Considering holding a public inquiry into the vascular services at Wales' largest health board is a request made to the Welsh government by a senior coroner.
According to John Gittins, he wrote to every cabinet member of the Welsh government to express his "concerns" about the service being provided by the Betsi Cadwaldr University Health Board (BCUHB).
The coroner reported that he has not heard back after seven weeks.
A statement from the Welsh government has been requested.
Vascular services are frequently used by patients with other medical conditions, such as diabetes, to diagnose and treat people for issues with their arteries, veins, or blood circulation.
Four vascular patients who received treatment at Ysbyty Glan Clwyd, Denbighshire, died in 2021 after passing away, according to Mr. Gittins, senior coroner for north east and central Wales.
After a review of the clinical records and a Royal College of Surgeons (RCS) report that identified risks to patient safety, the cases were referred to him in the autumn of 2022.
Mr. Gittins read the letter he sent via email to nine Welsh government ministers on May 12, 2023, at a pre-inquest hearing in Rhuthun on Friday.
It said: "I'm currently conducting inquests into a number of deaths that have been referred to me, though they have not yet been fully resolved, would appear to relate to vascular treatment provided to the deceased by BCUHB and more specifically to the quality of care and treatment afforded to the health board.
"In light of the aforementioned facts, I feel obligated to bring these issues to the attention of the ministers so that they may consider whether the provisions of Section 29 of the Inquiries Act 2005 now necessitate the holding of a public inquiry.
"In addition to the cases that are under investigation, members of the public who work in the legal and medical fields have brought to my attention concerns that touch on a number of different problems with the delivery of vascular services in BCUHB. ".
Additionally, the coroner stated in his letter that he would be happy to offer more specific information for this purpose.
Given that complex vascular services were centralised from Ysbyty Gwynedd in Bangor and Wrexham Maelor Hospital to Ysbyty Glan Clwyd, Denbighshire, in 2019, vascular services in north Wales have come under scrutiny.
Following the RCS report in 2022, the services were labeled as "requiring significant improvement" by Health Inspectorate Wales (HIW).
After a second inspection revealed that the quality of care had improved, though further improvement was still required, HIW de-escalated that status on Thursday.