1 00:00:06,600 --> 00:00:09,855 There are countless factors that can lead to your death. 2 00:00:09,880 --> 00:00:14,855 As Senior Coroner, I deal with almost 4,000 fatalities a year. 3 00:00:17,000 --> 00:00:21,015 Every single person in this mortuary that has died unnaturally 4 00:00:21,040 --> 00:00:23,695 is under the control of the coroner. 5 00:00:23,720 --> 00:00:26,535 LESLEY SHARP: The coroner can make any inquiries necessary 6 00:00:26,560 --> 00:00:29,135 to find a cause of death. 7 00:00:29,160 --> 00:00:32,495 As the police, if the coroner asks you to do something, you do it. 8 00:00:32,520 --> 00:00:37,055 With unprecedented access, we follow the full investigation 9 00:00:37,080 --> 00:00:39,255 into unexplained deaths... 10 00:00:39,280 --> 00:00:42,055 Forensic medicine is all about being very suspicious. 11 00:00:42,080 --> 00:00:45,415 ...from the moment of arrival in the mortuary, 12 00:00:45,440 --> 00:00:49,135 to the final conclusion of the inquest. 13 00:00:50,440 --> 00:00:51,615 All rise. 14 00:00:51,640 --> 00:00:54,495 I'm sorry that you're attending court under these circumstances, 15 00:00:54,520 --> 00:00:56,415 and I appreciate that the evidence 16 00:00:56,440 --> 00:00:58,255 that you will hear today may be distressing. 17 00:00:59,600 --> 00:01:01,775 It's tearing my family apart. 18 00:01:01,800 --> 00:01:05,975 I wanted to know what happened - why, how? All those answers. 19 00:01:06,000 --> 00:01:07,695 If you die here, 20 00:01:07,720 --> 00:01:11,335 if it's violent, unnatural, or of an unknown cause, 21 00:01:11,360 --> 00:01:13,135 it's my job to find out how. 22 00:02:06,400 --> 00:02:08,895 We kind of thought on the way there, 23 00:02:08,920 --> 00:02:12,295 maybe Mum was just sat at the side of the pool. Mm. 24 00:02:12,320 --> 00:02:14,775 She might have gone a bit light-headed or something like that. 25 00:02:17,080 --> 00:02:19,695 We didn't expect to be walking into what we walked into. 26 00:02:19,720 --> 00:02:23,895 Police, paramedics, first response, it was traumatic. 27 00:02:32,760 --> 00:02:36,095 Her heart had stopped. Obviously, in a bit of a state of shock, 28 00:02:36,120 --> 00:02:39,095 shouting to Mandy, you know, "Come on, Mandy, stay with us.” 29 00:02:42,240 --> 00:02:44,415 We were only in there seconds, and then police said, 30 00:02:44,440 --> 00:02:46,615 "Come on, you know, you don't need to be seeing this, 31 00:02:46,640 --> 00:02:48,295 "they need to work and do their job." 32 00:02:48,320 --> 00:02:50,415 We were clinging onto hope. 33 00:02:52,960 --> 00:02:57,455 Mandy Lewis' heart had stopped suddenly. 34 00:02:57,480 --> 00:03:00,375 The 52-year-old mother-of-two was transferred 35 00:03:00,400 --> 00:03:05,015 to Royal Blackburn Hospital's intensive care unit. 36 00:03:05,040 --> 00:03:09,335 Mandy had CPR for about 90 minutes in total, 37 00:03:09,360 --> 00:03:11,375 and her heart eventually started 38 00:03:11,400 --> 00:03:14,375 to pump blood independently without CPR. 39 00:03:16,960 --> 00:03:20,255 After Mandy's heart was beating by itself, 40 00:03:20,280 --> 00:03:24,255 a series of tests and investigations started. 41 00:03:24,280 --> 00:03:27,095 So she had a CT scan of her brain, 42 00:03:27,120 --> 00:03:30,495 she had a dye test looking at the arteries of her heart 43 00:03:30,520 --> 00:03:32,855 to see whether she'd had a heart attack. 44 00:03:32,880 --> 00:03:34,335 But the dye tests showed 45 00:03:34,360 --> 00:03:37,215 that all the arteries of the heart were completely unblocked. 46 00:03:37,240 --> 00:03:39,855 She then had a CT scan of her lungs 47 00:03:39,880 --> 00:03:41,775 to look to see whether she had a blood clot, 48 00:03:41,800 --> 00:03:43,655 which can sometimes cause a cardiac arrest, 49 00:03:43,680 --> 00:03:46,415 but there was no blockage to the blood flow to the lungs. 50 00:03:46,440 --> 00:03:49,375 So, at this point, there isn't a clear cause. 