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A mental health nurse who specialised in eating disorders used her inside knowledge to hide the anorexia that killed her, an inquest has heard.
Laura Charles, 29, died in the hallway of her home after becoming dangerously ill and weighing just 5st.
She used her knowledge of eating disorders to hide her rapid weight loss as her family said she learned how to "manipulate" to system to conceal her illness .
Her family say that her life could have been saved if she had been admitted to hospital – but no beds were available so she was being treated at home.
Laura was in the process of being sectioned under the Mental Health Act when she died at home in Kingstanding, Birmingham, on March 6, after frequently cancelling appointments.
birmingham mail
And when she did end up in hospital for emergency treatment, she discharged herself against the advice of medics, Birmingham Coroner’s Court was told.
Tragically, her problems began when she was told by doctors to cut out lots of foods after suffering a burst gastric ulcer in 2013.
Her sister, Clare Charles, told the inquest that was when Laura developed the eating disorder, reports the Birmingham Mail .
She said that up until she had the burst ulcer Laura had been a healthy size 10, weighing between 9st 7lbs and 10st, and was fit and active.
But in the last months of her life, although she had a fridge “packed full of healthy food”, she was surviving on just 500 calories a day and burning off the food she ate by doing lots of walking.
birmingham mail
Laura had also been diagnosed with epilepsy as a teenager, but was “religiously” taking her medication, said Clare. She had been cleared to drive and was holding down a job.
But in 2014 she had been sectioned and admitted to the Barberry psychiatric unit in Edgbaston.
She was released just before Christmas and kept all of her out-patient appointments.
In March 2015, however, she was re-admitted to the Barberry and at one point her weight plummeted so much that she had to be transferred to the Queen Elizabeth Hospital for emergency treatment.
She went back to the Barberry, but then in November 2015, discharged herself against doctors’ advice.
Between then and her death in March, she was being treated by Birmingham and Solihull Mental Health Trust as an out-patient – but frequently cancelled appointments and would only communicate with the home treatment team via text.
Hannah Bruce, Laura’s designated mental health nurse, said that Laura was a joy to deal with but sought ways to avoid her problem being monitored.
“She was lovely, one of the nicest girls I had worked with,” said Hannah. “She was a registered mental nurse herself and was highly intelligent, really kind and a real pleasure to deal with.”
birmingham mail
After “lots of cancelled appointments”, five days before her death, Hannah and her consultant pyschiatrist eventually managed to meet Laura at Costa Coffee in the Princess Alice Retail Park in New Oscott. “We think Laura suggested that because she felt we wouldn’t be able to do our assessment properly in a public place,” said Hannah.
Following that coffee shop meeting, and a further assessment in clinic, the team treating Laura decided she was once again dangerously underweight and began the process of getting her admitted back to the Barberry. “Laura wasn’t keen,” said Hannah. “She said she was ‘too fat’ to go into hospital.”
Consultant pyschiatrist Kandathil Mathew said that because of Laura’s reluctance to go to hospital they began the process of getting her sectioned under the Mental Health Act.
But there were no beds immediately available, so in the interim they arranged for her to have one phone consultation and one visit a day at home.
Dr Mathew said the lack of beds for mental health patients was a “big problem”.
Less than a week later, Laura was found dead at at her Kings Road home after police forced an entry. They had been alerted by the anorexic nurse’s family and mental health team.
A review into Laura’s care was carried out by Birmingham and Solihull Mental Health Trust.
Natalie Willetts, from the trust, said it revealed several shortcomings in her care and said new guidelines had now been put in place. These included making sure that the time between a patient being seen by a health professional was no longer than 28 days, better bed management, and for families to have more involvement with their loved one’s care.
Senior Birmingham Coroner Louise Hunt recorded a narrative conclusion that Laura had died from sudden unexplained death in epilepsy combined with anorexia.
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WHEN Laura was found dead on March 6 this year, she weighed just 5st 7lbs (36.8kg) with a Body Mass Index of just 12.4.
Pathologist Adrian Yeung, who carried out the post-mortem examination, said for a woman of her height – 5ft 9ins – she should have been at least 8st 6lbs (55kg) with a BMI of between 18.5 and 24.9.
He gave the cause of death as sudden unexplained death in epilepsy, with anorexia as a contributing factor.
He also said her heart was very small for a woman of her age – weighing just 189g instead of the normal 284g – and this was due to her anorexia.
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SPEAKING after the inquest, Laura’s family said they “felt let down by the NHS”.
“If they’d had enough beds and Laura was in one of them, she’d be with us now,” said her father, Robert.
They also said they felt the NHS did not address the mental health issues which were causing Laura to be anorexic, and were just treating the physical symptoms.
The nurse’s mum, Adela, said: “If they’d intervened sooner instead of when Laura was dangerously underweight, they’d have stood a better chance of helping her.”
Sister Clare said Laura used her inside knowledge as a mental health nurse to “manipulate” the team treating her.
“She knew all the right answers to their questions,” she said. “But she had accepted that she needed help.
“She wanted to go back into hospital – she didn’t want to die.
“Although they were preparing the papers to section her, it wouldn’t have come to that.
“Laura had her things all packed up. She’d got herself the Sex and the City boxset to watch while she was in there, and was ready to go into the clinic again.”
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