North East woman's death after surgery error came after cancer screening delays

A Sunderland coroner has raised concerns after a woman died following a delay in finding a cancerous tumour in her bowel. Marie Bell, 58, did at Sunderland Royal Hospital on July 29 last year. This followed a complication of surgery which took place on July 25. Ms Bell, of Houghton-le-Spring, had gone under the knife to remove a bowel obstruction - but this appears, a coroner found, to have resulted in a "perforation" to her bowel, with fatal consequences. The cancerous tumour was discovered during the operation itself. However the coroner's concerns relate to months earlier, when Ms Bell was referred for a colonoscopy. She had undergone a FIT test - part of the bowel cancer screening process - in January and was sent for the colonoscopy a month later. At that appointment, she was unable to undergo the procedure as "imminent hip surgery" meant it was not possible for her to move into the positions required. That screening service is run by the Gateshead Health NHS Trust. Assistant coroner for the city of Sunderland Abigail Combes subsequently wrote to NHS England raising her fears that no alternative screening process was offered to Ms Bell. In summarising the issue, Ms Combes said: "Where one means of investigation is not suitable for a patient due to comorbidities or conditions this does not mean that the patient is declining all investigations and an alternative should be explored." Ms Bell's formal cause of death was noted as peritonitis - an infection - as a result of a small bowel perforation. Going into further detail, the assistant coroner said: "Unfortunately due to imminent hip surgery [Ms Bell] was unable to get into the positions required for the administration of the colonoscopy, and it would appear that she was then deemed to have declined further testing from the Screening Service. She still had symptoms, but these were not recognised as being significant until July 2025, when she was referred for a CT scan which identified a mass within the abdomen. "This mass was ultimately found to be cancerous following a surgical procedure and, although the mass had not significantly increased in size, the delay between February and July for the surgery meant that Marie's abdomen was distended, and the surgery was more complicated as a result." The coroner said that while Ms Bell had died due to an "error in the surgery" her death had not been caused by the delay in diagnosing her cancer, but that this could be the case when it comes to other patients. In response, an NHS England national medical director wrote to the coroner. They said: "I would like to express my deep condolences to Marie's family and loved ones. NHS England is keen to assure the family and yourself that the concerns raised about Marie's care have been listened to and reflected upon. "Your Report raised concerns that alternative screening tests were not offered when Marie was unable to tolerate the planned colonoscopy procedure due to her comorbidities. This was then incorrectly marked as her having declined the test. "NHS England can confirm that there is existing published national guidance which sets out the Bowel Cancer Screening pathway requirements which includes actions required regarding colonoscopy or other diagnostic tests." They added: "There is also published national guidance which covers the scenarios of individuals being unfit for colonoscopy and where there is an incomplete colonoscopy." The NHS England guidance includes, the health boss added, "a computed tomography colonoscopy (CTC) for those that meet the criteria for a colonoscopy but who are assessed as medically unfit for the procedure". The medical director added: "The National Bowel Cancer Screening programme team at NHS England will work with local services to ensure the published national guidance is understood and implemented." A regional response from NHS North East and Yorkshire executives was also shared with the coroner. This included: "[The] North East and North Cumbria Integrated Care Board (ICB) will ask the Trust for a review of their criteria for patients referred for Faecal Immunochemical Tests (FIT) but who are unable to undergo a colonoscopy. "They will establish the criteria for when deeming a patient to have 'declined' treatment, what their mitigations are and whether they have consultant oversight. The ICB have advised that they will use the learning from this Report to highlight this as a system risk." Dr Shaz Wahid of the South Tyneside and Sunderland NHS Trust added: "I would like to offer our sincere condolences on behalf of our Trust to Marie's family and friends. The safety of our patients is of the utmost importance to us and we have spoken to her loved ones to express our sadness following their loss. "Marie underwent further surgery following a recognised complication of her initial operation. Whilst the inquest identified no criticism of her care, we always strive to learn by reviewing such events in order to identify any way in which we can improve our services." A Gateshead Health NHS Trust spokesperson said: "We offer our sincere condolences to the family and loved ones of Marie Bell. While we note the coroner's comments that earlier diagnosis would not have changed Ms Bell's outcome, we are always keen to learn from cases and to further improve the care we provide. "NHS England sets the screening guidance nationally, this guidance makes sure that patients who choose to delay an investigation get information on the risks and know how to restart their care when they are ready. We will consider any recommendations or new guidance issued as a result of the coroner's report and make sure these are put into action in our Trust." Our ChronicleLive Daily newsletter is free. You can sign up to receive it here. It will keep you up to date with all the latest breaking news and top stories from the North East. ChronicleLive has created a dedicated WhatsApp community for breaking news and our biggest stories. You can join this WhatsApp community here. It will keep you up-to-date with news as it breaks and our top stories of the day sent directly to your phone. ChronicleLive is now on WhatsApp and we want you to join our communities. We have a number of communities to join, so you can choose which one you want to be part of and we'll send you the latest news direct to your phone. You could even join them all! To join you need to have WhatsApp on your device. All you need to do is choose which community you want to join, click on the link and press 'join community'. 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