51 00:03:53,240 --> 00:03:56,055 CT scans showed early signs 52 00:03:56,080 --> 00:04:00,735 that Mandy's brain had been deprived of oxygen and blood flow. 53 00:04:03,760 --> 00:04:06,895 Had a conversation with Mandy's family and told them 54 00:04:06,920 --> 00:04:09,775 there's a higher likelihood that Mandy's not going to survive this, 55 00:04:09,800 --> 00:04:12,735 and this might be signs that her brain's under a lot of stress. 56 00:04:15,200 --> 00:04:17,335 Just spent the rest of the time with her. 57 00:04:17,360 --> 00:04:18,855 We even got to take the dog in. 58 00:04:20,360 --> 00:04:24,175 She went running in and jumped on my mum's bed. 59 00:04:24,200 --> 00:04:26,015 Sort of nuzzled her and licked her, 60 00:04:26,040 --> 00:04:28,135 and then just laid down quietly, didn't she? 61 00:04:30,920 --> 00:04:33,095 Whilst Mandy was in hospital, 62 00:04:33,120 --> 00:04:35,855 her mum flew back from her home in Gambia. 63 00:04:37,360 --> 00:04:39,335 I didn't pack a bag, nothing. 64 00:04:39,360 --> 00:04:41,975 I just picked my handbag up, boom, gone. 65 00:04:51,720 --> 00:04:55,655 When I finally got there, my God, when I walked in there, 66 00:04:55,680 --> 00:04:58,055 just grabbed her, you know? 67 00:04:59,280 --> 00:05:00,375 And, er... 68 00:05:01,920 --> 00:05:05,455 ...I'm talking to her, "Mandy, come on, wake up, wake up." 69 00:05:09,320 --> 00:05:11,855 Then we sat there for about an hour or so, 70 00:05:11,880 --> 00:05:14,855 and then doctor come, and everything, and said, 71 00:05:14,880 --> 00:05:16,495 "Very soon, we'll turn t'machine off." 72 00:05:16,520 --> 00:05:20,575 I said, "No, you're not. You can't turn the machine off." 73 00:05:20,600 --> 00:05:23,335 SHE SNIFFS, SOBS SOFTLY 74 00:05:23,360 --> 00:05:28,495 So... we kept on till about six o'clock. 75 00:05:29,760 --> 00:05:31,135 And then they said, 76 00:05:31,160 --> 00:05:35,295 "Look, to be fair, we need to turn it off." 77 00:05:37,760 --> 00:05:40,055 And then that were it. 78 00:05:43,600 --> 00:05:45,055 Sorry. 79 00:05:47,560 --> 00:05:49,295 It's difficult. 80 00:06:05,800 --> 00:06:09,335 We've had a referral from the medical examiner's office. 81 00:06:09,360 --> 00:06:14,375 They've had the death of Mandy Lewis, who's 52 years old. 82 00:06:14,400 --> 00:06:17,055 So, she was swimming in her local swimming baths with her friend, 83 00:06:17,080 --> 00:06:19,855 and she's suddenly become unwell, 84 00:06:19,880 --> 00:06:22,495 and she was taken to hospital. 85 00:06:22,520 --> 00:06:26,695 She remained in hospital in the ICU for two days, 86 00:06:26,720 --> 00:06:28,335 and she sadly passed away. 87 00:06:28,360 --> 00:06:31,055 This is an unexplained death. 88 00:06:31,080 --> 00:06:33,655 For me, looking at the information that I've got, 89 00:06:33,680 --> 00:06:35,695 it doesn't really make sense. 90 00:06:35,720 --> 00:06:39,455 She's medically fit, she's no medication, she's under 60, 91 00:06:39,480 --> 00:06:43,295 there isn't an obvious reason as to why she should just pass away. 92 00:06:43,320 --> 00:06:46,215 So I'm gonna run this by Dr Adeley, the senior coroner, 93 00:06:46,240 --> 00:06:47,535 and see what he thinks. 94 00:06:51,160 --> 00:06:53,855 She's no medical issues, nothing, 95 00:06:53,880 --> 00:06:56,895 so how can somebody like that just die? 96 00:06:56,920 --> 00:06:58,535 It doesn't really make sense. 97 00:07:01,600 --> 00:07:04,615 I just need to know what was the cause, what was the reason? 98 00:07:04,640 --> 00:07:06,055 We need answers. 99 00:07:21,200 --> 00:07:23,335 I'm coming to see Dr Adeley about Mandy. 100 00:07:23,360 --> 00:07:24,975 Due to the circumstances 101 00:07:25,000 --> 00:07:27,855 and this being a sudden unexpected death, 102 00:07:27,880 --> 00:07:30,335 I just want to go and have a conversation with him 103 00:07:30,360 --> 00:07:33,575 and give him all the information so that he can make 104 00:07:33,600 --> 00:07:36,015 any necessary decisions that need to be made. 105 00:07:53,600 --> 00:07:56,135 We first met when we were 11 years old at school. 