Cricket star's daughter Bethan James would 'have likely survived' if medics had acted differently, inquest told
An expert witness said Bethan's cardiac arrest could have been avoided, and that she could have survived if it had been. Bethan is the daughter of former Glamorgan and England cricketer Steve James
Bethan, who died in 2020 aged 21, was the daughter of Glamorgan and England cricket star Steve James
A seriously unwell 21-year-old woman would have 'likely survived' if medics had acted appropriately sooner, an expert witness has told the coroner overseeing the inquest into her death.
Bethan James, the daughter of former Glamorgan and England cricketer Steve James, died on February 8, 2020, just a few hours after being admitted to the University Hospital of Wales (UHW) in Cardiff.
The ongoing inquest into her death, which began on Tuesday, June 3, at Pontypridd Coroner's Court, heard that she died of sepsis and pneumonia. Her illness was complicated by the immune suppressing effects of Crohn's disease, it was heard.
Budding journalist Bethan's dad, Steve, a highly respected sports journalist himself, was away covering Wales' Six Nations match in Ireland when his daughter was taken seriously ill.
Heartbreakingly, due to weather delays, he was unable to get home and see her before she died.
During the third day of the inquest on Thursday, June 5, coroner Patricia Morgan heard evidence from Dr Duncan Thomas who treated Bethan at hospital.
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He said he was surprised by how quickly her condition worsened when she was brought into UHW, and expressed 'frustration' that Ms James had not been brought to the resuscitation area – used for treating the most seriously ill patients – earlier.
However, he did not believe there was anything that could have been done to save her.
Dr Thomas said: 'I was, I think it's fair to say, astounded at how quickly Bethan was deteriorating.
'The rate of Bethan's deterioration was not something I had previously observed in someone of her age group, and, in my career, I have only ever seen it one more time.'
While Dr Thomas said the hospital should have received a 'pre-alert' from paramedics bringing Bethan to UHW, he did not believe it would have saved her life, with damage to multiple organs already present before she arrived.
'It's my belief that, unfortunately, Bethan would have died,' he said. 'Bethan's presentation and rate of deterioration were incredibly atypical of someone of her age group.'
Bethan James pictured celebrating her 21st birthday
Dr Thomas said Ms James' death had a 'profound' impact on him and other staff at the hospital, adding: 'I wish there was something I could have done'.
However, the inquest later heard from expert witness Dr Chris Danbury: an intensive care consultant at University Hospital Southampton and an honorary senior lecturer at the University of Southampton Medical School.
He disagreed with evidence heard earlier on Thursday, stating his view was that Bethan's cardiac arrest could have been avoided.
Ms Morgan asked him: 'Is it your evidence that if [Bethan] had been taken into the resus area [straight away] then a cardiac arrest could have been avoided?'
Dr Danbury replied: 'Yes. That's based on my experience. We have seen patients like this frequently. If you [act] aggressively when they come through the door you can avoid cardiac arrest.'
He further explained: 'Resus is a safe place…I have no problem with her staying in resus until a bed came available at [the intensive care unit]. Resus is the place she should be safe until she gets stabilised and is safe to move elsewhere in the hospital.'
Referring to Dr Danbury's pre-prepared report, Ms Morgan said: 'You say if she hadn't gone into cardiac arrest, in your view, she would have likely survived?' He responded: 'Yes.'
Responding to Dr Thomas's description of Bethan's presentation of 'atypical', Dr Danbury said: '[It is] something I have seen before and no doubt I will see it again.'
During the first day of the inquest on Tuesday it was heard how Bethan was 'dismissed' by a number of medics in the weeks that led up to her death.
On Wednesday the coroner heard from the ambulance crew who tended to Bethan and brought her to UWH. The paramedics agreed that A&E should have been warned that Bethan was on her way.
Speaking at the hearing on Tuesday, her heartbroken mother, Jane James, described Bethan as a 'caring' and 'beautiful' person who always put others before herself.
Diagnosed with Crohn's disease in 2019 at the age of 20, Bethan documented her experience of the condition through a vlog and had hopes of becoming a journalist.
Mrs James said: 'As a person she never moaned, she never made a fuss. She was very caring. She was just beautiful.
'She put people before herself. She was more interested in other people and their stories and I think that's why she would have made a brilliant journalist.' The inquest continues.
