INQUEST: Clevedon dad Andrew Nichol
By Carol_Deacon | Wednesday, March 06, 2013, 12:03
A FATHER of three died after collapsing in the pool of his hotel in Tenerife after playing a game of water polo.
Andrew Nichol, 38, had been on holiday with his wife Jane and their three children in the Tamaimo Tropical Aparthotel in Peurto Santiago, Santiago Del Teide when tragedy struck.
Mr Nichol, a company director, had been enjoying a game of water polo organised by the hotel's entertainments team on October 18, 2010, when lifeguard Yohandy Fonseca spotted him lying face down in the water.
Despite desperate attempts to resuscitate Mr Nichol, a part time swimming coach, by Mr Fonseca, hotel guests, doctors and paramedics, he died.
An inquest at Flax Bourton Coroners Court heard how Mr Nichol had been diagnosed with hypertrophic constructive myopathy and mild asthma and had been under the care of cardiologist Dr Andrew Skyrme-Jones.
Doctor Karen Denton, a consultant cardiologist at Southmead Hopsital in Bristol who carried out the post mortem examination gave the cause of death as unascertained.
But she added that the most likely cause of death was he had suffered a cardiac event in the water.
Dr Denton said: "Hypertrophic constructive myopathy can cause sudden death, especially following exertion."
Lifeguard Mr Fonseca, a trained first aider pulled an unconcious Mr Nichol out of the pool where he tried to resuscitate him.
He said Mr Nichol had a faint pulse and when doctors and paramedics arrived they used a defibrillator, but to no avail.
Mr Fonseca said: "I did my best to save him and could have done nothing more."
Mr Nichol had been under the care of cardiologists since first suffering problems with chest pain in 2006.
Tests revealed that he was suffering with hypertrophic constructive myopathy and he was put on Betablockers and blood thinning medication and told to avoid any intense exercise .
He had regular ecocardiograms and tests and over the next few years was admitted to hospital on a number of occasions with chest pains and palpatations.
Discussions had taken place about whether Mr Nichol should be fitted with an implantable cardioverter defibrillator (ICD) which works by sending electric shocks to regulate the heart beat.
But although medics said Mr Nichol had two of the risk factors - abnormal blood pressure response to exercise and ventricular tachycardia - a non sustained rapid heart beat - he did not meet NHS guidelines to be fitted with the device.
Mr Nichol was then admitted to Frenchay Hospital in May 2010 after he collapsed ahead of taking a swimming exam.
Doctors also identified two other potential unconfirmed risk factors - a thickening of the left wall of the heart and the fact he may have fainted ahead of the exam.
However medics said rather than fitting an ICD they were minded to send Mr Nichols to a specialist hospital for further tests ahead of any further treatment being decided.
Mr Nichol had a further ECG in July 2010, but because of an administrative error, a follow up appointment was not made - a move described as a 'missed opportunity' to review Mr Nichol's condition.
Consultant cardiologist Dr Skyrme-Jones said: " I don't think that had the appointment happened, I would have changed my advice."
An independent report into Mr Nichol's death was carried out by consultant cardiologist, Dr Stephen Brecker.
Mr Brecker said: "This was not a clear cut case.
"The weight of evidence was to do something, but there was room for debate."
Coroner Maria Voisin recorded a narrative verdict and said: "On the balance of probability his death was associated with his known medical condition of hypertrophic constructive myopathy.
"In some time in July Mr Nichol should have seen his consultant. Due to an administrative error this did not take place. This resulted in a lost opportunity to render medical care and treatment."
In a statement released after the hearing the family said: "Jane Nichol and Andrew's family would like to thank the coroner for her very thorough examination of the circumstances surrounding his tragic death.
"They remain deeply concerned about the quality of care he received in the months leading up to his collapse in the pool.
"If Andrew's condition had been managed with an implantable defibrillator by those responsible for his medical treatment in the UK he would most likely still be with us today.
"We are keen to ensure that any lessons of this avoidable tragedy can be learned by the hospitals and everyone involved so that other families don't have to experience such a loss.
"They would like to thank all of the friends and family who have helped and supported them through these past years.
"Andy would be happy to know that you have all been so kind."