A former teacher who studied at a Liverpool university visited A&E 28 times in the six months before she died.
Kimberley Drinnan, 35, suffered liver failure after taking a "significant quantity" of over-the-counter painkillers in September 2019, an inquest heard. She died on September 30, 2019, three days after being admitted to hospital following an "intentional overdose".
Three years on from her death, an inquest was held on October 5 at Bolton Coroner's Court, Manchester Evening News reports. The hearing heard how in the six months prior to her death, she visited the hospital's A&E department 28 times.
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Kimberley's mum Kathleen Drinnan told the hearing of some "personal issues" her daughter was facing. Having grown up in Kearsley, Bolton, Kimberley went on to study Japanese at Liverpool John Moores University before moving to Japan to teach English. Living there for 10 years, the former teacher moved back to Bolton in 2017.
Kimberley’s care coordinator Philip Carroll made further reference to events in Japan, one of which involved an "altercation" in a bar, but he did not go into detail about the precise circumstances. He told the hearing Kimberley was "quite open" in making those reports in her time spent with the team.
Dr Ratnarajah, GP at Shanti Medical Centre, confirmed the 35-year-old had been diagnosed with borderline personality disorder and emotionally unstable personality disorder and she also had a history of self-harm. The hearing heard how Kimberley was alcohol dependent and was known to recovery services since January 2018, Natalie Derbyshire from Achieve confirmed.
As of August 2019, she was drinking one bottle of vodka per day, Dr Ratnarajah’s report said. Consultant psychiatrist Dr Sohi told the hearing: "Kim had reported quite a lot of traumas throughout her life and this led to a very shattered sense of who she was and where she belonged.
"There was a lot of self-deprecation, where her opinion of herself deserving good things was very low. Coupled with that was intelligence and dry wit, where she’d understand what course of treatment for her particular sets of difficulties was and what could and should be done in order to do that and the pitfalls of taking away her freedoms.
"What was really difficult for Kim was to reconcile what could be there and what she was actually going through. It was actually quite sad in a number of ways because she knew what had to be done and understood some of the acts that she did were in order to express her distress in terms of situations and get that comfort and care that she so desperately craved."
A report from consultant in emergency medicine Dr Damian Bates revealed that Kimberley had presented to Royal Bolton Hospital on 28 occasions in the final six months of her life, with the most frequent reason being "intoxication" and "overdose". Following this, she was referred to the safeguarding team 15 times and mental health services a further 10.
Siobhan Barlow, who was the manager of the Oak Ward during that time, said Kimberley was a "very intelligent woman" who understood her risk and felt "safe and supported" in the hospital environment. Ms Barlow said sometimes, Kimberley would rip alarms from the wall and pour milk on the ward in a bid to be kept there, rather than being sent home.
When asked why they would not keep Kimberley on the ward in these situations, Ms Barlow said that there is a "bigger picture", adding: "We don’t want to enforce these behaviours."
Dr Gareth Hughes, consultant in intensive care and respiratory medicine at Royal Bolton Hospital, confirmed that Kimberley was admitted to hospital on September 27, 2019 following an "intentional" overdose. She died three days later, at 6.17pm on September 30.
A post mortem carried out by pathologist Dr Patrick Waugh found that Kimberley died as a result of "fulminant liver failure, as a result of paracetamol overdose". Forensic toxicologist Julie Evans also confirmed that she had "excessive" amounts of paracetamol in her system, along with therapeutic levels a sedative that is often used to treat symptoms of alcohol withdrawal.
Following Kimberley’s death, external doctor David Chambers concluded there had been "no missed opportunities and nothing to consider that might have had a bearing on the outcome". Senior coroner Timothy Brennand commended Greater Manchester Mental Health Trust (GMMH) as he recorded a conclusion of "misadventure".
He added: "This was an unintended consequence of a deliberate act to self-medicate and a high risk strategy designed by her to get herself into hospital for the full cycle of care that she had received in the preceding months, on no fewer than 27 other occasions."
Addressing GMMH’s lawyer in court, he said: "Can I commend the Trust? It is important that the Trust understands that this court can occasionally be critical but it’s equally the case where best and good practice is demonstrated that the court says so and I do say so in this case."
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