Staff at mental health unit failed to carry out more than 100 checks on patient Molly-star
INQUEST INTO DEATH OF ‘HAPPY AND LOVING’ 20-YEAR-OLD
STAFF at a mental health clinic in Nottinghamshire failed to conduct the required number of checks on an inpatient before her death, an inquest has heard.
Molly-star Kirk was 20 years old when she was found unresponsive in her room at the Farndon Unit in Newark. Her death is currently being treated as unexplained
Molly had been an inpatient at the clinic since October 2021, detained under Section 3 of the Mental Health Act. The inquest was told on Monday that staff at Farndon Unit, run by Elysium Healthcare, failed to perform all the required checks on Molly in the last hours of her life.
Molly, who was described by her family as “bright and chatty”, was on a high level of observation due to her risk, her care plan requiring her to be checked 12 times per hour, the equivalent of once every five minutes. During her admission, Molly experienced multiple seizures which were understood by staff to have been caused by non-epileptic attack disorder, as well as other health issues arising from self-harm.
She was also prescribed a number of different medications in order to manage her mental health conditions, which included emotionally unstable personality disorder, posttraumatic stress disorder, and bulimia. The inquest, which is expected to last for 10 days, resumed at Nottingham’s Council House yesterday, when a jury formed of 11 members was sworn in.
During the opening, Coroner Laurinda Bower told the hearing that Molly spent prolonged periods of time in care, predominantly under Section 3 of the Mental Health Act, between 2017 and May 29, 2022, when she died.
Over the years, she made multiple suicide attempts and was admitted to a number of hospitals across Northampton, Milton Keynes, London, Maidstone, and, finally, Newark.
Because of the requirements of her care plan, Molly should have been checked on 180 times between midnight on May 29 and 3pm on the same day. Only 78 checks were conducted, however, with Molly being checked on as few as three times in some of the 60-minute intervals.
Molly was last seen outside her room the night before she died as she did not come out of her bedroom, which members of staff said was not unusual for her.
According to Bhatt Murphy Solicitors, who represent the family in the proceedings, one of the other patients reported that the young woman had been feeling unwell.
Molly was last checked at around 2.10pm, after which she was not observed again until she was found unresponsive by a staff member at about 2.30pm. Paramedics arrived, however, Molly was pronounced dead shortly afterwards.
The court heard how Molly had multiple seizures the day before she died, on May 28, and even made a 999 call to report this. Emergency services thought it was a prank call, however, and another call was made by a member of staff at 2.38pm.
After paramedics tried resuscitating Molly, who was in cardiac arrest, to no avail, a collective decision was taken to cease advanced life support and declare her deceased at 3.18pm.
A statement read out to the inquest by Coroner Bower from an EMAS tactical commander revealed that the staff members present at the time of his arrival to the clinic were unable to answer his questions about Molly. A recording of the 999 call made by the staff member was played in court and revealed the caller was unsure about Molly’s age but said she was around 18.
The dispatcher is then heard asking repeatedly if Molly is breathing again, but receives no response.
The inquest was also told that Molly was initially given CPR on her bed, which affected the effectiveness of the compressions.
She was later moved to the floor upon the arrival of emergency services, where attempts to resuscitate her continued.
Kay and Peter Kirk, Molly’s mum and stepdad, her brother, and other family members and friends, were present at the hearing.
Molly was described as “happy and loving” despite the challenges she was facing and was family-orientated and loved listening to music.
The inquest continues.