Missing body parts victim Norman Palmer could have done something to save himself in the days before his death, a Supreme Court judge ruled yesterday.

Puisne Judge Geoffrey Bell rejected an application by the 57-year-old's family to quash a coroner's verdict that Mr. Palmer's death by natural causes on April 12 last year was contributed to by self-neglect.

The judge said the deceased "clearly had the opportunity of doing something" after he was told by an emergency room doctor on April 6 that his condition was potentially life-threatening — but did not follow the advice given.

The self-employed Brit, an asthmatic with a 40-year-old gunshot wound in his neck, died despite the efforts of three ER doctors at King Edward VII Memorial Hospital after getting into breathing difficulties at his Paget home.

Many of his organs and tissues were found to be missing after his body was flown to Britain for cremation and his family still has no idea where they are after Police here concluded that no criminal offence had taken place.

An inquest earlier this year heard that six days before he died, Mr. Palmer attended ER with rasping in his throat and was told an x-ray showed metallic foreign bodies in his neck, causing an airway obstruction.

The ER doctor advised him of the dangerous nature of his complaint and told him he must see an ear, nose and throat specialist (ENT) the next day at the least.

Although his wife tried to get him appointment with an ENT, no slot was available until April 18. Mr. Palmer saw his own GP, Monica Hoefert, on April 9, when she prescribed him an asthma inhaler and booked a scan of his throat for April 14. The inquest heard he was under the impression she disagreed with the ER doctor's diagnosis.

Coroner Khamisi Tokunbo ruled that Mr. Palmer's decision not to be admitted to hospital on April 6 and his failure to return to ER in the days that followed, when he continued to feel unwell, was a "gross failure to obtain basic medical attention".

Jeffrey Elkinson, lawyer for Mr. Palmer's widow Kathleen and his two sisters, argued at a judicial review earlier this month that Mr. Tokunbo's "self-neglect rider" was unreasonable and illogical.

Mr. Elkinson said Mr. Palmer, who ran his own excavating business, was a "man who wanted to live" and who simply followed the advice of his trusted GP.

But Mr. Justice Bell said Mr. Palmer could have sought help from the hospital after April 6 but before he saw Dr. Hoefert. The judge said during that period, Mr. Palmer would no doubt have had the words of the ER doctor "clearly in mind" and would have appreciated that he was "putting himself at risk by failing to take" the recommended action.

He pointed to evidence at the inquest from ER director Edward Schultz, who said Mr. Palmer "would have been saved" had he returned to hospital or gone to an ENT office.

As such, said the judge, it could not be said in law that the Coroner was unreasonable in reaching his conclusion and adding the self-neglect rider. He added: "It is not therefore open to me to interfere with his finding."

Mr. Palmer's sister Marion Bishop said she was disappointed with the verdict but had not decided whether to pursue the case further.

"I realise that the decision was made on a legal basis and I understand that," she said. "What I find difficult to accept is that my brother went to his GP and did everything he could to get help and still the verdict is 'grossly neglectful'. He did seek medical attention."

The family's application to have the self-neglect rider overturned was contested by Dr. Hoefert's lawyer David Kessaram, as well as lawyers separately representing the Coroner and Bermuda Hospitals Board (BHB).

Allan Doughty, for BHB, said yesterday: "The judge made his findings and the Bermuda Hospitals Board agrees with them. We otherwise continue to offer condolences to the Palmer family."

A second inquest into Mr. Palmer's death is still to be held in the UK. Ben Batley, coroner's officer for East Somerset, said yesterday that it could not go ahead until the judicial review was concluded.