Woman dead just days after leaving hospital 'feeling more like herself'

A woman died just days after she was sent home from hospital. Marie Stevens died at her home on Holden Road in Brighton-le-Sands around two weeks after she was savaged by two Rottweilers.

Marie, described in court as a "kind and bubbly animal lover", had suffered "serious and significant" injuries to her arms and legs in the attack. She had been visiting her sister on August 18 when the two dogs set upon her on Park Lane West in Netherton at about 5.45pm.

An ambulance rushed Marie to Aintree University Hospital, where she stayed until September. During her time in hospital, an inquest heard that she received two operations.

READ MORE: Much-loved teenager who accidentally drowned in river was 'oblivious' to risks, coroner rules

These included a skin graft on her left calf following the attack. Marie was discharged home on September 1, an inquest at Sefton Coroners' Court heard.

The court heard that Marie's husband had found her lying on her back outside their downstairs bathroom at about 9.30am on September 3 2023. An ambulance was called but sadly paramedics declared her deceased shortly after arriving at the scene.

Following her surgery Marie had not been given two doses of blood thinning medication, the court heard. A post-mortem examination found that Marie had died of a pulmonary embolism, a blood clot in the lungs.

Graham Jackson, assistant coroner for Sefton, Knowsley and St Helens, concluded today: "There was no evidence that Marie Stevens had suffered from a blood clotting disorder before the dog attack and in her opinion she said it was mainly the trauma and subsequent inability from those dog bites which predisposed to the development of the clots in the deep calf vein of her left leg.

"These clots broke off, travelled in the circulation to the lungs. They blocked the blood supply in her lungs and that was the cause of the collapse and death of Marie Stevens."

The inquest heard that Marie had a procedure called a 'split skin graft' on August 24. Giving evidence in court, consultant plastic surgeon Maha Nagarajan said that the procedure was "uncomplicated and took less than an hour", with a graft being taken from Marie's thigh.

Marie when had a 48 hour recovery period in bed following the surgery. By August 29 she had been keen to mobilise, with senior orthopaedic physiotherapist Emily Rankin saying that she was "feeling more like herself".

Two days after this Marie was described as being eager to complete a stair assessment. The day after it was decided that Marie would be discharged from the hospital.

At the time Marie still required the use of a a frame, crutches, and a handrail on the stairs. The decision to discharge her ultimately came down to consultant orthopaedic surgeon Matthew Kent, Marie's named consultant when she left hospital.

Giving evidence, Mr Kent said that Marie's injuries were "significant that required surgical intervention" and "serious but not life-threatening". He added that at the time of her discharge she had been doing well and he "didn't really have any great concerns about her", adding that she was "medically well to be discharged" and there was no sign of infection.

He went on to say that despite her having several risk factors which could lead to pulmonary embolism or deep vein thrombosis, tests were not carried out because there had not been a "material change" in her medical circumstances.

Mr Kent told the court that he did not know Mrs Stevens had missed two doses of medication after her first operation on August 19. However, he said it would not have changed the circumstances of discharging her when he did.

He told the court that "the missing of the two doses wouldn't prompt me to start investigating deep vein thrombosis", adding: "My interpretation was she was mobilising, her surgery was over and the risk was diminishing instead of escalating."

Dr David Simcox, a consultant haematologist at the Liverpool University Hospitals NHS Foundation Trust, told the court that Mrs Stevens had a number of "very clear risk factors", as a result of her injuries which would have caused damage to blood vessels. When asked by the coroner Mr Jackson if it would be reasonable to suggest the missed doses increased the risk, he said: "The risk is probably slightly increased."

Mr Jackson also asked if the development of the blood clot resulted from the missed doses, with the doctor responding: "On the balance of probabilities, I couldn't confirm that." He added he could not confirm at what time the blood clot developed - and when asked by the coroner: "Could it have developed post-discharge or was it there at the time of the discharge?" responded "either is entirely possible".

A post-mortem by Home Office pathologist Alison Armour found Mrs Stevens' cause of death was pulmonary embolism and deep vein thrombosis. She said Mrs Stevens sustained serious dog bites to both legs which required bed rest, and this led to the blood clot forming in her left calf. Part of this broke off and travelled through the bloodstream to her lungs, causing her to collapse."

Dr Nikhil Sharma, director of patient safety at Aintree University Hospital, confirmed that Mrs Stevens' missed doses of blood-thinning medication were down to "human error". He said changes had been made to the hospital's digital system and additional mandatory staff training was in the process of being rolled out with a view to being completed at the end of 2024.

Delivering a narrative conclusion, the coroner acknowledged there had been a delay in Mrs Stevens' prescription, leading to her missing two doses of blood-thinning medication, but said this "was not sufficient to establish neglect". He said: "In my opinion this error, not giving those dosages for the first two days, was a human error and not a system failing. There was a system in place but it wasn't followed by the humans.

"Before the first operation the medication would not have been given because of the risk of bleeding, but post-op the doctors had a plan to give that. However it wasn't immediately prescribed for two days. Mrs Stevens was in a complex medical environment...in the case of Mrs Stevens, sadly no one person checked to ensure the prescribed doses were given right at the start."

Mr Jackson added: "While missing those two doses following the first procedure would have increased the Mrs Stevens' risk of developing a blood clot, it cannot be established that that error led to her acquiring the pulmonary embolism which caused her tragic death."

Liverpool Crown Court heard in May this year that Mrs Stevens was bitten in a "frenzied" attack by Rachel and Brian Walshe's Rottweilers, with the latter allegedly telling her: "Get up will you? There's nothing wrong with you." Both defendants, who have no previous convictions, admitted owning a dangerously out of control dog causing death. They were handed 10-month imprisonments suspended for 18 months with rehabilitation activity requirements of up to 20 days.