Virus tests 'missed' at intensive care - inquest

A man looking straight at the camera, with his index finger resting on his temple and a pair of glasses across his forehead. He is sitting in a restaurant. A barman is standing behind a bar in the background, making a cocktail.Image source, Mollinghoff family
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Patrice Mollinghoff died on 8 December 2023, aged 74

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Seriously unwell patients are not always tested for respiratory viruses when they should be, an intensive care consultant told an inquest.

Dr Christopher Westall, an intensive care consultant at Broomfield Hospital, in Chelmsford, told Essex Coroner's Court on Thursday that some tests had not been completed on Patrice Mollinghoff before he died on 8 December 2023, aged 74.

"We know he didn't have Covid or influenza, but there were other respiratory viruses he should've been tested for but wasn't," he said. "They are the most frequently missed microbiological tests we do. It's something we're trying to work on."

The tests would not have changed Mr Mollinghoff's treatment, Dr Westall said.

The tests could be missed for several reasons, which include challenges obtaining swabs from patients or clinicians not thinking to complete them, he added.

The Mid and South Essex NHS Foundation Trust, which runs the hospital, said it was grateful to the coroner for recognising Mr Mollinghoff's treatment had been appropriate.

Image source, Elliot Deady/BBC
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A hearing into Mr Mollinghoff's death was held at Essex Coroner's Court on Wednesday and Thursday

The inquest had sought to establish the cause of death of Mr Mollinghoff, who had been treated for lung cancer, most recently using immunotherapy.

The court heard how Mr Mollinghoff visited Broomfield Hospital's accident and emergency department on 30 November 2023, displaying symptoms of severe respiratory failure.

He was later admitted to the high dependency unit, where doctors identified he had either pneumonia, external or pneumonitis. He received treatment for both possibilities.

'Rare complication'

The coroner recorded bronchopneumonia as Mr Mollinghoff's cause of death, with an "immune related adverse event secondary to immunotherapy" given as an underlying cause.

Assistant coroner Jeane Mellani said bronchopneumonia was a "rare but recognised" complication of the immunotherapy drug Mr Mollinghoff, from Bicknacre, had been prescribed.

Bronchopneumonia is a condition that causes inflammation of the lungs. A post-mortem examination found Mr Mollinghoff's lungs were three times heavier than usual when he died.

His consultant oncologist, Dr Andreja Podvez Navajda, said there were no other treatments available and that he had not been eligible for surgery.

Hundreds of her patients had responded well to immunotherapy, but only about 10 of those had lung cancer, she added.

On Wednesday, proceedings were delayed because the hospital had failed to provide evidence, including more than 200 pages of medical notes, before the hearing started.

Dr Mellani said it had not been a good use of the court's time and insisted the trust returned on Thursday with a written apology for the family.

"I can see Patrice was extremely loved and will be deeply missed," she told the family after delivering her conclusion.

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