A jury has found an RAF sergeant nurse was exposed to and infected with tuberculosis from a patient in hospital with the bacterial infection - but her illness was missed and treatment was "too late". Carrianne Franks was diagnosed with various other suspected illnesses, including pneumonia and Covid-19, and was only screened for TB, an aggressive form of the disease, before she died.
The tragic circumstances surrounding her death were heard at a jury inquest in Nottingham. A narrative conclusion was delivered by the jury on Friday (May 26).
They found the delay in diagnosis "probably more than minimally" contributed to her death from TB. The jury forewoman said: "On the balance of probabilities, opportunities to make an earlier diagnosis of pulmonary tuberculosis were missed".
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Assistant coroner Laurinda Bower flagged concerns at the end of the inquest - which she will raise with the National Institute of Clinical Excellence, NHS England and the UK Health Security Agency - hoping this will give the family comfort knowing there will be improved protection for health professionals.
Carrianne, 30, of Tuxford, worked for the RAF and, through the force, she volunteered to support the NHS. For 26 months, Carianne helped at various NHS wards and units across different organisations.
One of those positions was at the Chelsea and Westminster Hospital, where in November 2020 Carianne was working in the acute assessment unit. That same month a patient in the unit was confirmed to have TB and was moved into a side room.
Whilst Carrianne was not that patient’s main nurse, there was an overlap between her and the patient on two dates. After the patient's diagnosis, a "verbal risk assessment" found there was no breach of protocol, and consequently no screening of staff, or patient warn or inform letters sent out.
Carrianne did not recall, or receive, any documentation of a pulmonary tuberculosis case whilst working in the ward in Chelsea and Westminster Hospital, nor did the RAF. The jury forewoman said at the inquest: "It is uncertain whether Carrianne had any direct contact with Patient 1. However, it is likely that she would have come in contact on the ward".
"On the balance of probabilities, it is likely Carrianne contracted pulmonary tuberculosis whilst working at Chelsea and Westminster Hospital".
After the symptoms started on June 9, 2021, which she reported to the RAF GP via eConsult on July 1, 2021, her symptoms were a sore throat, developing into a cough, which became progressively worse. She was admitted to Lincoln County Hospital on July 14, 2021, where she remained for 28 days.
A&E doctors were treating her for pneumonia, most likely Covid-19. Despite negative Covid 19 tests, her treatment plan for Covid-19 continued, said the jury forewoman.
At no point during her time at Lincoln was a test for pulmonary tuberculosis requested or carried out. "Immeditely prior to transfer to ICU a sputum sample was taken, however, this was not tested for for TB," said the juror. "This was another missed opportunity".
Later, a review by a respiratory consultant, gave a disagnosis of Crytogenic Organising Pneumonia (COP) and treatment began. While the handwritten notes suggested TB testing, this was not carried out.
By August 12, 2021, she was declared medically fit for discharge. But three days later she was admitted to Bassetlaw General Hospital, Worksop, with her discharge summary from Lincoln and treated for a fungal infection.
A sputum sample was taken on August 26, 2021, and confirmed TB. But her condition started to decline rapidly due to overwhelming infection.
The following day she became very unstable and went into cardiac arrest later that evening. She died of pulmonary tuberculosis, caused by mycobacterium tuberculosis.
The antibiotic treatment was administered too late to treat the overwhelming infection, said the jury in their findings.
"There were a number of missed opportunities throughout Carrianne's care, both at Lincoln and Bassetlaw, to take sputum samples for the wide-ranging microbacterium test, when Carrianne was well enough to do so," their findings read. "On the balance of probabilities, opportunities to make an earlier diagnosis of pulmonary tuberculosis were missed".
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