A man who died after a series of telephone appointments should have had an urgent face-to-face consultation, a GP expert has told a coroner.
David Nash, 26, had four phone consultations with a GP practice over a 19-day period in October and November 2020, an inquest in Wakefield was told on Monday. Mr Nash's condition deteriorated dramatically after the final consultation on November 2.
He was taken to hospital by ambulance after a series of NHS 111 calls, but died two days later. It was later found that he had developed mastoiditis in his ear which caused an abscess on his brain, leading to his death.
Abigail Combes, assistant coroner, read a statement from GP expert Alastair Bint, who said a nurse should have organised an urgent in-patient appointment after Mr Nash's fourth telephone consultation. However, Dr Bint said he did not criticise the remote nature of Mr Nash's first three consultations.
A face-to-face appointment, which is likely to have led to a hospital admission, could have saved his life, he concluded.
In her evidence, read to the court, advanced nurse practitioner Lynne White said she accepted that when she told Mr Nash on November 2 "you're sounding like you're feeling a bit sorry for yourself, are you feeling a bit rotten", it appeared now as if she was being dismissive. But she insisted she was simply reflecting that the patient seemed unwell.
Dr Bint said Mr Nash's presentation of fever, neck stiffness and night-time headaches were "red flags" and the nurse's diagnosis of a flu-like virus was "not safe". He said: "This was a patient that needed to be seen in person."
The GP expert said it required "an urgent face-to-face assessment that morning". He added: "Had he been seen in-person, it seems likely to me he would've been admitted to hospital."
Dr Bint's report stressed that the NHS was dealing with an unprecedented situation at the time, during the pandemic, and that NHS England advice was for GP patients to be seen remotely in most cases. He noted that the patient would have been in hospital 10 hours earlier but it was for a neurosurgical expert to comment on whether the outcome would have been different.
Mr Nash's parents, Andrew and Anne Nash, from Nantwich, Cheshire, have campaigned to find out whether the mastoiditis would have been identified and easily treated with antibiotics if their son had undergone a face-to-face examination earlier.
They have described how Mr Nash had five "shambolic" calls on November 2 with the NHS 111 system before being taken to St James's Hospital in Leeds by ambulance, in a confused state, where he fell when he was left alone, causing an injury to his head.
Mr Nash died on November 4 2020, despite efforts to save him by neurosurgeons at Leeds General Infirmary. He had just started the second year of a law degree at Leeds University. He had spent a number of years as a drummer on Leeds' music scene, touring Europe with his band Weirds and recording an album.
His mother told the court on Monday she was "eternally grateful for an amazing 26 years of love and hilarity". Mrs Nash said: "Your huge smile, your compassion and your ability to enjoy every moment could never be replicated."
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