Doctor urged ME patient to stay on ward - inquest

Maeve Boothby-O’Neill had suffered with ME since she was 13

A senior doctor pleaded with a woman with myalgic encephalomyelitis (ME) to remain in hospital months prior to her death, an inquest has heard.

Maeve Boothby-O’Neill, 27, had suffered with the condition since she was 13 and was being treated at the Royal Devon and Exeter Hospital before she died at home in October 2021.

An inquest in Exeter heard Miss Boothby-O’Neill had been admitted to the hospital three times that year for treatment for malnutrition.

The hearing is focusing on the last few months of Miss Boothby-O'Neill's life by which time she was confined to bed, unable to chew food and had difficulty drinking because she was not able to sit up.

'Very difficult situation'

During her second admission, between May and June, Dr Kashyap Patel, a consultant in diabetes and endocrinology, said he tried to persuade her to stay on the ward despite her request to be discharged.

Dr Patel told the hearing the situation was "tough" and "he wasn’t expecting" Miss Boothby-O’Neill's request, but as she had mental capacity, he could not stop her from leaving.

He said: “I was prepared to keep her in as long as was needed.

"There was no intention from my side to send her home because it was a very difficult situation we were in.

“It was made very clear to me by an experienced occupational therapist later on that she requires 24-hour care.”

'Please stay'

The inquest heard Miss Boothby-O'Neill told doctors she wished to be discharged and to continue treatment at home in Exeter.

Dr Patel said he spoke with Miss Boothby-O’Neill’s mother, Sarah Boothby, and sought advice from other doctors, social workers and occupational therapists.

“I said, ‘please stay’. I found it very hard, but I also understood her point of view that she felt hospital is not the right place for her,” he said.

“I am a very persuasive consultant. I tried speaking to Sarah as well.

"I understood both sides and I had a very frank chat with Sarah that she couldn’t manage."

Dr Patel told the inquest he "spoke to safeguarding" and offered the family respite which "Maeve wasn't keen on".

During this period, Miss Boothby-O’Neill was being fed nutrition via a syringe into her mouth and hospital records recorded a “slow and steady improvement” in her daily calorie intake.

'Seemingly irrational choices'

“She expressed her wish to be discharged home as soon as possible irrespective of whether the long-term care package was in place,” he told the inquest.

“Maeve also stated she was happy with the care (her) mum has provided and felt safe going home and appreciated her mum was under significant strain and would like her to have some support long-term."

Dr Patel told the inquest the "only reasonable option" in the short term to respect Miss Boothby-O'Neill's wishes was "to discharge her with the urgent care team and additional support from her mother.”

Asked if he could have done any more for Miss Boothby-O’Neill, Dr Patel replied: “I found it very tough and difficult, and it is often the case with any medical professional when someone is making seemingly irrational choices."

He added: “If I had known the future, I maybe would have tried my extreme persuasion skills, but I did not know the future.

"Had I known that I would have definitely tried.”

The inquest continues.