Press Release – January 2023
David Nash, a 26-year old law student studying at Leeds University, died on 4th November 2020 following the withdrawal of life support with the agreement of his family.
David had suffered from significant childhood issues affecting his ear, nose and throat (ENT). He had suffered from chronic suppurative otitis media (a condition of ear disease in which there is ongoing chronic infection of the middle ear without an intact eardrum, which is a chronic inflammation of the middle ear and mastoid cavity), with associated hearing impairment requiring the insertion of grommets.
Examination under anaesthetic had revealed that he had a high jugular bulb and neuro-otology referral was recommended with recurrent infection.
David’s condition then settled and for a number of years he had no further ENT issues beyond what would be considered to be normal.
Between 14th October and 2nd November 2020 David consulted with his GP Practice, Burley Park Medical Centre on 4 occasions complaining initially on 14th October of neck lumps, on 23rd October 2020 of ear pain, on 28th October of a fever for the previous 4 to 5 days and blood in his urine and on 2nd November 2020 with a fever lasting 7 days with associated neck pain, pain behind the eyes, blocked sinuses and general exhaustion.
Each consultation took place by telephone due to the practice’s policies in respect of Covid-19, and David was advised not to attend on one occasion due to his fever and the risk that he may be developing Covid despite David reporting a negative PCR.
On 2nd November 2020, after David became increasingly delusional after a sleep, David and Ellie consulted with NHS 111 on several occasions. The operators followed the 111 investigation pathways but this did not pick up on David’s underlying condition of mastoiditis.
David was admitted by ambulance from home to A+E at St James’ University Hospital, with a history of confusion that was thought possibly to be associated with an infection in his right ear.
He was initially assessed by a nurse who arranged for him to be seen as a priority.
A doctor assessed him and, recognising he could have meningitis or encephalitis, prescribed intravenous antibiotics and antiviral medication. He also booked a CT (computerised tomography) scan of his head. The scan findings were concerning and given the seriousness, immediately phoned through to the ED registrar.
David was reassessed and moved to a resus area and his case discussed with the neurosurgical team at the LGI. During that time David became disorientated and whilst the nurse caring for him went to obtain some medication for him from the treatment room, he climbed off his trolley and fell to the floor, hitting his head on a bedside table.
On immediate assessment by a doctor who had heard the fall, he was not breathing adequately so he was given oxygen and transferred to the resuscitation area. Emergency critical care teams attended, and he was intubated (tube placed in his windpipe) and ventilated to support his breathing.
He was transferred by emergency ambulance to the LGI with the critical care team to enable immediate surgery to be undertaken to relieve the pressure on his brain.
Sadly, despite further emergency surgery, David died on Wednesday 4th November 2020 in the intensive care unit at Leeds General Infirmary, after life support was withdrawn with the consent of his family.
The inquest into David’s death will explore the various contacts with his GP practice and the issue of him not having been at a face to face meeting at any point as well as the treatments received at hospital when he attended.
Iain Oliver, partner and clinical negligence solicitor at Ison Harrison solicitors, commented:
“David’s family would like the inquest into his tragic death to raise awareness of various issues, including the need for GP practices to see patients face to face to enable proper assessment of conditions to be made that will be missed during a telephone consultation.
“They would also like to highlight the need for continuity of care within GP practices to ensure that the patient is considered holistically, particularly where there are repeated consultations for a developing condition that may be identified by such an approach.
“Additionally, the family wishes to highlight the limitations of the NHS 111 algorithms.”
ENDS
David’s family is being represented by solicitor Iain Oliver of Ison Harrison Limited and Counsel Rose Harvey-Sullivan of 7 Bedford Row Chambers.
For further information, interview requests and to note your interest please contact Iain Oliver – iain.oliver@isonharrison.co.uk
