Paramedic struck off after leaving elderly patient who was permanently paralysed from fall

Raymond Byron of West Midlands Ambulance Service has been taken off the medical professional register after failing to notice his elderly patient had broken his back

A paramedic has been dismissed after spending only nine minutes attending to an elderly man who was left permanently paralysed following a fall.

Raymond Byron responded to a 999 call after the pensioner suffered what was initially believed to be a "minor head injury." He found the "vulnerable" man on the floor and helped him back into bed before leaving just minutes later. A complete set of tests was not conducted during Mr. Byron's brief visit.

It was later revealed that the patient had fractured his spine and was permanently paralysed. He was taken to the hospital by a second team of paramedics who grew worried about his condition during a follow-up visit.

Mr. Byron admitted he "let himself down by not concentrating or remembering" to bring equipment from the ambulance into the patient's home. He was suspended for 12 months following the incident.

A review hearing took place this year by a panel from the Health and Care Professions Tribunal Service who decided to remove his name from the register of medical professionals. The tribunal previously noted that Mr. Byron worked for West Midlands Ambulance Service University NHS Foundation Trust from April 1992 until he "retired on grounds of ill health" in 2018.

He was working a night shift alone when he responded to an emergency call from a 'vulnerable' man on January 4, 2018. The 89-year-old was on the floor and had 'sustained a minor head injury' after falling during the night.

A report from the panel read: "Mr Byron lifted the patient up off the floor, put him into bed, and then left the scene. "He was recorded as arriving at 3.17am and leaving at 3.26am."

Two paramedics later visited the same patient and took him to hospital over concerns he was 'unable to bear his own weight'. They also noticed a cut to the back of his head - later described by Mr Byron as 'more of a carpet burn'.

The patient's condition 'deteriorated' on the way to hospital, forcing the ambulance to pull over. Back-up was requested, with a further paramedic arriving in a rapid response vehicle to assist.

The elderly man was admitted to hospital, with medics later discovering he had a displaced fracture of his cervical spine. The report read: "The patient sustained permanent paralysis and remained in hospital for some months."

A hearing in August 2023 was told that Mr Byron 'made no record' of seeing the patient - which breached trust policies. An electronic patient record (EPR) needed to be completed for all incidents but this was not done, the panel heard.

It meant that the paramedics who cared for the patient in the follow-up visit 'were deprived of the opportunity to compare observations' as Mr Byron had made no record of his call-out. Following the incident, Mr Byron told a manager he did not take any equipment into the patient's house with him.

In a general report form, the paramedic said: "I said I needed to do some further [checks], he said "I'm fine and don't need anything more". He added: "With hindsight I should have done paperwork to this effect but as I had already left patient, did not do so, my mistake."

When asked why he did not complete an EPR in an interview with the trust on January 24, Mr Byron said: "Because I had forgotten about it until I got back out in the car, I turned around, the door was shut and the porch light was off, so I took it as a lift only, I didn’t know why I didn’t go back… they had gone back to bed, it was too late and I left it, I shouldn't have done."

He added: "I shouldn't have let myself of falling into the trap of going in without equipment, had I of taken everything in with me and the EPR, I would have done a full set of obs…I would have been able to evidence what had been done and what was said…I let myself down by not concentrating or remembering."

Mr Byron - described as a 'conscientious and caring paramedic' by a colleague - confirmed he was 'aware' of trust policies and had received the relevant training in October 2017. The tribunal found the paramedic did not 'undertake the minimum observations and investigations' required.

It said he also 'seemed to accept little responsibility or understanding of the seriousness of the concerns' at the time. The report read: "In relation to the patient's request to simply put back into bed and not taken to hospital, the panel found that, as the required investigations had not been undertaken by Mr Byron, the patient was incapable of giving informed consent."

It added: "The panel found Mr Byron's conduct to have constituted a serious falling short of what was expected, and that fellow practitioners would consider it to be deplorable. Accordingly, they determined that it amounted to misconduct."

The panel found the allegations against Mr Byron proved - that he did not maintain adequate records for the patient and he did not act in the patient's best interests by taking him to hospital. It said his fitness to practise was impaired as his actions amounted to misconduct and handed him a suspension order on August 11, 2023.

At the most recent hearing in August 2024, the panel heard that Mr Byron had not provided any evidence to show 'his fitness to practise is no longer impaired'. A further suspension would be 'pointless' as Mr Byron had not 'engaged' or 'expressed a desire to address his failings', the panel said.