Advising with empathy and experience

999 call handler told dying teacher to make her way to A&E, inquest told.


A young science teacher who called 999 after complaining she could barely walk died hours later after an operator mistakenly advised her to make her own way to A&E, an inquest heard.

Amber Hickford, 26, had said she was experiencing dizziness and blurred vision after falling into a bedside cabinet but her 999 call was 'coded' incorrectly on the scale of emergency and no ambulance was sent to her address.

Instead, Miss Hickford was required to climb down two flights of stairs to get her to hospital and she refused to go despite being offered help by her boyfriend Jason Hanmer.

She tried to sleep it off but Mr Hanmer called 999 again later when he found her unresponsive in bed and started Cardiopulmonary resuscitation (CPR) while an ambulance was sent to their apartment in Rochdale, Greater Manchester.

Three ambulances arrived at the property within ten minutes of the second 999 call but Miss Hickford was pronounced dead shortly afterwards. Tests revealed she had inadvertently taken a toxic level of paracetamol tablets for severe stomach pains she had been experiencing following a urinary infection.

Enquiries revealed she had been discharged from the same hospital only two days earlier and given stronger codeine painkillers. 

The hearing at Heywood was told Miss Hickford was admitted to Fairfield Hospital, Bury, on April 19 2019 with stomach problems. Doctors gave her strong painkillers and sent her home, advising her to attend a follow up appointment but, on April 21, she rang the NHS 111 service at around 8.40pm saying she was struggling to walk.

Mr Hanmer told the inquest: “As I got home Amber was sat in the hallway and she said she was feeling drowsy. I made her tea but later that evening she fell into a shoe cabinet and into the bedside table.

“She couldn't walk and went drowsy every time she stood up. I could tell she was very unsteady. I rang 111 and the operator said they would not to talk to me and asked to speak to Amber herself.

“They told her to ring 999 but, when she rang, the call handler told her to go to A&E. We were up two flights of stairs and I couldn't get her down safely by myself. Her parents arrived but Amber stated that she didn't want to go to the hospital and her parents left.

“I went out to move my car and went straight back to the bedroom and Amber was in there making snoring noises.

'I moved her onto her side and was gone again for only 10 minutes before I went back to check on her. I shouted out but didn't get a response and rushed over to her and she was cold. I listened to see but she wasn't breathing.

'I pulled her onto the floor and called 999, and they talked me through CPR. The paramedics arrived but said Amber wasn't breathing and her heart had stopped and that their machines were doing it for her. They called another ambulance for help getting her downstairs. Amber passed away later in hospital.”

Miss Hickford's father Neil said: ”She had mentioned that she did have some stomach pains but she had just started a new job and felt some of that might be down to nerves.

“At around 9pm that evening, Jay rang saying they had called the emergency services and asked us to help him convince Amber to go to hospital as she wasn't listening to him. /more...

'When we arrived Amber was standing and dressed but still didn't want to go to hospital. We stayed until around 10pm. We were almost home when Jay phoned again around 10.20pm saying he had rung the ambulance and wanted us to go back.

“There were three ambulances outside and the paramedics were working on Amber on the floor in the bedroom. It was devastating to be told she could not be resuscitated.

“Amber was a science teacher and would be aware of the nature of the medication she was taking and the effects that that may have. She would never have knowingly taken more than she should have.”

Deputy sector manager for the North West Ambulance Service, Angela Lee, said: “On April 21, an emergency call was received and, although Amber's abdominal pain seemed to have subsided, she was now struggling to walk and experiencing dizziness, drowsiness and blurred vision.

“At 10.24pm - around two hours later - a further call was received from Amber and three emergency response vehicles were allocated.

“The initial emergency call was coded a category four but should have been coded as a category two response. When I listened to the emergency call I didn't hear anything that gave me cause for concern but if the call had been categorised as a category two, there may have been an emergency ambulance to attend to Amber.

“The call handler who handled the call has received feedback which revolved around a one to one session.”

When questioned by Amber's family about why the caller handler had not despatched an ambulance following the first 999 call, Ms Lee said: “They have a couple of seconds to make that decision and it's a very difficult task. The call was passed to a clinician who spoke to Jay and then to Amber and the clinician gave the advice to attend the emergency department.”

Adjourning the hearing for further enquiries, coroner, Michael Salt, said: “I accept that the call was coded incorrectly. I need to know more about the potential effect of the delay in the arrival of the ambulance and what could have been achieved in that time that seems to me at least an hour and 36 minutes.

“I have heard about the way in which the categorisation error came about in a very difficult situation. A judgement needs to be made very quickly and I don't in any way criticise the call taker.

“The question is whether something could have been achieved in the time that might have been available. The important thing is to try to find out whether the delay contributed to death and whether it was a missed opportunity.”