An inquest into the death of a 27-year old from Cambourne has heard how the “complex” disorders that she was suffering with challenging for medical professionals to treat.
An inquest into the death of a 27-year old from Cambourne has heard that her "complex" health disorders were challenging for medical professionals to treat.
Emma Brown, was found dead in her flat in Cambourne, by her mother on August 22, 2018.
A post-mortem examination recorded Emma's medical cause of death as lung and heart disease, with anorexia and bulimia nervosa as contributory factors.
Today (Thursday) the hearing heard how finding the right "care package" for Emma was "pretty much impossible", after she was diagnosed with anorexia and a personality disorder.
The inquest, which is being held at Huntingdon Town Hall, heard from Dr Mark Morris, consultant psychiatrist in psychotherapy, who had worked at the Cambridgeshire and Peterborough Foundation Trust in 2016.
On January 30, 2018, Emma had attended a best interests meeting at Addenbrooke's Hospital's S3 eating disorders unit, where doctors, psychologists and social works tried to find a treatment plan for her eating disorder.
Dr Morris told the inquest that he had attended the meeting, and had helped draw up a few possible options for treatment for Emma, who he described as being "very high risk".
Medical professionals suggested that Emma continued to be treated in the community.
Included in these options, were stays at specialist wards around the country, where Emma would be legally detained under the mental health act, care in the community, where she would be allowed to go home and would have regular visits from mental health professionals, and even putting her in a medically educed coma, which meant she would be fed through a tube.
However, Mr Morris admitted they knew that the detainment of Emma hadn't proved successful in the past, due to her personality order.
"Emma was frequently aggressive and violent, when she was restrained," he said.
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The inquest then heard that Emma's weight was so low that she was "at high risk of sudden collapse" which ruled out other options, including going under anaesthetic.
The possibility of being re-admitted to Addenbrooke's at some point in the future was, however, left open.
In fact Emma was admitted to hospital in June that year under the Mental Health Act, but was found dead just two days after being allowed to return home.
Mr Morris went on to explain how he decided to use a "light approach" with her as her personality disorder could leave her feeling controlled by the medical teams.
"In Emma's case it seems clear to me that a heavy handed oversight would be counterproductive and that a light approach would be much better. I found that with Emma, if she was getting in trouble or deteriorating she would get in touch. A much more proactive approach has not been successful in the past. Of course, I do identify, that on some occasions, we don't always get it right. I knew this would be a risk, but I believe that it is a positive risk."
Assistant coroner Sean Horstead asked him: "Would you say on the face of it, that it is doomed to fail."
Mr Morris explained that the two conditions that Emma had been suffering with, could contradict each other, making it very difficult to treat.
"Emma had two types of crisis points that she usually got to. The first was when her weight dropped too low, and the second would be her self harming," Mr Morris said.
The inquest also heard how it wasn't until Emma found herself at "crisis point" that she would seek help.
Emma's mother Jayne said: "This is the issue we had. The lower Emma's weight was the more extreme her personality order was, and she would self harm for help. When she was told at a meeting "it's over to you" I think, sadly, Emma saw that as abandonment, it was devastating for her."
The case of Emma Brown is among five anorexia deaths of patients treated by Cambridge and Peterborough Foundation Trust between 2012 and 2018
A separate inquest into the death of 24-year-old Maria Jakes, who died of multiple organ failure in September 2018, concluded last month that insufficient monitoring of her condition might have played a part in her death.
Separate inquests are due to be held for Amanda Bowles, 45, who died in September 2017, 18-year-old Madeline Wallace, who died in March 2018, and Averil Hart, 19, who died in December 2012.