Inquests into the 1989 Hillsborough football disaster have begun hearing evidence relating to the last movements of those who died.
Some 96 Liverpool fans died as a result of a crush in pens 3 and 4 at the stadium in April 1989.
The inquest jury heard evidence relating to Carl Lewis on Monday and Tuesday of this week. He was 18 when he died.
Fan Derek Richards described seeing Carl in pen 3 at around 10 minutes after kick off. He said Carl seemed to be in discomfort and his face was red. He added that Carl was conscious and seemed to be shouting.
Footage showed Carl lying in pen 3 at 3.21pm. Retired police sergeant Peter Gardener gave CPR to a man thought to be Carl soon after. He said he couldn’t feel a pulse.
Carl was carried out of the stadium on an advertising hoarding to a road behind the South Stand at around 3.36pm.
Ambulance worker Phillip Boyce arrived at the ground at 3.30pm and tried to resuscitate a man thought to be Carl.
He said Carl was “very cyanosed”, where parts of the body appear blue, and there was no obvious sign of life. Boyce stopped working after someone who said he was a doctor said there was nothing more he could do.
Boyce confirmed that the doctor did not examine Carl.
The court heard that ambulance worker John Flack said Carl had a good colour when he was going to hospital.Boyce said he left Carl with an airway in his mouth. Paramedic Peter Howes arrived at the ground at around 3.54pm and treated a man believed to be Carl at 3.57pm.
He said there was no sign of an airway. Howes told the court, “He was face down with what appeared to be a shirt pulled over his head.”
Howes found no evidence of a pulse after checking for six seconds and no sign of breathing. He said Carl was warm when he reached him.
Dr McHugh, an anaesthetic registrar at the time of the disaster, also helped Carl.
He said Carl had no pulse or respiration but that the resuscitation “appeared to be effective” because Carl’s pupils were still small.
“I didn’t see dilated pupils, or large pupils, as meaning that the patient had succumbed to irreversible brain damage,” he told the court.
Police constable Ruth Harper helped give cardiac massage to Carl. She said, “There was hope for him, so that’s why we were working on him.”
Harper said her 2013 statement that Carl was breathing when she first saw him was a mistake.
Former police officer Alan Wadsworth said he heard reference to Carl having a pulse when he was put in the ambulance. He told the court, “I remember hearing it for definite, because it was sort of a little bit of good news.”
Dr Christopher Stoddard was on duty at Sheffield’s Royal Hallamshire Hospital and was involved in caring for Carl when he arrived there.
He said Carl’s pupils were fixed and dilated, indicating no activity or circulation to the brain.
The inquests are due to hear evidence relating to Jon-Paul Gilhooley tomorrow, Wednesday. Jon-Paul was the youngest victim of the disaster. He died aged ten.
Medical experts consider if victims could have lived
Nolan said the causes of death could be divided into two groups – problems primarily affecting breathing and problems primarily affecting the heart and circulation.
It could take “one to two minutes” for someone who stopped breathing completely to lose consciousness. They would be in respiratory arrest. If the heart stopped pumping effectively they would be in cardiac arrest.
Nolan said this would occur between three to 11 minutes from the time the person entered respiratory arrest.
Compression outside the body can affect the heart and circulation and lead to cardiac arrest. Nolan said the chances of surviving a cardiac arrest outside hospital are low.
Soar said it would be difficult to accurately assess casualties in the environment of the Hillsborough disaster.
He said shallow breathing can be missed and skin colour is unreliable in assessing life or death. Nolan said it is easy to miss a pulse that is very weak or slow.
He said it is common for people in cardiac arrest to have dilated pupils that do not respond to bright light. There was a common view in 1989 that they had little chance of being resuscitated – but this is not true.
Forensic pathologists professor Jack Crane and Dr Nathaniel Cary also gave evidence.
Crane told the jury that there are “limitations” to the reliability of the original post-mortem reports.
Some pathologists carrying out the autopsies were hospital pathologists, not forensic pathologists. And there was pressure for the examinations to be conducted quickly. Some detailed information is not in the reports.
Christina Lambert, counsel to the inquests, asked about a condition called cerebral oedema, where the brain swells due to too much water. Crane said this suggests that the person survived for about an hour after the crush before dying.
Crane said that to identify cerebral oedema small pieces of the brain would need to be examined under a microscope. He said, “That was not done in the deaths from the Hillsborough disaster”.
He added there could be other reasons for a brain appearing swollen.
Cary said inconsistencies in the original pathology reports made it harder to judge whether oedema was present. He also pointed out that both people who died in the pens at Hillsborough were alongside those who survived.
The inquests continue.