A Brit pensioner with learning difficulties who needed supervision when eating choked to death on jelly after hospital medics made a fatal mistake.

Edward Cassin died during a stay at Milton Keynes University Hospital on June 28, 2023, four days after he was handed the food, which a court head caused a fatal reaction. Milton Keynes Coroner’s Court heard the 62-year-old, who suffered from dysphagia, was waiting to be discharged to a new care home during his short stay.

But he developed aspiration pneumonia as the jelly turned to liquid in his mouth, the court heard, and died partially as a result of hospital medics’ neglectful actions. A coroner ruled that had he received adequate and timely treatment for the fatal condition, he would not have died when he did, and the investigation found hospital guidelines were not followed.

Edward, who has suffered from brain damage since he was born, and a combination of type 2 diabetes and dysphagia – a condition that makes swallowing difficult – was admitted to hospital following a hypoglycaemic episode on June 24, 2023. Edward’s dysphagia meant he had to follow a modified diet, and required supervision while eating to reduce the risk of choking.

But the court heard his dietary guidelines were not followed, and he was given jelly throughout his stay despite the food being listed as one he should not be given. Following his death on June 28, Assistant Coroner Sean Cummings ruled it was partly caused by neglect, and concluded his medical cause of death was aspiration pneumonia, chronic dysphagia and type 2 diabetes.

Caron Heyes, a director at Fieldfisher representing Mr Cassin’s family, said following the ruling that Edward’s loved ones were “shocked” to discover guidelines were not being followed at the hospital. She said: “We were shocked that eight years after Public Health England issued clear guidelines about the dangers of feeding inpatients with dysphagia and learning disability, they are still not recognised in a major hospital.”

The coroner is expected to issue a Prevention of Future Deaths notice to the hospital and NHS chiefs, with Edward’s family saying they “welcome and applaud” the verdict in a statement to the Milton Keynes Citizen. They said: “We welcome and applaud the verdict from HMAC and feel vindicated at as a family regarding the poor and appalling treatment our brother received which led to his death, Eddie was the most vulnerable in our society, one where we placed our faith and trust in MKUH to provide basic care which did not happen as proven in the inquest.”

“Whilst Eddie had severe learning disabilities, he was also the beacon that shone through our family, he was adored and loved by so many due to his vivacious and kind nature, Eddie loved nothing more than a party with his family and being sociable. It was so difficult not be feel happy and even elated when he was around and he truly touched the lives of many.”

“We now have to move forward with a gaping hole in our hearts since Eddie has gone, one which could have been prevented.” A spokesperson for Milton Keynes University Hospital NHS Foundation Trust apologised for the failings outlined in the court, and pledged to work to understand what happened.

They said: “We are profoundly sorry for the failings in Mr Cassin’s care. We fully acknowledge the deep distress experienced by Mr Cassin’s family and would seek to assure them that we have taken careful steps to understand what happened, including commissioning an independent external review. We will respond to His Majesty’s Coroner’s Prevention of Future Deaths notice in full.”

Get email updates with the day’s biggest stories