Cheshire law student 'likely to have lived if he had been given face-to-face appointment'

A law student who died after four remote GP consultations is likely to have lived if he had been given a face-to-face appointment, a coroner has concluded.

David Nash, a 26-year-old student at University of Leeds, died on 4 November 2020 of a mastoiditis in his ear which caused an abscess on his brain.

He had four phone consultations with a Leeds GP practice over a 19-day period in October and November 2020, but was never given a face-to-face appointment.

Assistant Coroner Abigail Combes told Wakefield Coroner's Court, that this failure to arrange the in-person examination of the musician was a "missed opportunity".

She said the failure of the GP surgery to see Mr Nash meant the neurosurgery he underwent on what turned out to be a brain abscess was 10 hours later than it could have been.

In her narrative conclusion she said: "On 2 November 2020 there was a missed opportunity to direct David to seek face-to-face care during his GP appointment that morning.

"Had he been directed to seek face-to-face or urgent care by the GP practice it is more likely than not that he would have undergone neurosurgery approximately 10 hours earlier than he actually did which, at that time, it is more likely than not would have been successful."

A week-long inquest heard how Mr Nash first contacted Burley Park Medical Practice, in Leeds, on 14 October 2020, and told a GP over the phone about his concerns about lumps on his neck.

He rang again on 23 October and told an advanced nurse practitioner about his painful and hot right ear.

On 28 October he told a locum GP he had blood in his urine and he was diagnosed with a urinary tract infection.

His fourth consultation was with another advanced nurse practitioner who diagnosed him a flu-like viral infection on 2 November.

The coroner heard how Mr Nash’s condition deteriorated on November 2 and he and his partner made five calls to NHS 111, which his parents, Andrew and Anne Nash, have described as “shambolic”.

After the final NHS 111 call, Mr Nash was taken to St James’s Hospital in Leeds and later transferred to Leeds General Infirmary for neurosurgery.

But he died on 4 November.

He had developed mastoiditis in his ear which caused an abscess on his brain, leading to his death, the inquest heard.

GP expert Alastair Bint said the nurse should have organised an urgent in-person appointment after the fourth phone consultation on 2 November 2020 as his symptoms were “red flags”.

Dr Bint said he thought it likely such a face-to-face consultation would have led to his hospital admission and neurosurgery 10 hours earlier.

Neurosurgeon Simon Howarth said, in a statement read to the court: “On the balance of probabilities, had this intervention been 10 hours previously, his death would probably have been avoided.”

Mr Nash was a talented musician, spending a number of years touring Europe with his band Weirds.

He had just started the second year of a law degree at Leeds University when he died.