Woman died after clot was not diagnosed - inquest

Dena Collins died at Queen Elizabeth Hospital in Greenwich after initially being sent home

A primary school teacher died with an undiagnosed blood clot one day after visiting a hospital complaining of leg pain and fever, documents submitted to an inquest state.

Dena Collins, 28, died at Queen Elizabeth Hospital in Greenwich, south-east London, on 12 January 2023 after being sent home - despite medics initially suspecting a clot might be the cause of her symptoms.

An inquest at Southwark Coroner's Court on Monday was adjourned until June due to last minute evidence being submitted to the court.

A Lewisham and Greenwich NHS Trust spokesperson said: "Following Dena's death, we undertook a full and thorough review of her care."

Ms Collins, from Eltham, sent texts to friends and family saying she suspected she had a blood clot after researching her symptoms and the potential side effects of antibiotics she was taking.

She also visited her local GP three days before her death complaining of pain in her left leg, and was diagnosed with muscular pain.

Father gave CPR

The day before her death, the nursery and reception teacher visited the Queen Elizabeth Hospital, complaining of four days of leg pain, fever and diarrhoea.

She was using a crutch to walk because of the pain and was limping and short of breath.

Despite the possibility of a blood clot being noted at triage, and a positive D-dimer test, which is used to identify clots, she was given a diagnosis of a possible ruptured cyst at the back of her knee and told to return the next day for a scan.

However, Ms Collins collapsed at her family home the next morning.

Her father gave her CPR before an ambulance arrived and took her back to the same hospital, where she died a couple of hours later.

'Missed red flags'

A serious incident report written by Lewisham and Greenwich NHS Trust found although Ms Collins saw four doctors at the hospital, an undiagnosed deep vein thrombosis (DVT) - a blood clot in a large vein, commonly in the leg - led to Ms Collins' fatal heart attack.

It read: "Had the DVT been diagnosed earlier and she received anticoagulation her outcome may have been different."

The report concludes there were "some missed red flags" in Ms Collins' care, including her shortness of breath, leg pain, a recent illness and the D-dimer result, as well as "elements of cognitive bias that affected clinical decision making".

However, the report said, given her heart attack occurred 16 hours after being discharged "it is unlikely that this would have been preventable".

Lives 'forever changed'

Her sister Clare Collins, 33, told the hearing in a witness statement: "We spent two years fighting to get answers for Dena and now we have to wait six more months.

"Our lives have been forever changed and the thought of living the rest of my days without her by my side leaves me unable to breathe."

Speaking after the hearing she said she believed Dena "had every chance of surviving", if she had been given anti-clot medication.

"She knew she had a clot, she knew, and nobody listened to her," she said.

Clare added Dena was "completely and utterly devoted to every class and every child that she taught", particularly those with special educational needs.

Dena was also a longstanding Crystal Palace Football Club fan who held a season ticket for more than 20 years, sitting side by side with her father at every home game.

A Lewisham and Greenwich NHS Trust spokesperson said: "We are truly saddened by Dena's death and recognise the devastating and lasting impact this has on her family and friends.

"Following Dena's death, we undertook a full and thorough review of her care, which has been shared with her family.

"It is very difficult for us to comment any further during today's inquest, but we continue to offer the Collins family our sincere condolences and any support they need."