A King’s Lynn man with a heart condition died two days after a senior doctor accidentally viewed the wrong scan and sent him home, an inquest heard.
Lucas Allard, 28, of Mill Houses, was admitted to the town’s Queen Elizabeth Hospital with chest pain, which radiated to his back, shoulder blades and abdomen on March 12 last year.
Mr Allard, a technological support worker, was seen by a specialty grade doctor, who ordered a CT angiogram, and was given two doses of morphine, the hearing was told on Monday.
Area coroner Yvonne Blake, who gave a narrative conclusion at the hearing, said the doctor had mistakenly viewed a scan from November 2018, which did not show any abnormalities.
“Lucas’s ECG and bloods were normal and he was discharged home with advice to return if the pain returned or worsened,” she said.
The inquest, held at Norfolk Corner’s Court in Norwich, heard Mr Allard had Marfan syndrome, a genetic disorder of the body’s connective tissues which could cause heart defects.
At that time, Mr Allard was awaiting cardiac surgery for a known aneurysm.
On the morning of March 14, another hospital consultant was reviewing the scans when he realised Mr Allard’s correct scan was in fact “abnormal”.
Ms Blake said: “Eventually, they spoke to Lucas and advised him to return to the emergency department as soon as possible, he arrived shortly afterwards and went straight into resus.
“As he was transferring from a wheelchair, Lucas suffered a cardiac arrest and attempts at resuscitation were unsuccessful.”
The inquest heard the QEH was taking steps to prevent the error reoccurring, including upgrading computer systems.