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The health board told WalesOnline it has met its deadline for sending that information, and Ms Morgan will now consider the evidence to decide if a regulation 28 to prevent future deaths should come into effect. Although the outcome of the inquest confirmed the family's intuition all along, Steve and Jane said the validation offers them little closure. Jane, a physiotherapist for Sport Wales, said: 'The whole thing is torture, but to think it has been five years that we have been pushing for this, and what it has taken out of us emotionally. It is constantly in your head and you are constantly waiting for the next email. 'All of these things should have happened in that first year and we should have had all the answers within the first year and we have still been learning new things in the inquest.' Bethan with her parents Steve and Jane James with her younger brother Rhys (Image: Steve James ) Getting emotional and turning to her husband, she said: 'I don't know about you, but the grief feels worse at the moment.' Steve replied: 'It feels like she has died again. It is horrendous.' He added: 'We are obviously happy with the conclusion because it is what we said and thought all along. 'But it doesn't give us closure, it actually makes it worse because it validates the fact that she should be here and it doesn't make anything better. "But from our point of view, we said all along that we had to fight for Bethan, we had to fight for justice. 'The coroner saying that she shouldn't have died is pleasing for us in terms of all the work we've had to do to get to that point.' They said part of that fight had been getting their hands on Bethan's medical notes, which they described as being a long and laborious process. Once they received the notes Jane said she was taken aback by 'how poorly' the notes were written, including notes not being signed and others written in retrospect after Bethan's death. Steve and James want Martha's Law to be rolled out to all hospitals in Wales (Image: Steve James ) She said: 'My heart goes out to any families that have to go through anything like this process to get answers from the NHS and find out what happened to their relative because having experienced what we have gone through, with those barriers put up when you are at the lowest point in your life; you look for answers and you are constantly pushed back.' 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Jane said the family understands that a scheme called Call4Concern is currently being piloted in some Welsh hospitals. However, when she visited UHW A&E in May 2025 with a family member she said she was appalled to see that 'nothing had changed' in the last five years. She recalled seeing no posters or leaflets referring to the pilot. Paying tribute to her daughter, Jane said: 'Bethan was just a joy all through her life. We keep saying she was the kindest and that's because she was. 'Even from a young age she was kind and considerate. She had that way about her where she always thought of others. 'She was shy growing up until her teenage years when she was 14 and 15 and she became interested in vlogs. 'At first we were reluctant for her to do that on social media, but we soon realised it was her forte. 'She would film them on all sorts of subjects like mental health, make-up and Crohn's. She really came into her own and she lost that shyness about her. 'She was doing really well with her journalism degree. In that January that's when she did her pitch for [a] BBC Crohn's documentary; off her own back she got in touch with Amy Dowden.' Steve added: 'I was amazed when she started doing the vlogs because of her shyness. She had a lot of health problems growing up that she fought through, but it obviously added a real inner steel to her. 'Those vlogs revealed a side of her that I wasn't aware of previously. The Crohn's diagnosis hit her hard but she was then determined to raise awareness through the Crohn's and colitis [charities]. She was always thinking of others - that sums up her character. 'At the end of her life she almost felt like a burden, because she was always thinking of others. She was such a kind and caring soul.' Bethan was a 'kind and caring soul', her family said (Image: Steve James ) A Welsh Government spokesman said: 'Ensuring the voices of patients and their loved ones are heard, is paramount to us. 'To improve patient safety across Wales, we're working with NHS organisations to identify the best patient and family-initiated escalation model. Call4Concern is one scheme being piloted by a number of health boards in Wales and has seen positive steps in improving patient safety. 'We are also implementing phase one of our patient safety plan to ensure people of all ages have an evidence-based early warning scoring system, which will help clinical staff identify deteriorating patients earlier." The coroner's office said: 'In relation to your request for a comment in relation to this inquest hearing, I respectfully refer you to Page 16 of the Guide to Judicial Conduct 2023 (attached), providing details on why a coroner (as a Judge) would be in breach of the Code for Judicial Conduct and liable to disciplinary action were they to comment publicly on individual judicial decisions.' A spokesman for the health board said: 'Our deepest sympathies and heartfelt condolences remain with Bethan's family and loved ones at this difficult time. The health board provided a comprehensive written response to the coroner's request for additional information within the seven-day deadline. "We are unable to provide further comments until the coroner has reviewed the supplementary evidence." Liam Williams, the Welsh Ambulance Service's executive director of quality and nursing, said: 'On behalf of everyone at the Welsh Ambulance Service, I would like to extend my deepest sympathies to Bethan's family through what continues to be a difficult time, and offer a renewed apology for the errors which were identified in Bethan's case. 'While we cannot change the outcome, we remain a learning organisation and are sincerely grateful to the coroner for her thorough examination of this tragic case. "As a trust, we have taken steps to ensure that the learning we identified at the time were considered and changes implemented. 'This includes the introduction of the electronic patient clinical record, which enables crews to capture a patient's information on an iPad in order to pre-alert healthcare partners prior to a patient's arrival at hospital, and share the documentation of clinical assessment and care given. Article continues below 'Our invitation to meet with Bethan's family remains open should they have any outstanding questions or areas that they would like to speak with us about.'
