Skull-fracture victim ‘could have survived’

A TOP neurosurgery expert said Arnold Siddall could have survived had he been treated earlier, an inquest was told yesterday.

The 47-year-old welder, from Failsworth, was admitted to the Royal Oldham Hospital three times on September 22, 2007, following an argument outside the Lock Pub, Oldham Road, Failsworth.

Mr Siddall had been pushed to the ground and fractured his skull. He died two days later.
The inquest heard how on his first admission just after 2am, the on-duty triage nurse had not seen the paramedic’s form which stated that the patient had fallen on the floor and lost consciousness for three minutes.

The triage nurse attributed his condition to alcohol and gave him a priority three rating, that he should be seen within the hour.

Speaking on the fourth day of a five-day inquest, Prof John Pickard, professor of neurosurgery at the University of Cambridge, said had the information from the paramedic been known, he would have expected a CT scan to be issued as a matter of course.

He said Mr Siddall had two mass lesions that should have been removed surgically to significantly reduce the degree of pressure inside his skull.

He said: “Had he had surgery and appropriate care management, on the balance of probability, he would have survived, but he would have been left with significant problems with higher mental functions and personality change.”

He said these would have included poor short-term memory, inappropriate behaviour, as well as difficulty planning and managing money.

It was only after Mr Siddall was admitted to the Royal Oldham Hospital for a third time at 6pm that a CT scan was requested as his left pupil was fixed and dilated, a critical stage indicating pressure on the central brain stem.

However, Prof Pickard said the course of action taken by the triage nurse on first admission was appropriate, given the history she had about Mr Siddall.

Dr Charles Wilson, a Home Office forensic pathologist, conducted a post-mortem examination which revealed an abrasion and bruising to the back of Mr Siddall’s head and a linear fracture to his skull.

He had bleeding on both sides of his brain, which was swollen, and all injuries were typical of a fall on to the back of his head.

Dr Wilson said a person could sustain serious and potentially fatal brain injuries but not die immediately. However, during a lucid period, the injuries could cause the brain to swell, cause pressure on the base of the brain and lead to their death.

Dr Wilson gave cause of death as from blunt-force head injury.

When asked whether earlier intervention would have altered the outcome, Dr Wilson said he had seen people with no medical intervention and those with early medical intervention and both had died.

Proceeding.