Patient’s anorexia was the “most severe case I have ever seen”, doctor tells inquest

Emma Brown with her Dad Simon.

Emma Brown with her Dad Simon. - Credit: Archant

Emma Brown had “remarkable strength” when it came to dealing with her condition, an inquest at Huntingdon Town Hall has heard.

A 27-year old from Cambourne who died following a long battle with anorexia, was the "worse severe case" her GP told the inquest heard.

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.

Dr Richard Wilson, a general practitioner at the Monkfield Medical Centre in Cambourne told the hearing how he monitored Emma weekly as part of her "care package".

He said: "In 30 years of working as a GP this is the most severe case of anorexia that I had seen."

The inquest, which is being held at Huntingdon Town Hall, heard how Emma would see her GP for weekly appointments where they would monitor her weight, do a strength test and then perform a blood test.

Most Read

The hearing heard how this service was not commissioned by the Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) meaning that GP surgeries do not have to provide the service.

Dr Wilson said that in this case, he was happy to meet with Emma weekly. He explained that some GPs may refuse to provide the monitoring service if they felt that they didn't have the expertise, or time, or capacity, and that it was not commissioned by the CCG it was not compulsory to provide this service.

"We had arranged that Emma would turn up on a Thursday, and then we could see her blood test results on Friday. I only work part time, so I preferred to be the doctor to go through them with her."

Dr Wilson also told the inquest how on some occasions, Emma would not turn up to appointments, or would turn up but not have taken her potassium medication, something that if missed, would increase her chances of death.

When asked by assistant coroner, Sean Horstead whether Emma knew the consequences of not taking her medication, Dr Wilson replied "yes".

"Emma knew when she needed to take herself to hospital," he said.

Dr Wilson went on to tell the inquest how Emma had "remarkable strength" being able to perform all the tests that were asked of her, including getting in and out of a chair without help, something that would be difficult for someone at "such a low weight".

Emma's parents Simon Brown and Jayne Edmunds-Grezio thanked Dr Wilson for his support.

Mr Brown said: "I don't think we could appreciate the extent that you helped Emma."

Ms Edumnds-Grezio also raised concern around the confidentiality of patient records, and how sometimes she would call the surgery to find out information about Emma but was refused.

"It was a major worry to me, and I am hoping it is something you can address in the future. We were very worried that Emma was dead, and so wanted to phone through to see if she attended her appointment on the day of her death, but we couldn't get that information."

Mr Brown also raised issues around the gap between social support and clinical support available for Emma, saying that the provision of "help in the community" was a vital lifeline for Emma.

He said that on one occasion Emma had tried to take her own life and was found by police after he raised concern for her welfare.

Dr Wilson said: "Emma wouldn't take her medication and knew she could die, but when I asked her 'what's your reason to go on', she told me 'my relationship with my dad'.

Mr Brown then said he was grateful for the GP support that Emma received but that he was worried that this service isn't delivered by all doctors in the area.

"I am horrified. I couldn't imagine how we would have dealt with Emma if a GP had refused to see her. God help us if support wasn't available."

The case of Emma Brown is among five anorexia deaths of patients treated by Cambridgeshire and Peterborough Foundation Trust between 2012 and 2018.

Mr Horstead has said that although he describes these as a "cluster of deaths" he has not yet formerly linked them.

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.

If you are affected by anything in this article you can call Samaritans on their free helpline 116123. Or you can contact the eating disorder charity BEAT on 0808 801 0677.