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There were ‘failings’ before the death of a young mum who was found on the M20, an inquest has found.
Elle-Mae Wood was killed after being hit by a car on the coastbound carriageway of the motorway in Ashford.
Assistant Coroner Catherine Wood said there were failings on behalf of East Kent Hospitals Trust after the 20-year-old was deemed to have enough capacity to leave the William Harvey Hospital.
The inquest into her death finished today with the coroner reaching a narrative conclusion.
The court had heard previously how Ms Wood, of Elwick Road, Ashford, had been brought to the William Harvey Hospital by police in the early hours of June 14, 2020, in a confused state.
Officers had been informed by a concerned member of the public who stayed with the 20-year-old until she was picked up.
After taking her to the A&E department of the hospital, police then left her with the reception team and requested to be informed if she left.
The court heard that it was common practice for police to hand over to clinically-trained members of staff at the hospital, but there was nothing in terms of official policy at the time.
While waiting to be seen, Ms Wood left and came back several times, including on one occasion where a receptionist began to phone police but dropped the call when she walked back in.
She then went outside and approached a security guard to ask him to walk her home, as well as requesting a lift from an ambulance crew who were at the hospital.
Paramedic Inese Rozina told the court that she responded “we’re not a taxi service”, before becoming concerned for the young woman and alerting the reception desk to her condition.
“I told her about Elle-Mae and said that she was coming and wanted a lift,” she explained.
“Elle was not in a position to fully make any decisions with any insight into her condition..."
“I specifically said ‘I don’t think she’s safe to be left’, but then she came back in and sat down."
Finally, at 2.32am, she left for the final time, and walked down to Junction 10a of the M20, before walking on the entry ramp to the carriageway.
It was there that she was hit by a car driven by Csaba Sajtos, who was driving to catch an early train to Europe.
The Surrey man said in a statement that he did not realise he had hit a person.
The final day of the inquest centred around whether the 20-year-old, who had a young son Kian, now three, had sufficient capacity to be allowed to leave the hospital.
Making her findings, Mrs Wood said: “Elle was not in a position to fully make any decisions with any insight into her condition – at best her capacity fluctuated, but she was not in a position to make a fully informed decision on her safety.
“It would have been wise for a full capacity assessment to have been carried out; it was a failure not to conduct the assessment.
“An assertion was put forward that she appeared to be coherent and there was no indication to warrant that extra check, and that if she did then she could well have answered coherently anyway.
“However, on the evidence we’ve seen, she did warrant a further check, whether or not she would have answered questions to indicate capacity is irrelevant because we will never know.”
In an impact statement today, Ms Wood’s mother Carly Edwards alleged that her daughter had been let down, and that her death had been avoidable.
“When we received the news that Elle had been found dead, life as my family and I knew it stopped," she said.
“Elle was so let down on the last night of her life and for this my heart breaks every single time I think about how this was avoidable. Avoidable if people cared about others.
“Numerous professionals encountered Elle on the night of her death and each one had the capability to help her.
“The only slight saving grace or comfort that I can take from Elle’s death is that she is now at least free from anyone else being able to let her down, ever again.”
Representatives for East Kent Hospitals Trust – which runs the hospital – and Kent Police denied any negligence on their parts.
“When we received the news that Elle had been found dead, life as my family and I knew it stopped..."
Police representative Hannah Hinton said the force had acted “appropriately and as good samaritans” in picking Ms Wood up and taking her to hospital, and asking staff to call police if she left the premises.
She also said the force had shown “a great deal of willingness” to work with the trust to ensure understanding and communications with all cases in the future.
Trust representative Steven Hooper said the trust had enacted an action plan to address the issue of capacity checks.
He said: “It is clear in the action report that there have been significant learning processes arising from this case, and we have made enormous strides in addressing issues that have arisen.
“This includes a formal capacity check and the placement of clinically-trained members of staff at the front of the hospital, to ensure the right questions are being asked.”
The coroner made no official recommendations as part of her findings.
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