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17-06-2025
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The tragic daughter of a former England cricketer would have survived if medics had treated her properly, a coroner ruled today. Bethan James, 21, daughter of ex-England and Glamorgan batsman Steve James had visited hospital multiple times in the days leading up to her death - but she continued to be ill when released home. Paramedics were called to her house when she deteriorated at home - but a coroner found delays in her treatment and a lack of urgency. By the time she was seen at hospital Bethan was gravely ill and died with sepsis within hours of being admitted to the emergency department. Her sports journalist father had been covering the Six Nations rugby match between Wales and Ireland in Dublin when his daughter was taken seriously ill. But due to weather delays was unable to get home and see her before she died. The inquest heard ambulance staff attending Bethan's home had not requested emergency backup, struggled to insert an IV line, and did not issue a pre-alert to the hospital to warn them of her serious condition before she was admitted. On arrival to University Hospital Wales, Cardiff, Bethan was admitted to the less serious 'majors' unit rather than to resus where medics held a 'cognitive bias' to more immediate treatment. The hearing was told that a lactate reading obtained an hour after her arrival eventually prompted more senior doctors to become involved in her care. Senior Coroner Patricia Morgan said: 'I find that if earlier recognition and prompt action in response to Bethan's condition by ambulance services had occurred this would have resulted in a pre-alert to the emergency department. 'This would, and ought to have, resulted in direct admission to resus with clinical staff waiting for her.' She added: 'Earlier treatment would and ought to have commenced' and that 'the involvement of other specialists would and ought to have occurred at an earlier stage.' 'Cognitive bias towards resus patients, as described by Dr Thomas, would have been directed in Bethan's favour from the time of her arrival rather than once the lactate result was available. 'On balance, I find that had this direct admission to resus and prompt recognition and treatment occurred, then cardiac arrest would not have occurred when it did, which would have enabled more time for other specialities to become involved in Bethan's care. 'On balance I find that Bethan would not have died.' A post-mortem examination found Bethan died from a combination of sepsis, pneumonia and Crohn's disease. Bethan had been diagnosed with Crohn's in the previous months and had been admitted to hospital on a number of occasions in the days leading up to her death but sepsis was never diagnosed. During the hearing, her mother Jane James the court she felt medical staff missed opportunities to treat journalism student Bethan for sepsis and had been 'dismissive' of her condition. She said: 'It's heartbreaking as a mum to know that her life could have been saved.' Mrs James described Bethan as a 'caring and beautiful' beautiful person who would have made a 'brilliant' journalist. Giving a narrative conclusion the coroner said Bethan had attended hospital 'multiple occasions' between 27/1/2020 and 6/2/2020 but was repeatedly sent home. Ms Morgan said: 'Bethan was reluctant to return hospital due to her lack of confidence arising from earlier attendances at hospital.' When her condition deteriorated on February 8, 2020 her mother Jane dialled 999 and a rapid responder arrived at her home. Ms Morgan said: 'The rapid responder identified Bethan was in need of admission to hospital and request a back up ambulance at a non-urgent grade of P3, Bethan's condition warranted an emergency response. 'There was no pre-alert issued to hospital to make them aware of the seriousness of her condition. 'Bethan was transferred to the UHW majors area of the department when she should admitted directly to resus. 'There was an extended transfer between ambulance and hospital and a delay in recognising Bethan's critical condition once she was admitted. 'This delayed the escalation of her treatment and the input of specialty doctors into her care. 'Bethan sadly went into cardiac arrest and died.' Following the ruling Ms Morgan offered her condolences to Bethan's parents who had sat through the hearing.
