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We will miss Naomi endlessly, say family

Tributes were today being paid to a 'wonderful' teaching assistant from Wolverhampton who relatives said would be 'missed endlessly'.

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Relatives of Naomi Dawes-Dickson spoke of their love for the church-goer who they said was loved by all – after a doctor told an inquest that blood tests should have been taken from her on the day she went to hospital twice before her death.

Naomi Dawes-Dickson, who had worked at Eastfield Primary School in Wolverhampton, was sent home from New Cross Hospital's accident and emergency department on two occasions, but later died of an infection, an inquest has heard.

See also: Woman died after two visits to New Cross A&E

Black Country Coroner Robin Balmain said further tests were warranted on her second visit to hospital which may have identified the infection.

Mrs Dawes-Dickson's twin sister Ruth Dawes, aged 48, described her as 'my right hand, my best friend, she meant the world to me and everyone else'.

Mrs Dawes-Dickson's husband Everton Dickson of Willenhall Road, Wolverhampton said following the inquest: "She was such an asset to me and I will miss her endlessly."

Deteriorated

After her first visit to New Cross Hospital on October 2, 2011, Mrs Dawes-Dickson returned hours later when her condition deteriorated.

She was initially seen by a triage nurse and then junior doctor, Dr Maliha Chowdhury, but no blood tests were taken.

The hearing heard the doctor did not conduct blood tests or assess the level of Mrs Dawes Dickson's dehydration, and did not administer antibiotics. She gave her two litres of fluid, and the nurse discharged her.

Dr Chowdhury did not see her to assess whether the rehydration process had helped, but had authorised the discharge after seeing the nurse's notes

Mr Balmain asked: "Do you think you should have assessed the level of dehydration?"

She answered: "In retrospect, that was warranted. I went on what I could see in front of me in terms of dehydration."

She told the hearing: "At the time I didn't think she was ill enough to be admitted."

She said she had thought that due the vomiting and diarrhoea she needed fluid. The hearing heard the hospital has a policy that if a patient visits the accident emergency department on more than one occasion in a seven day period, they should be seen by a senior physician before they are discharged.

When asked about this Dr Chowdhury answered: "At that time I wasn't aware of the policy. I didn't think that she was ill enough to see someone more senior at that time."

The next day Mrs Dawes-Dickson was admitted to A&E again, before she was taken to intensive care and died.

A post mortem concluded organ failure which caused the cardiac arrest, due to the infection streptococcal septicemia.

Expert witness Dr Alistair Makin said the blood tests could have indicated there was an infection, which then would have been treated with antibiotics and investigated further.

Possible

But the inquest heard that it would not be possible to say whether the vomiting and diarrhoea were a symptom of the infection, or whether she had a viral gastroenteritis and then later contracted the infection. The hearing was told someone could succumb to streptococcal septicaemia within hours.

Senior coroner Robin Balmain recorded a verdict of natural causes. He said it was not justified to say that Mrs Dawes-Dickson's illness was due to the streptococcal infection, as it was not possible to say that she had the infection when she visited the hospital on the first two occasions.

He said: "Investigations were warranted on the second occasion (she visited hospital) but were not fully implemented.

It it is not possible to say whether she was suffering from the infection that led to her death."

Mrs Dawes-Dickson's sister Ruth added: "It's just not the same anymore.

"I expect to see her come bounding through the door with her beautiful smile, but that will never happen again."

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