A man who was on the waiting list for a double kidney transplant died in hospital at the age of just 46.
William Unsworth died on July 12 this year at Royal Bolton Hospital.
Mr Unsworth suffered with stage three chronic kidney disease, which severely limited his renal function. He regularly had to undergo dialysis.
On June 15 he collapsed at his home on Broad Walk, Westhoughton.
Paramedics were called and he was taken to hospital, where he remained up until his tragic death.
On July 3, it was noticed that he was haemorrhaging blood from his kidney and he was given a blood transfusion.
Despite an initial bounce back, he deteriorated further and died on July 12.
An inquest into his death was held on November 6 at Bolton Coroners' Court.
Coroner Michael Pemberton read out the testimony of his sister, Lorraine Unsworth, who was present in court.
The court heard that Mr Unsworth had suffered with diabetes from a "relatively young" age, before suffering a stroke in 2015 which caused problems with his kidneys. He had to undergo dialysis three times a week.
Mr Pemberton added: "He was still able to do some things himself, but did need personal care. Your mum was able to do it.
"He was waiting for a transplant for both of his kidneys. As time went on, dialysis became very difficult as it made him feel unwell afterwards."
The family had concerns of missed opportunities in his care, including whether he should have had the blood transfusion on July 3 at an earlier time.
The inquest heard how Dr Elizabeth Ryan was the on call registrar on the night shift of July 2 to July 3.
She was asked to review Mr Unsworth, who was at that point a high risk patient.
Dr Ryan diagnosed him as suffering with aspirational pneumonia and prescribed him with antibiotics.
Mr Unsworth also underwent a blood test, which found he had low haemoglobin, the protein in blood that carries oxygen. She thought that this could be related to the dialysis.
He was handed over in the morning to the day team. Later that day he was tested, with his haemoglobin still found to be low.
A CT scan was given at 3.30pm and the source of bleeding was found to be a perinephric haematoma, which is bleeding from the kidney.
Royal Bolton Hospital anaesthetist, Dr Alastair McCorkindale, told the inquest about Mr Unsworth's treatment at the hospital.
He told how he was admitted in the early hours of June 15, being put onto the intensive care unit (ICU).
Mr Unsworth stayed on the ward until July 2, when he was transferred to Salford Royal Hospital to undergo dialysis. He was then returned to Bolton.
He suffered a perinephric haematoma on July 3.
A further CT scan took place on July 7, which showed progression of a previous stroke he had suffered. Despite an initial bounce back, he deteriorated further and died on July 12.
Dr McCorkindale said: "It is very unusual, it is an extremely spontaneous thing that can happen. Chronic kidney disease itself could cause such a problem."
He also admitted that while there "may have been a delay", that an earlier transfusion wouldn't have had an effect on the outcome.
He said: "We had a discussion on would it have changed anything for William if he had a blood transfusion.
"It would have been one unit of blood over three to four hours to see if haemoglobin came back. I don't think it would have changed anything."
Dr McCorkindale added he still believed Mr Unsworth would have been "in a situation where things went very wrong" due to the size of the haematoma.
Pathologist Dr Patrick Waugh gave his medical cause of death as hypovolemic shock, caused by a spontaneous perinephric haematoma, caused by chronic diabetic renal failure.
Concluding, Mr Pemberton said: "I note it is accepted a blood transfusion should have occurred sooner on July 3.
"I have, however, received clear evidence that whilst that transfusion should have occurred earlier, it would not have made an outcome on the terms of William's condition."
He concluded the death as being due to natural causes.
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