Surgical error played role in death of climber seriously injured in 30ft fall

A narrative conclusion was recorded at Caernarfon after the tragedy of John James Appleby, 68, a respected climbing writer and blogger from the Corwen area, who died in March 2022. He’d been climbing with a friend above the A5 near Betws-y-Coed when he fell.

Mr Appleby had been airlifted by a rescue helicopter to Ysbyty Gwynedd, a hospital at Bangor and the nearest resuscitation centre, because of his serious condition. Internal bleeding was discovered and fractures.

But, because it was after 5pm on a Friday, there was no interventional radiology available – involving image-guided surgery to look inside a patient and minimally invasive procedures.

A vascular consultant from Ysbyty Glan Clwyd, Bodelwyddan, travelled more than 30 miles to Bangor instead and tried to stabilise Mr Appleby in an emergency operation. But it was a rare and difficult procedure for him and the wrong artery had been tied up (ligated) by mistake.

Mr Appleby, who grew up in Liverpool and founded the climbers’ blog Footless Crow, died days later after being transferred to the regional major trauma centre at Stoke-on-Trent. He had multi-organ failure.

Coroner Kate Robertson said it wasn’t to be reasonably anticipated at the Stoke hospital that the error had been made and a “wait and watch” approach had been adopted in his care. However, Mr Appleby’s condition deteriorated.

The coroner said Mr Appleby suffered multi-organ failure and died on March 22, 2022. His death was due to an accident against the background of an unsuccessful surgical procedure at Bangor. His prospects of recovery weren’t optimised.

“There quite clearly has been personal reflection in terms of what has occurred and there are a number of considerations the health board have undertaken, not least the availability of interventional radiology,” Ms Robertson remarked.

She added that “a catalogue of a lot of unfortunate events” had occurred.

Jon Dwyer, an orthopaedic consultant at the Stoke hospital where interventional radiology was available throughout the day, said grandad Mr Appleby had hit a cliff face at about 30mph. But, had the surgical error not happened – obstructing the blood flow - it was "more likely he would have survived".

Dr Karen Mottart, medical director for the Betsi Cadwaladr University Health Board in north west Wales, told the inquest it was very difficult for the surgeon to see “what was what” during the operation at Bangor.

She felt there was a “very high chance” of Mr Appleby dying, irrespective of the error. “Out of hours” interventional radiology remained unavailable.