The death of a dad-of-three could have been avoided if hospital staff had acted sooner.

Ralph Sim, 65, had surgery to replace his aortic valve at the Royal Sussex County Hospital, Brighton, on April 5, 2019.

Eight hours later at around 10.30pm, he suffered a sudden drop in blood pressure and developed an irregular heart rhythm due to a blood clot causing reduced blood flow to his heart.

However, hospital staff “failed to recognise the significance of the fall in blood pressure,” an internal NHS investigation report seen by medical negligence lawyers at Irwin Mitchell found.

Whilst staff attempted to treat Ralph’s deteriorating blood pressure, the University Hospitals Sussex NHS Foundation Trust has accepted that the marathon runner should have been returned to theatre for an angiogram in order to identify the cause of his post-operative deterioration. Instead, medics decided that he should be observed overnight.

The case was not referred to an on-call cardiology consultant based in Worthing, contrary to the unit’s policy.

The Argus: Ralph was a keen marathon runnerRalph was a keen marathon runner (Image: Family handout)

It was only during normal working hours the following morning that an urgent angiogram to assess Ralph’s blood flow was arranged. However, due to another emergency case at the hospital, the urgent angiogram was not carried out until just before midday, the trust’s incident investigation said.

This was more than 12 hours after the initial drop in blood pressure.

The angiogram started at around 11.45am and showed reduced blood flow to the heart, caused by a clot. Ralph, from Burgess Hill, then had a stent fitted. But because of the more than 12-hour delay, Ralph had already suffered irreversible heart muscle damage.

Ralph, previously a keen marathon runner, spent two weeks in intensive care before being transferred to a specialist unit for a heart transplant. However, by now he was too ill to be considered for a transplant and died five weeks later on May 25.

High Court legal proceedings were brought against the trust. It admitted that Ralph should have been returned to theatre and had an angiogram within an hour and a half of his post-operative deterioration, and no later than midnight that night. Had this taken place, the trust accepted that a stent would have been fitted and Ralph would not have died on May 25, 2019.

The trust has apologised to the family for its failing.

His family is now calling for “lessons to be learned” after securing an undisclosed settlement from the trust.

The Argus: Ralph's family is calling for 'lessons to be learned'Ralph's family is calling for 'lessons to be learned' (Image: Family handout)

Thomas Riis-Bristow, a specialist medical negligence lawyer at Irwin Mitchell, said: “Ralph’s loved ones continue to be deeply traumatised by his death.

“Worrying failings have been admitted by the trust. Every minute counts in cardiac surgery and, the longer reduced blood flow is left untreated, the more damage is caused to the cardiac muscle over time.

“Tragically, in Ralph’s case, had he received adequate care, his death would have been entirely avoidable. This is the impossible reality that his family must now face.

“While nothing can ever fully rectify the family’s and Ralph’s suffering, we’re pleased that, through the legal process, we’ve been able to provide Ralph’s loved ones with the answers they deserve.

“It’s now vital that the hospital trust learns lessons from the failings Ralph suffered to improve patient safety for others. Ralph’s family don’t want others to suffer another needless tragedy.”

The Argus: 'Ralph was a wonderful, husband, and father, who was adored by all of his family''Ralph was a wonderful, husband, and father, who was adored by all of his family' (Image: Family handout)

Ralph’s family said: “Ralph was a wonderful, husband, and father, who was adored by all of his family.

“He was a keen runner and used his love of running to help others, taking part in many fundraising events in aid of charity.

“While heart surgery isn’t something minor, when he went into hospital we never imagined the events that unfolded and he’d never come home.

“Seeing him in those final weeks was so upsetting. Ralph was a genuinely kind man who didn’t deserve to suffer and die in the way he did.

“While time has moved on it hasn’t for our family. The hurt and pain we continue to suffer is a strong now as it was when he died.

The Argus: 'Ralph didn’t deserve to suffer and die in the way he did,' his family said.'Ralph didn’t deserve to suffer and die in the way he did,' his family said. (Image: Family handout)

READ MORE: Free legal advice over Royal Sussex hospital 'failings'

“The hardest thing to try and come to terms with is that Ralph’s death should have been avoided.

“Whilst the Trust has apologised to our family it feels hollow. Ralph’s death was entirely unnecessary, and despite the issues in his care, it took the Trust several years to apologise.”

UH Sussex has been contacted for comment.

Sussex Police are investigating concerns around neurosurgery and general surgery at the the Royal Sussex County Hospital between 2015 and 2021.

Operation Bamber is now reported to involve alleged mistakes in the treatment of more than 100 patients, including at least 40 who died.