106 00:07:56,160 --> 00:08:01,855 1991 is when we actually started dating... 107 00:08:03,840 --> 00:08:06,015 ...and never looked back. 108 00:08:08,920 --> 00:08:11,255 She was just a beautiful soul inside and out, you know, 109 00:08:11,280 --> 00:08:13,135 everybody thought the same. 110 00:08:13,160 --> 00:08:17,335 VICAR: Mandy Jane, will you take Richard Norwich to be your husband? 111 00:08:17,360 --> 00:08:18,535 I will. 112 00:08:20,520 --> 00:08:23,375 The day after we had to turn t'machines off, 113 00:08:23,400 --> 00:08:26,535 I actually went back to the baths, I didn't sleep, 114 00:08:26,560 --> 00:08:29,695 so I got up about half-four, and I went off on a six-mile walk 115 00:08:29,720 --> 00:08:31,295 that myself and Mandy used to do. 116 00:08:32,440 --> 00:08:34,855 Literally cried all the way there, cried all the way back, 117 00:08:34,880 --> 00:08:37,415 and I just thought, "I need to get down to the swimming baths." 118 00:08:37,440 --> 00:08:38,855 Just felt I needed to go there. 119 00:08:40,520 --> 00:08:43,295 I walked in in a complete mess. 120 00:08:43,320 --> 00:08:48,295 Within minutes, I just, phew, calmed right down and just felt... 121 00:08:48,320 --> 00:08:51,135 I don't know, just felt she were there. 122 00:08:51,160 --> 00:08:53,215 Like I was closer to her, 123 00:08:53,240 --> 00:08:56,415 cos that's where she passed, as far as I'm concerned. 124 00:08:59,280 --> 00:09:01,655 It definitely did me some good 125 00:09:01,680 --> 00:09:04,015 because I did feel some form of comfort from it. 126 00:09:16,000 --> 00:09:17,175 Hello, Becky, how are you? 127 00:09:17,200 --> 00:09:19,735 Hiya. I just wanted to run something by you. 128 00:09:19,760 --> 00:09:22,615 I've got a lady called Mandy Lewis, she's 52 years old, 129 00:09:22,640 --> 00:09:25,415 and she has suddenly passed away. 130 00:09:25,440 --> 00:09:28,015 She was swimming as usual with her friend 131 00:09:28,040 --> 00:09:29,615 at a local swimming baths, 132 00:09:29,640 --> 00:09:31,775 and she's become unresponsive. 133 00:09:31,800 --> 00:09:33,175 The paramedics attended, 134 00:09:33,200 --> 00:09:36,535 she was in ICU for approximately two days, 135 00:09:36,560 --> 00:09:39,615 and unfortunately, she passed away. OK. 136 00:09:39,640 --> 00:09:42,815 She hasn't got a significant medical history, 137 00:09:42,840 --> 00:09:46,135 she's very active, and she isn't on any medications. 138 00:09:46,160 --> 00:09:49,375 Now, the doctor at the hospital, they have actually offered 139 00:09:49,400 --> 00:09:53,055 a cause of death as sudden adult death syndrome. 140 00:09:53,080 --> 00:09:56,855 And the family had also highlighted to me that there is a history 141 00:09:56,880 --> 00:09:59,655 of sudden deaths in the family 142 00:09:59,680 --> 00:10:02,015 that they believe to be heart-related. 143 00:10:02,040 --> 00:10:06,055 OK. There are diseases that run in families 144 00:10:06,080 --> 00:10:09,455 for sudden adult death syndrome, and some of them are treatable, 145 00:10:09,480 --> 00:10:10,695 some of them aren't. 146 00:10:10,720 --> 00:10:14,615 So, this needs to have an invasive postmortem. 147 00:10:14,640 --> 00:10:17,775 Samples need to be sent to Professor Mary Sheppard 148 00:10:17,800 --> 00:10:21,335 in London for specialist cardio pathology. 149 00:10:21,360 --> 00:10:25,295 And we're also running a pilot with Manchester 150 00:10:25,320 --> 00:10:29,655 for genetic analysis, so we need a sample of spleen 151 00:10:29,680 --> 00:10:32,015 to go to them for analysis. 152 00:10:32,040 --> 00:10:34,495 So you require to get the consent for that, all right? 153 00:10:34,520 --> 00:10:36,295 OK. That's fine. 154 00:10:38,400 --> 00:10:40,575 LESLEY SHARP: Sudden adult death syndrome 155 00:10:40,600 --> 00:10:44,495 affects around 500 people in the UK every year. 156 00:10:44,520 --> 00:10:45,975 To investigate the possibility 157 00:10:46,000 --> 00:10:48,175 of Mandy having an inherited condition, 158 00:10:48,200 --> 00:10:51,495 she will be the first person from Lancashire to be referred 159 00:10:51,520 --> 00:10:53,535 for a pioneering genetics trial 160 00:10:53,560 --> 00:10:56,935 at the Manchester Centre for Genomic Medicine. 