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A young mum-of-three was discharged from hospital just hours before she suffered a cardiac arrest and died, an inquest heard.
Twenty-five-year-old Sian Hollands was taken to Darent Valley Hospital on Saturday, November 14 2015 following complaints of severe pain in her chest and stomach, breathing difficulties, and she was finding it hard to walk without stumbling.
The inquest at Gravesend Old Town Hall, which began this morning and is expected to run until the end of the week, has been told how Sian, of Priory Hill in Dartford, was discharged on the Sunday despite still being in pain.
She had begun feeling unwell just a few days prior, not long after she had been released from prison, where she had suffered an ectopic pregnancy, and expressed her determination to quit drugs and get her life back on track.
Mum Nicola Smith told the court this morning that her daughter was "in really good spirits" before becoming unwell, and that she was on a methadone programme.
However, Sian had not taken her pills for three days by the time she was taken to hospital and doctors put her symptoms down to that.
Sian had been reluctant to go to hospital, but was eventually persuaded by her mum and former partner Carl Alleyne, who was still a close friend and had been looking after her when the ambulance was called on the Saturday.
Initially he was told that an ambulance would not be sent out, but he called back on the advice of Mrs Smith and an ambulance came to take Sian to Darent Valley.
She spoke to her mum over the phone after her arrival to say that nurses were "being horrible" to her and that the hospital "wasn't doing anything" to help. While waiting for a bed she called to nurses: "Hello? Remember me?"
She was eventually given a bed, but Mrs Smith received a phone call from a nurse in the early hours of Sunday morning to say that Sian was threatening to discharge herself.
Her mum was able to persuade her to stay put and in the morning was told that Sian would be administered with her methadone before being discharged, despite Sian still feeling unwell.
Mr Alleyne went to the hospital on the Sunday and was with Sian from around midday onwards. He told the inquest that nurses had told him Sian was being sent home because "she was fine, her ECG was fine, and they needed the bed space".
The inquest later heard that the hospital's A&E department was extremely busy when Sian was admitted.
Mr Alleyne also reiterated to coroner Roger Hatch that nurses weren't treating Sian properly, claiming they and the doctors "didn't appreciate how unwell she was".
Sian was still struggling to walk and spent much of the afternoon in a wheelchair in a waiting room with Mr Alleyne, who continued to tell the agency nurse assigned to Sian that she wasn't fit to go home.
"Losing my daughter has been absolutely devastating to me, her family, and my grandchildren" Nicola Smith
He said: "I told them she's not fine, she's still in pain, and she's not breathing properly, but the nurses kept saying she was fine."
Sian did manage to unconvincingly stumble her way about a metre from her wheelchair into a seat, which Mr Alleyne said one of the nurses used as evidence that she was alright. She is reported to have said: "See, see, she can walk."
By late afternoon Sian had started to burn up and Mr Alleyne was told by hospital staff to fetch some ice from the on-site Costa Coffee. By the time he returned, Sian had been taken behind a curtain to a resuscitation room.
Mrs Smith had been called to the hospital by then and recalled in court seeing her daughter struggling on the hospital bed.
"Her whole body was shaking and I remember holding her hand and there was nothing I could do," she said.
"Then all of a sudden they got a pulse and the whole room cheered."
Mrs Smith was told that if Sian showed further signs of recovery they'd be able to move her to a different room for further treatment, but she suffered a blood clot in her heart and went into cardiac arrest.
She was pronounced dead at just before 10pm, which was 27 hours after first arriving for treatment.
Mrs Smith continued: "Losing my daughter has been absolutely devastating to me, her family, and my grandchildren. I have a seven-year-old granddaughter who can't function without her mum.
"She came from a good home with lots of support and we always supported her no matter what. Sian wasn't ashamed of what she used to be. She was in a good place and she was very positive.
"You don't expect a 25-year-old to go into hospital and not come out. Call it a mum's intuition but I just knew something wasn't right.
"I've had lots of meetings with Darent Valley Hospital. I need answers. I need closure."
The hospital have already admitted seven failings in their care of Sian and last year confirmed that changes had been made as a result of an internal investigation, but a spokesman said the cause of death and any relationship to prior events will not be made clear until the conclusion of the inquest.
The inquest continues tomorrow.