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Woman Died Of Aggressive Lung Infection - Inquest

A mum-of-three died due to an "aggressive" bacterial infection which caused lung damage she could not recover from, a coroner has concluded.

Hannah Plumb, 32, died at University Hospital Coventry in December 2022.

An inquest heard that Ms Plumb died of natural causes, but that hospital staff did miss a medical problem which came up on two X-rays while she was in critical care.

Dr Christopher Bassford told the inquest that he did not believe this impacted the outcome of her death, but Ms Plumb's partner of 14 years, Gavin Hughes, said he still thought it amounted to neglect.

At the inquest on Thursday, Dr Bassford said the pneumothorax, also known as a collapsed lung, external, affected one of her lungs and was "moderate".

It was captured on two X-rays but was only spotted by a team from a different hospital more than 12 hours later.

Dr Bassford said if it had been spotted earlier, doctors would have put in a chest drain to deal with it, but he did not believe it would have stopped her dying.

He said that individuals had been "spoken to about it".

To reduce the risk of it happening again, he said doctors were looking to roll out X-ray machines that could automatically detect the issue.

During the hearing he also apologised to Mr Hughes that staff were not able to communicate better with him at two points in her treatment.

Mr Hughes told the hearing that Ms Plumb was a "lovely partner and mother" to their three children, now aged 9, 11 and 12.

He said she started coughing and feeling unwell in mid-November, but thought it was just a sickness bug and did not try and get medical help.

After three weeks, she started vomiting a lot and did not have any energy.

Mr Hughes called 999 after his daughter told him Ms Plumb could not breathe, only to be told it would be a five and a half hour wait for an ambulance.

They took themselves to A&E but it was "very busy" and he went up to the desk five or six times to ask when she would be seen, he said. 

She was then moved to intensive care and had a mortality risk of 29%, much higher than the threshold to be admitted to intensive care.

During treatment for the pneumothorax on 11 December, Ms Plumb suffered a catastrophic cardiovascular collapse and died, the hearing was told.

An independent post-mortem report found that she was suffering from necrotising pneumonia which was affecting both lungs.

There was destruction of lung tissue because of the infection, the autopsy found.

This "serious and aggressive" chest infection went on to cause sepsis and multiple organ failure, it said.

The coroner concluded that she had died of natural causes on the balance of probabilities.

What To Expect From A Lung Biopsy

If your doctor spots something out of the ordinary on your chest X-ray or CT scan, they may ask you to get a lung biopsy. In this procedure, a doctor removes a small sample of cells from your lung and checks it under a microscope for signs of disease.

You may also get a lung biopsy to help figure out why there's fluid in your lungs or to diagnose cancer. Whatever the reason, you may have lots of questions about how it's done and how to get ready. A lot depends on which type of lung biopsy your doctor recommends.

Your doctor puts a flexible tube that's about as wide as a pencil into your mouth or nose, and from there into your lungs. A light and camera help guide tiny tools that take cells from your lung out through the tube.

You'll be conscious but generally unaware of what is happening while this is going on, but you will get medication through an IV to help you to relax, as well as oxygen through a mask or nose tube.

To figure out the right spot to do the biopsy, your doctor may take an X-ray. Then they'll spray numbing medication into your throat.

After they put in the tube, you may feel uncomfortable in your throat and you won't be able to swallow, but you'll be able to breathe. After it's over, you may have a sore throat, cough, or hoarseness that goes away in a few days.

You usually get this type of lung biopsy when cells can't be reached with a bronchoscopy. Your doctor places a needle through your chest between two ribs to take a sample from the outer area of your lungs.

You'll be awake and your skin will be numbed, and you may get a sedative to relax. To find the best place to do the procedure, you'll get an ultrasound, CT scan, or a special type of X-ray known as fluoroscopy.

When the needle enters your lung, you may feel discomfort or pressure. You'll need to avoid coughing, and you may have to hold your breath.

You may also hear your doctor call this a video-assisted thoracoscopic surgery (VATS). It checks for problems on the outside of your lungs.

You'll get general anesthesia for this procedure, which means you won't be awake for it. Your doctor puts a breathing tube down your throat and into your lungs and keeps tabs on your breathing, blood pressure, oxygen levels, and heart rate.

The doctor makes up to three small cuts on your chest between your ribs, then puts a thin, lighted tube with a camera on the end and uses tiny tools to pull out some cells.

Your doctor will usually only suggest this type of biopsy when other methods can't get cell samples.

As with a thoracoscopic lung biopsy, you won't be awake for this procedure. Your surgeon makes a larger cut than in other methods, which may run from your chest and under your arms to your back. That lets your doctor reach your lungs and remove the cells.

To make sure a lung biopsy is safe, your doctor may suggest you get a full physical exam and blood tests. Let them know if you're pregnant or have any allergies, including to latex or drugs. Also let them know if you take medications, especially aspirin or other drugs that affect blood clotting.

You'll sign consent papers. Read them thoroughly to understand the procedure and risks.

