Stafford Hospital staff were busy, say friends of tragic cyclist John Moore-Robinson

John Moore-Robinson was unwell with chest pain, respiratory problems and vomiting following his admission to A&E, the hearing was told. The 20-year-old died in April 2006 after a ruptured spleen went undiagnosed following a mountain bike accident on Cannock Chase.

An inquest in 2007 recorded a narrative verdict but his parents Frank and Janet Robinson successfully fought for a fresh inquest which opened yesterday.

At the start of the four-day hearing, friends of Mr Moore-Robinson, of Sileby, Leicester, who were with him on the day said they were shocked at the standard of care. The inquest at Leicester Town Hall was told Mr Moore-Robinson received just two observations in three-and-a-half hours.

Friend Andrew Turner said: "I was just shocked. Being a normal member of the public you expect the professionals to carry out their job. You have got trust in them."

Fellow friend John Foulkes-Williams said there was vomit clearly on show in the cubicle and Mr Moore-Robinson was visibly ill.

He added there was little change in his condition between arriving at and leaving the hospital. "It was obvious he was in pain," he said. "He was a proud man. You knew there was something wrong if he needed help. All the staff seemed busy."

Paramedic Andrew Hopwood was called to Cannock Chase to assess Mr Moore-Robinson. He said his initial assessment was a problem with the ribs or something internal and there were respiratory issues.

He gave the patient morphine.

"I treated it from the potential of life-threatening," he said. "I have to figure in it is a strong possibility if it isn't simply rib injury it could be something else."

The High Court granted the Robinson family permission for a new coroner's inquiry after reviewing new evidence.

The narrative verdict returned at the first inquest has been quashed. The hearing continues.