A doctor who treated an anorexic teenager after she collapsed at university told a coroner there would have been no mental health support available from her admission on a Friday evening until Monday morning.
Averil Hart, from Newton near Sudbury, rapidly lost weight in her first term at the University of East Anglia and died around 10 weeks later, aged 19, in December 2012.
On Friday, December 7, she collapsed in her room and was rushed to the Norfolk and Norwich University Hospital (NNUH) with a dangerously low temperature, blood sugar and blood pressure.
Dr Crawford Jamieson, now medical director at Ipswich Hospital, oversaw Averil’s care on the NNUH gastroenterology ward on that Friday evening.
He told Thursday’s hearing in Huntingdon it was clear she was “seriously unwell” and there was a risk to her life from how poorly nourished she was.
Averil’s condition was so serious that he rushed back to the hospital on hearing of her deterioration.
MORE: ‘Fun-loving’ teenager with anorexia ‘referred into NHS team with severe staffing crisis’, inquest toldDr Jamieson said he recognised there was a need for “immediate liaison” with mental health teams given Averil’s declining health.
But when questioned about support available to an eating disorder patient during that weekend, Dr Jamieson said there was a nurse-led team operating 9am-4pm Monday to Friday, and a dedicated self-harm team running on Saturday and Sunday mornings.
Neither offered specific support to eating disorder patients, Dr Jamieson told the inquest.
He said Averil’s consultant psychiatrist from the Norfolk Community Eating Disorders Service, Dr Jaco Serfontein, had phoned earlier on December 7 to arrange an assessment on Monday morning.
Dr Jamieson also told assistant Cambridgeshire coroner Sean Horstead that his team did not monitor Averil’s food intake closely enough.
The inquest also heard from Dr Amy-Jo Farrow, a junior doctor in her first year of specialist training at the time of Averil’s admission.
She told the court that she had no experience of somebody with anorexia nervosa and that Averil was her first patient with the condition.
MORE: Death of gifted student with anorexia ‘could have been avoided’, mother tells inquestDr Farrow said when Averil was referred to the acute medical unit from A&E on the Friday afternoon all she knew about her was her name, age, and that she had been admitted with renal failure.
She was not aware Averil had anorexia until she spoke to and assessed the teenager.
Dr Farrow also said she had not requested Averil’s weight but had taken her height, adding that asking for weight and BMI was something she would have “expected herself to have done”.
She said she did not remember clearly why she did not ask for it, but gave two possible reasons; including fearing Averil may not provide her with an accurate weight, and that she knew from medical training that anorexic patients may find it difficult to discuss weight.
Lydia Pell, a mental health coordinator at UEA, told Thursday’s hearing that she accompanied Averil to A&E following her collapse.
She described the teenager’s weight being taken in the emergency department, and her surprise at how much she had lost.
MORE: Inquest to probe Suffolk student’s anorexia deathDr Farrow described referring Averil to the gastroenterology department after becoming concerned about her malnourishment and suspected lack of insight into how severe her eating disorder was.
She also arranged further tests for blood sugar, liver and kidney function.
Dr Farrow said Averil thought her weight loss was “secondary to fresher’s flu”, and added: “I was concerned that her insight into her condition was very poor, because she was under the impression that her anorexia wasn’t bad, and I disagreed.”
The inquest, set to last four weeks, continues.
Comments: Our rules
We want our comments to be a lively and valuable part of our community - a place where readers can debate and engage with the most important local issues. The ability to comment on our stories is a privilege, not a right, however, and that privilege may be withdrawn if it is abused or misused.
Please report any comments that break our rules.
Read the rules here