Medics did all they could to save Leanne, rules coroner

Picture shows heart transplant patient Leanne Nicholson from Choppington seen with her father Rob Nicholson being picked up by pink limousine from the Freeman Hopital at Newcastle.
Picture shows heart transplant patient Leanne Nicholson from Choppington seen with her father Rob Nicholson being picked up by pink limousine from the Freeman Hopital at Newcastle.
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HOSPITAL staff did everything they could to save Leanne Nicholson after her body rejected a transplanted heart three years ago, a coroner has ruled.

But Leanne’s distraught parents Rob and Helen, both 44, are convinced the 19-year-old’s life could have been saved.

They say she knew she was rejecting her heart despite not showing the usual signs of cardiac failure and believe medics should have acted on her concerns.

Leanne, of East Green in Choppington, had been a healthy youngster until she caught a viral infection at the age of 12.

That infection led to cardiomyopathy, also known as cardiac muscle disease, causing catastrophic damage to her heart.

Leanne had her first heart transplant in 2002 and another in 2008 after the first one was rejected.

Her second heart started showing signs of rejection later that year, leading to her medication being adjusted.

On July 15, 2009, Leanne was admitted to the accident-and-emergency department at Ashington’s Wansbeck General Hospital suffering shortness of breath, vomiting, a sore throat, swollen feet and a slightly raised temperature, as well as a faster than normal heartrate.

Medics telephoned the Freeman Hospital in Newcastle, where Leanne underwent her transplants, but because she was not displaying any signs of heart failure, it was decided that she should be monitored at the Northumbrian hospital overnight, an inquest held in Ashington last week heard.

It was believed Leanne was suffering from a viral illness – possibly swine flu – and that could have had severe repercussions because of the immunosuppressant medication she was taking, the hearing was told.

At 10.30am the following morning, Leanne appeared to be fine when she was assessed during a ward round.

As a precaution, however, it was decided that she should have an echocardiogram to detect any possible deterioration in heart function before she was discharged with a supply of the swine flu anti-viral drug Tamiflu.

However, on her way to have the scan, Leanne collapsed in a corridor and could not be resuscitated. She was pronounced dead at 11.44am.

A post mortem examination revealed the cause of her death to be acute rejection of a transplanted heart.

Speaking after the inquest, Rob said: “We last saw Leanne in the early hours of the morning.

“She was very concerned because she knew she was in rejection. She was quite scared – she knew she needed the rejection treatment – and she was crying. Our main issue is that they didn’t identify the fact that she was in rejection and needed treatment.

“Leanne was an expert on her own condition. She knew what to look for, and we knew what to look for. It had been drummed into us.

“She’s been through it many times before. She knew she was in rejection, and she could have been saved.”

Coroner Tony Brown said: “Dr Gareth Parry, a cardiologist at the Freeman Hospital, states that, following a transplant, rejection is almost constant, requiring monitoring on a regular basis. Patients are also seen in outpatient units regularly to identify any problems with the heart.

“Dr Parry said it would be foolhardy and irresponsible for him to advise that, in emergency cases, patients bypass the emergency department and be admitted to the transplant unit. It appears that this situation applies nationally.”

Mr Brown added: “The circumstances of Leanne’s death must have been extremely distressing for Leanne’s parents and the medical staff involved.

“Leanne’s parents have expressed that they feel Leanne’s condition was not recognised when she attended hospital, that the level of care was not adequate and that Leanne should have been taken directly to the transplant unit at the Freeman Hospital.

“Despite the very tragic outcome, the evidence showed that Leanne’s condition was carefully assessed and monitored by hospital staff.

“Leanne’s sudden and unexpected death from cardiac arrest on the morning of July 16 was not predicted by medical symptoms displayed before that.”

Mr Brown recorded a narrative verdict that Leanne died as a result of rejection of a second transplanted heart.

Rob said: “If she had been a child, she would have gone straight to the Freeman and she would have had an echocardiogram straight away. Any signs of rejection and she would have been put in a room and given high doses of steroids.

“As an adult you have to go to the GP and on to the accident-and-emergency unit, sitting there for many hours, and hopefully on to the Freeman.

“What we really want to make sure is the transition period between child and adult changes for the better. That’s what we want.”

Rob and Helen added that they wanted to thank staff at the Freeman Hospital for the care Leanne had received in the past as well as reinforce the importance of organ donation, which gave them, along with sons Scott, 20, and Ryan, 14, precious years with their daughter.