Medics at the King Edward VII Memorial Hospital have been accused of a lack of care since a bike crash victim died five days after being admitted in 1996.

Howard Berkeley, 50, died of head injuries, but had originally been diagnosed with a broken leg after smashing into a parked car in Cavendish Road, Pembroke on August 6, 1996.

Mr. Berkeley, from Serpentine Road, Pembroke, suffered massive brain haemorrhaging three days later.

But an operation to relieve pressure on the brain failed to stop massive bleeding for Mr. Berkeley who already suffered from a blood condition.

His life-support machine was turned off two days later because he was brain dead. Brain swelling and other head injuries were also factors in his death.

His family's lawyer, Saul Froomkin, told an inquest yesterday: "He went into the hospital with a broken leg and he ends up dead.'' But medics at the hearing all denied responsibility.

Dr. Joseph Froncioni testified he was the orthopaedic surgeon responsible for the bone fractures and was junior to the anaesthetist and the senior surgeon responsible for Mr. Berkeley's life.

"I would be aware of the medical condition of the patient generally prior to the operation,'' he told the court.

He had "no recollection'' of who was the senior surgeon.

Dr. Froncioni said the 22 litres of blood Mr. Berkeley was given in the three days following the accident was "greater than what I would expect''.

Head of the Emergency Department of the hospital, Dr. Edward Schultz, read the original report of Dr. Dean Okariki who wrote Mr. Berkeley had been X-rayed about the face, neck, spine, left hip and leg.

Dr. Okariki also said Mr. Berkeley smelled strongly of alcohol and had bruising over his left cheek.

Mr. Berkeley had a blood platelet (or red blood cell) count of 35,000 per millilitre of blood which he admitted was a "surgical risk''. The inquest also heard that on August 7, 1996, the count dropped to just 14,000 where the normal level for an adult male is between 200,000 and 350,000.

Emergency room doctors did not find evidence of a stomach injury despite ambulance crew reporting Mr. Berkeley had abdominal pain.

Mr. Froomkin said: "We're trying to find out why this man died.

"You can find, according to the Senior Magistrate, that there was accidental death by lack of care.'' Mr. Froomkin continued: "As coroner you evidently have to determine... .

by what means this person suffered intercranial bleeding not caused by the accident.

"The family and the public are entitled to know if the deceased had proper medical care.'' Hospital accused of lack of care for crash victim Hospital under fire at inquest General consultant Dr. Terence Elliott denied being responsible for the patient throughout his stay at the hospital.

He said: "I was told the patient only had fracture of the leg and did not require general surgical assessment before being admitted to the care of the orthopaedic surgeon.

"I was not involved in his care until the following day of August 7, 1996 when he complained of belly pains. He was given a CAT scan and nothing of concern was found.

"I had nothing to do with the patient until the ninth when he had deteriorated and a CAT scan showed bleeding which again is a general surgical problem.'' Dr. Elliott said he could not remember when he first knew that the patient suffered from a low platelet count which he admitted was a surgical risk.

He added that when treating patients with few platelets a blood transfusion was necessary yet he had not requested platelets when ordering blood for Mr.

Berkeley's operation.

But he said only if a patient had less than 30,000 platelets would he worry about huge haemorrhaging under surgery.

Dr. Elliott said he did not believe Mr. Berkeley's agitation and confusion were symptoms of a cranial injury.

He said: "Because he was a known drug abuser and alcoholic and because there was no history of losing consciousness we presumed these symptoms were consistent with withdrawal from drugs and alcohol.'' He said the intercranial bleeding must have been a separate event.

Mr. Froomkin said: "We know he suffered a brain injury at some stage, either before surgery, during surgery, or after surgery.'' Dr. Elliott admitted emergency room staff had found no signs of brain injury when the patient was admitted, but said there was a possibility he had sustained a tiny injury in the smash which had blown up later.

Mr. Froomkin wondered why no CAT scan had been done on the patient's brain when he was admitted despite the fact that he had suffered facial injuries.

But Dr. Elliott said he had shown no symptoms of suffering a head injury.

Because Mr. Froomkin will be off the Island, the inquest has been adjourned until October 6.