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Doctor admits mistake during anorexia inquest on woman’s death

A doctor is currently facing inquest proceedings at the coroner’s court, in Huntingdon Racecourse for the death of Amanda Bowles. Dr. Jane Shapleske, clinical psychiatrist, is part of the team assigned to assess Bowles‘ mental capacity. Dr. Shapleske apologised to the Bowles‘ family for not intervening sooner after she diagnosed the patient with critically low BMI when she came for a consultation in August 2017. Dr. Shapleske said it was a wrong decision on her part for not organising an admission at the time since a low BMI is a red flag for increased risk of sudden death. Bowles was found dead at her Cambridge home on September 7, 2017.

According to an article on the BBC, Bowles, 45, was discharged from the Adult Eating Disorder Service (AEDS) at Cambridge and Peterborough Foundation Trust in December 2016. At the inquest, it was reported that Bowles had not been monitored for about four months since being discharged from the service. Records show that she had phoned the AEDS in April 2017 to inform them of this and that she was “struggling with eating and concerned she was losing weight.”

On May 25, 2017, Dr. Mark Dourish made a visit to Bowles at her residence to carry out an assessment as this was required prior to regular monitoring by district nurses. He said her temperature and blood pressure results produced normal readings and she was also “able to perform the squat test without difficulty.”

Sean Horsetead, assistant coroner for Cambridgeshire overseeing the investigations said Bowles should have been weighed during the home visit. However, Dr. Dourish explained that Bowles said she had no scales which contradicts what Bowles‘ family said that she had two sets of scales in her home. Dr. Dourish said he took her word for it not thinking that she would hide her weight since she had asked for monitoring. It was also known that Bowles was registered for “assisted technology” which means she was responsible for recording her own weight and reporting this to the GP surgery.

During the inquest, Dr. Shapleske said the assessment was due to be carried out the day before her death but was delayed because she got distracted by other work.

“I regret not doing it”, Shapleske said.

“I took the decision in a way I felt was respecting her, I think I got the balance of decision wrong. It weighs incredibly heavy on me. I’m extremely sorry,” she addressed the Bowles‘ family.

After Bowles‘ last consult on August 24, Dr. Shapleske phoned Bowles multiple times but failed to make contact. She then sent a letter informing her of the need to perform a mental health assessment if she did not agree to a voluntary admission should a bed become available.

The coroner’s court was informed that a bed vacancy was on hand on September 4, but due to a staffing crisis, Ms. Bowles could not be offered the vacancy immediately.

The reported cause of Ms Bowles‘ death was pneumonia with a pathology report stating her eating disorder was likely to have been contributory. She also suffered from obsessive compulsive disorder, depression as well as agoraphobia.

The inquest proceedings are set to continue.

anorexia
Psychological symptoms of anorexia have been linked with differences in gut bacteria
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