived the transfer. He said the aim was to save Mr Pagan’s life and stabilise his condition.
The cause of death was multiple organ failure and sepsis, due to an obstructed parastomal hernia, caused by iatrogenic bowel perforation during endoscopic surgery for colorectal cancer in 2014 and subsequent Hartmann's procedure.
Dr Nicholas Shaw, assistant coroner for Cumbria, said: “Stephen’s life was wrecked by the surgery he had in 2014.
“The surgery was badly performed, probably by the wrong person. Negligence has been admitted. It was life-changing. He lost his health, his mobility, his job. He lost his purpose in life.
“He must have had considerable mental resilience to cope with it.”
Dr Shaw said the delay in time to Mr Pagan being admitted to hospital from the ambulance would have had a ‘minimal effect’ on the causation.
He said Mr Mortada would have faced a ‘very challenging case’ and handled it as well as he could do. Dr Shaw said the causation dated back to 2014 when Mr Pagan had the endoscopic surgery.
The coroner returned a narrative conclusion, which said: “Stephen Pagan died in The Cumberland Infirmary on October 2, 2023.
“In 2014, surgery for colorectal cancer left him with abdominal lesions and a stoma.
“On September 30, 2023, his small bowel became obstructed by the stoma, which led to pain and sepsis. He required emergency surgery for this.
“He developed ischemic bowel and multiple organ failure.”
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