Wigan dad’s tragic death after paracetamol overdose
A coroner has examined the care given to a dad for both physical and mental health problems in the weeks before he died.
Mark Evans, 49, was taken to Wigan Infirmary three times in January, with the final occasion after a paracetamol overdose.
He was treated for issues with his physical and mental health, and sought support for a drinking problem.
An inquest at Bolton Coroner’s Court heard Mr Evans had been homeless since his marriage ended in 2019 and had slept on the sofa at his sister Shirley Molyneux’s home.
He was there in January when she found him “lethargic” after drinking heavily.
His GP told her to take Mr Evans to Wigan Infirmary, where he was said to be suicidal and had alcohol withdrawal symptoms.
He was seen by the mental health urgent response team but also complained about abdominal pain and rectal bleeding, so was referred to A&E.
Mr Evans stayed in hospital until January 20 when he was deemed to be medically fit
A mental health gatekeeping assessment the previous day found he no longer needed a mental health admission and he would instead receive support in the community.
He was discharged to the Mercure Hotel, due to a positive coronavirus test while in hospital.
He received daily phone calls from Wigan’s crisis resolution and home treatment team, when he denied having suicidal thoughts.
He was offered a face-to-face appointment on January 28, after his isolation period ended, but he declined.
Mr Evans returned to A&E on January 27 complaining of headaches and vomiting. He left the same day and went to stay at a hostel in Leigh.
Mr Evans spent the following day with his sister, who described him as being “full of life”, but he was “quite different” when she saw him the next day, saying he was cold and not eating or drinking.
On January 30 he was found unresponsive at the shelter and taken to A&E by ambulance, but he died in hospital that afternoon.
A post-mortem examination found Mr Evans had fatty change to his liver - normally associated with alcohol-related liver disease - and cirrhosis.
There was build-up of fluid in his kidneys - a sign of kidney failure - and bronchopneumonia in his lungs, possibly related to coronavirus.
His blood contained paracetamol at an elevated level associated with fatalities.
Pathologist Dr David Barker said he died of liver failure, caused by alcohol-related liver disease and paracetamol toxicity. Coronavirus was found to be a contributory factor.
Mr Evans’ GP told the inquest he had been diagnosed with depression in 2017 and was drinking heavily.
He was admitted to hospital with suspected alcoholic hepatitis in 2018 and tests in 2019 showed fatty change to his liver. He reported drinking heavily again in 2020.
Sarah Humphreys, service manager for We Are With You, said Mr Evans received support for his alcohol use from September 2019 to June 2020, when he was discharged after being abstinent for eight weeks.
He referred himself back to the service in January, but did not answer his phone when called by a member of the team as he was in hospital.
She explained that while the usual process was to contact the hospital to set up a meeting of partners to discuss his case, this did not happen.
Ms Humphreys said there was now a hospital liaison worker in place to assess patients on wards and help them to engage in treatment.
The inquest heard a review of the mental health care given to Mr Evans found there were “gaps” but they did not contribute to his death.
Coroner Catherine Cundy said the assessment on January 19 appeared to be “extensive”, but she did note records did not show if the assessor was aware he would be going into isolation on discharge.
Ms Cundy was not satisfied Mr Evans intended to take his life. Instead, she recorded he died from the ingestion of an excessive quantity of paracetamol on a background of alcohol-related liver failure, but his intentions were not known.
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