Ask your doctor what to expect during the procedure. Some things to think about as you talk over the options:

If you get a bronchoscopy or needle biopsy, you'll recover faster. However, doctors remove fewer cells than with other procedures, which sometimes makes it more difficult to make a diagnosis

If you're getting a thoracoscopy or open biopsy, you can get the sample of cells tested right away. Depending on the results, your doctor can remove more samples, or even an entire lung, during the same surgery.

At least 8 hours before your lung biopsy, usually around midnight, you'll likely need to stop eating and drinking. If you'll be awake during the procedure, you may be able to drink water in the morning.

Your lung biopsy sample will be sent to a lab, and you'll get results within a week.

You may get a chest X-ray to make sure your lungs are working OK. If you weren't asleep, you should be able to go home after a few hours. Have someone pick you up, because it's not safe to drive. Otherwise, you may need to stay in the hospital for one or more nights.

For the next few days, your chest may feel sore. If you have a wound from the procedure, follow your doctor's directions to clean it. You can usually go back to your normal activities but may need to avoid intense physical activity for several days. Only take pain medications your doctor prescribes, since some, like aspirin, can make you bleed more.

Pneumonia is a risk for all types of lung biopsies.

Pneumothorax, where air leaks out between the lung and chest cavity, can make it hard to breathe or cause your lung to collapse with these procedures, but your doctor will watch for this and suck out air as needed.

Other rare but serious complications of surgical lung biopsies may include severe bleeding, wound infection, and blood clots.

Call your doctor if you have any signs of infection or complications, which include:

Fever over 100.4 F

Redness, swelling, or blood or fluid leaking from the wound

Severe chest pain

Shortness of breath

Coughing up blood or blood-tinged mucus

'I Thought I Had A Chest Infection But My Lung Had Collapsed - This Is What It Felt Like'

While most people taking part in the London Marathon begin training about four months before the event, Richard Few began his preparations last summer. The 40-year-old sales training business owner has had to build his endurance up much more gradually than most, because when he joins thousands of runners making their way around the 26.2-mile course on April 21, he will be doing it with just one lung.

Richard had always been fit and well until his right lung suddenly collapsed without warning. "It was Valentine's Day 2008 and my fiancée Lucy and I were busy planning our wedding for July that summer," he recalls.

"I had been feeling tight-chested and initially assumed I had an infection, but eventually Lucy forced me to take myself to A&E.

"There, I was given an X-ray and couldn't believe it when the doctors told me it showed that my lung had collapsed. I didn't even think that was possible without an injury or illness," admits Richard, who lives in Clitheroe, Lancashire, with Lucy, now 42, and their son Ellis, 11.

At the time, Richard was just 24. "Doctors had no idea what triggered it, but it was the first of many collapses over the following three months, which resulted in aspirations, drains and, eventually, two lots of surgery at Harefield Hospital in Hillingdon.

"There, doctors ultimately removed most of my right lung in an attempt to prevent it leaking air into my chest cavity."

It was an experience that would change Richard forever. "When I left hospital after the surgery, I was acutely aware it would impact my life," he says. "It was a wake-up call really as I had met a lot of very poorly people in the specialist heart and lung unit. I realised good lung health was something we should never take for granted."

Beforehand, Richard had been very sporty, playing football and golf regularly. "My initial urge was to wrap myself up in cotton wool and stop playing sport and take things easy, but I met so many people on the ward who were in a much worse position than me, who were never going to get better and who couldn't do anything. They gave me the strength to get myself fit again and into shape."

That's not to say living with just one lung hasn't impacted Richard. "My specialist told me that I'd find sport harder, that I would never be as fit as I was before having the lung removed and that my ability to do endurance-type sports would decline and probably get worse as I got older. But I refused to let it stop me from being active," says Richard, who took up rugby eight months after his surgery.

"I was warned I would hit the wall sooner than other players and have to start training much earlier in the season to keep up, but I wanted to get the best out of my remaining lung and was still playing at the end of last season."

Staying so active has meant running his first marathon in his forties was a possibility. "I double checked with my doctor that it was going to be safe for me to take part, and he said I could go for it, so I started training last summer," says Richard.

Building up his remaining lung's ability to function has been essential to his preparation. "I get out of breath more easily when running," he explains.

"I began by running just a few miles a week. It has been tough but I've already done the 20-mile test run, which was brutal. I'd never run further than 10km before I began so it has been exciting to see how far I can push myself.  

"I still struggle sometimes, but my body has learned to make up for the loss of a lung. I still get conscious of my breathlessness and I get out of breath quickly, even when running at a slow pace, and can't always hold a conversation when others could.

"My heart rate is more elevated at the beginning of exercise too as my heart is having to work harder to give my body enough oxygen, but I am determined to get to that finish line. I want to show Ellis you don't have to let adversity hold you back in life." 

Richard is running on behalf of Asthma + Lung UK, to help raise awareness of lung conditions and the importance of lung health. To sponsor his marathon attempt, go to justgiving.Com/page/onelungmarathon

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