Clearer guidelines on when attempts should be made to resuscitate patients have been given to hospital staff across North Wales.

The stricter policy has been introduced following the case of a Mochdre, Colwyn Bay, man in which two doctors disagreed over whether action should have been taken.

An inquest in Ruthin heard that although senior house officer Dr Ziah Ahmad believed that administering CPR to 69-year-old John Norris would be futile because he had been dead for some time, his senior, Dr Fawad Muhammad, who arrived on the scene about 20 minutes later, decided to call the crash team.

A brief attempt to save Mr Norris proved in vain and Mr Norris, whose death was unexpected as his condition had been improving, was certified as dead.

After a post-mortem examination the cause of death was given as pancreatitis and John Gittins, coroner for North Wales East and Central, recorded a conclusion of natural causes.

But it was the difference of opinion over the need for CPR in such cases which was the main issue at the inquest.

Mr Norris, a mechanical engineer, of Bevan Avenue, Mochdre, died at Glan Clwyd Hospital on September 25 last year, three days after being admitted with a high temperature, stomach pains and diarrohea. Part of his pancreas had died previously.

His wife Philomena, a qualified nurse, said his condition improved and he expected to be back home in a couple of days.

Nurse Sandra Thomastiminzi said that on the night of September 24 she spoke to Mr Norris several times and he got out of bed because he was more comfortable in a chair.

At 2.20am, about 20 minutes after she had last seen him, she found him unresponsive and called Dr Ahmad, who arrived very quickly.

“Dr Ahmad said he had already passed away. I asked if the crash team should be called but he said it was not necessary,” she said.

Dr Ahmad told the inquest that Mr Norris showed no signs of life and was cold, having apparently been dead for some time.

Asked by the coroner if, in retrospect, he thought his decision not to administer CPR was appropriate, he replied: “Yes”.

He said he was surprised by Dr Muhammad’s decision 20 minutes later to call the crash team because it was questioning his own judgment, adding: “But he was my senior.”

Dr Muhammad said he had called the team to check on any heart activity and a judgment call had to be made in each individual case.

“I made the call to have a go,” he said.

Dr Emma Hoskins, medical director with the Betsi Cadwaladr University Health Board, said it was a very unusual case because Mr Norris’ death was unexpected and it was unusual to attempt to resuscitate after such a long time.

“I am very sorry that, having made a sound clinical judgment, we put him through a procedure which was going to be futile. I am surprised that happened,” she said.

She said that after reviewing the circumstances a clearer policy had since been adopted.

“In the case of an unexpected death and in the absence of a DNR (Do Not Resuscitate instruction) the default position is to attempt CPR,” she said.

Recording his conclusion, Mr Gittins said that after the evidence he did not feel it necessary to issue a Regulation 28 notice to try to prevent future deaths.

The professional judgments made by both doctors were appropriate based on the information available to them, he added.