A WOMAN who died while being treated in hospital for an overdose of painkillers had not intended to take her own life, an inquest found.
Rebecca Peacock, 37, of Carlisle, died at Furness General Hospital on October 31, 2021, after going into cardiac arrest.
An inquest into her death held at Cockermouth Coroners’ Court on Wednesday heard that Ms Peacock was born in Scunthorpe and moved to Carlisle as a young child.
She attended Morton Secondary School and left at 16 years old. She went on to work at TK Maxx and then Dorothy Perkins, working her way up to be assistant manager.
Ms Peacock later married and it was during this time that her family became aware of her self-harming.
Over the following years, her mental health deteriorated and she was diagnosed with emotionally unstable personality disorder in 2007.
The inquest heard from Ms Peacock’s mother, Gail Peacock, who felt her daughter had been 'totally let down by the system'.
A statement from Mrs Peacock said: “I am totally devastated by the loss of my daughter.
“She was the most loving, caring and genuine person you could meet.
“There are no winners here. I have lost my first-born child.
“I feel like throughout her life, the mental health system let her down. I hope and pray she is now at peace.”
The inquest heard that Ms Peacock had been staying with her friend, Chloe Forsyth, in Walney before she attended Furness General Hospital on October 30, 2021.
Ms Forsyth said she received a Whatsapp message in the early hours of the morning from Ms Peacock, saying she had phoned 101 and was going to the hospital.
The inquest heard statements from police officers who were called to an incident at Furness General Hospital.
It was reported that Ms Peacock was leaving A&E, stating she was going to kill herself.
PC Massey said he saw a female sat on the floor outside the entrance. He approached her and asked if she was ok.
Police became aware that Ms Peacock had taken a paracetamol overdose and tried to persuade her to go back into A&E. She became 'agitated'.
Ms Peacock was then detained under the mental health act and taken back to A&E. Medical staff decided it was in Ms Peacock’s best interests to sedate her to enable them to treat her for the paracetamol overdose.
Ms Peacock was given a canula in her arm but pulled it out so a second canula was given in her foot.
The inquest also heard statements from medical staff who treated Ms Peacock in A&E.
Ms Peacock was 'shouting and declining treatment'. She had taken paracetamol and the level was 'very high'.
The inquest heard that Ms Peacock 'did not have capacity' and a decision was made to insert a canula and 'the plan was to keep her sedated'. She was later transferred to the intensive care unit.
Ms Peacock went into cardiac arrest and CPR was carried out for over an hour until the decision was made to stop and she was pronounced dead.
The inquest heard a statement from Hollie Edmondson, who was Ms Peacock’s care co-ordinator at the NHS Trust responsible for her care.
Ms Edmondson said Ms Peacock was admitted to the Carleton Clinic in 2006 and then again in 2007 following reported threats of suicide.
She had numerous out of area admissions throughout her adult life and over 150 psychiatric admissions.
Ms Edmondson said the hospital admissions were 'counter-productive' and Ms Peacock was 'highly dependent' on services.
Ms Peacock had told her care co-ordinator that she didn’t feel safe unless she was in constant eyesight of a professional.
Her reliance on services began when she had attended hospital after becoming seriously unwell with meningitis while at school.
Another girl who contracted meningitis at the same time had passed away. Ms Peacock described how it was on the news and 'made her feel special'.
Ms Edmondson said that Ms Peacock 'didn’t have her own life outside the hospital walls.'
The inquest heard that Ms Peacock had been admitted to hospital 18 times in 2021.
On October 20, she had travelled to Newcastle 'to jump off a bridge'. She was taken to the RVI and was treated in the intensive care unit due to taking a paracetamol overdose.
A statement from Ms Peacock’s GP said she had a long history of self-harm and suicidal behaviour.
Dr Stuart Beatson, group medical director and consultant psychiatrist at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, told the inquest that Ms Peacock’s treatment was in accordance with NICE guidelines.
An investigation carried out by the NHS Trust found no causative issues to Ms Peacock’s death, but did find areas of future learning, including better involvement of carers.
A toxicology report revealed that the amount of paracetamol in Ms Peacock’s system was in the lethal range.
The medical cause of death was pulmonary thromboembolism, with obesity and paracetamol toxicity given as contributing factors.
In her concluding statement, coroner Kirsty Gomersal said Ms Peacock was cared for appropriately at Furness General Hospital and there was no evidence of any delays.
She said there were no findings that Ms Peacock intended to take her own life.
Ms Gomersal said Ms Peacock had multiple incidents of self-harm which she used as a chance to get access to face-to-face services.
The coroner gave a narrative conclusion and concluded that Ms Peacock’s death was due to natural causes contributed by a deliberate overdose of paracetamol, with no intention to take her own life.
When life is difficult, Samaritans are here – day or night, 365 days a year. You can call them for free on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.
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