A policy for dealing with urgent medical scans was only put in place at King Edward VII Memorial Hospital after a patient with a burst appendix suffered life-threatening damage to his heart and lungs owing to avoidable delays.

Bermuda Hospitals Board revealed yesterday that procedures for ordering and processing emergency CT scans came into force in 2011, after Kamal Williams suffered his ordeal on May 30 that year.

Mr Williams successfully sued the board for damages and, earlier this week, the Privy Council in London upheld a court decision granting him $60,000 in compensation.

The judgment in the case details how KEMH did not have a policy about when a request for a CT scan should be urgent at the time of Mr Williams’s medical emergency.

The patient arrived at the hospital’s ER department at 11.17am on May 30, 2011, with agonising stomach pains. According to the judgment, a scan was probably not ordered by Dean Okereke, the doctor who examined him, until almost two hours later.

The scan took place at 5.27pm and, in the meantime, Dr Okereke’s shift ended and he was replaced by Christine Di Lullo. Dr Di Lullo didn’t receive the report on the scan until 7.30pm and that was partly because, according to the judgment, the scan was sent overseas for interpretation after the hospital’s imaging department closed at 6pm.

Mr Williams went into surgery for suspected acute appendicitis at 9.30pm — more than ten hours after he arrived at the ER.

He was found to have a ruptured appendix and widespread pus throughout his pelvis. He suffered septic shock, a heart attack and lung complications, requiring life support in the intensive care unit. Mr Williams eventually made a full recovery.

The Supreme Court judge who heard Mr Williams’s civil claim for $100,000 damages found that in the case of suspected appendicitis, the ordering of a CT scan should be urgent “as a matter of normal practice”.

He concluded that the management of Mr Williams’s case by KEMH fell below the “proper standard” and that if the scan had been obtained urgently, his condition would have been diagnosed and he’d have been treated more quickly.

A spokeswoman for the BHB told The Royal Gazette yesterday: “BHB developed a new policy around emergency CT scans in 2011. When urgent scanning is required, staff are now advised to speak directly with the radiologist on duty to ensure that the patient receives ‘next case’ priority and that the patient is transported as rapidly as possible to the CT scanner, accompanied by an appropriate member of the emergency department staff, with the required paperwork.

“After regular business hours, staff monitor for CT reports for emergency cases and, if they are not received within 30 minutes, they follow up as a matter of urgency and escalate as required to ensure a timely result is provided.”

Mr Williams said: “I hope there is an improvement. I’m hoping the result in my case will encourage people — if they [the BHB] don’t live up to these changes — to do something about it. I want them to be accountable.”

The patient was initially awarded just $2,000 in damages but the amount was increased to $60,000 after the Court of Appeal ruled that the BHB materially contributed to the complications arising during and after his surgery.

The board paid the compensation but appealed the decision on a point of law to the Privy Council, on the advice of its medical malpractice insurers. The insurers will now foot a legal bill estimated by Mr Williams’s lawyer to be at least $500,000. BHB has been asked but has not shared the name of the insurers.