161 00:10:56,960 --> 00:11:02,055 Mandy Lewis is a lady who is very active, rides horses, 162 00:11:02,080 --> 00:11:04,855 swims three times a week. It's an unusual death. 163 00:11:05,960 --> 00:11:09,655 Sudden adult death syndrome is a diagnosis of exclusion, 164 00:11:09,680 --> 00:11:12,375 and what that means is you have looked for everything else, 165 00:11:12,400 --> 00:11:15,095 coronary artery disease or any other factors 166 00:11:15,120 --> 00:11:20,095 that might have caused the heart to malfunction electrically 167 00:11:20,120 --> 00:11:22,775 or stop beating, and you can't find anything. 168 00:11:24,520 --> 00:11:27,175 The difficulty with sudden adult death syndrome 169 00:11:27,200 --> 00:11:30,495 is that it may also affect close family members, 170 00:11:30,520 --> 00:11:33,815 and what we are trying to do is to get as much information 171 00:11:33,840 --> 00:11:37,615 to provide as much safety as we can for them. 172 00:11:37,640 --> 00:11:40,775 Both her grandads had heart attacks and died. 173 00:11:40,800 --> 00:11:43,735 I think one was in their 80s, the other one was in their 70s. 174 00:11:43,760 --> 00:11:48,815 But then, her cousin, which we now know was coronary artery. 175 00:11:48,840 --> 00:11:53,695 But then, her other cousin, I'm sure, was only about 32. 176 00:11:53,720 --> 00:11:56,775 You start thinking, well, there are signs, you know? 177 00:11:56,800 --> 00:11:59,255 Whether they're linked, who knows? 178 00:11:59,280 --> 00:12:00,975 Is it hereditary, is it something 179 00:12:01,000 --> 00:12:03,855 that the kids need to be tested for going forward? 180 00:12:03,880 --> 00:12:06,455 And we don't want it to happen to any other family, if we can. 181 00:12:06,480 --> 00:12:10,215 If one person survives from being checked and doing this pilot scheme, 182 00:12:10,240 --> 00:12:11,655 then it's worthwhile. 183 00:12:18,080 --> 00:12:19,535 That's it, itch him there, H. 184 00:12:19,560 --> 00:12:22,935 He absolutely loves a good itch. With your nails. 185 00:12:22,960 --> 00:12:24,575 It's his favourite. 186 00:12:27,120 --> 00:12:28,575 I got my first horse when I was 12, 187 00:12:28,600 --> 00:12:32,575 and then in the September of 2020, we got King. 188 00:12:32,600 --> 00:12:35,135 Mum found him, and because he were three, he wasn't broken. 189 00:12:35,160 --> 00:12:37,455 He were just in a field. 190 00:12:37,480 --> 00:12:40,455 He basically came over and rested his head on Annabel's shoulder. 191 00:12:40,480 --> 00:12:42,455 I just thought. "Yeah..." He's a softie. 192 00:12:42,480 --> 00:12:44,535 "..he's sort of chosen her.” 193 00:12:44,560 --> 00:12:48,335 Mum helped me brake him. So, like, you have to stand in the middle 194 00:12:48,360 --> 00:12:50,255 and lunge them and do a lot of groundwork. 195 00:12:50,280 --> 00:12:52,455 So, Mum would do that while I was riding. 196 00:12:52,480 --> 00:12:54,255 But I wouldn't have been able to do it without Mum 197 00:12:54,280 --> 00:12:55,695 cos she's had horses all her life. 198 00:12:57,880 --> 00:12:59,415 I ride him now and I think, 199 00:12:59,440 --> 00:13:01,695 "Well, this is something me and Mum have done." 200 00:13:01,720 --> 00:13:04,695 I've never really jumped any of my horses, 201 00:13:04,720 --> 00:13:06,455 I'm a bit of a wuss, 202 00:13:06,480 --> 00:13:09,495 but Mum were always like, "Go on, just give it a try, give it a try." 203 00:13:09,520 --> 00:13:12,255 Quite nice, really, cos we did the tiny, tiny jump, 204 00:13:12,280 --> 00:13:14,335 but Mum were able to see that. 205 00:13:14,360 --> 00:13:19,295 Cos we did that on the Sunday as Mum fell ill on the Thursday. 206 00:13:19,320 --> 00:13:23,495 So, it were quite nice that she saw just before she passed, 207 00:13:23,520 --> 00:13:25,535 she did see me, a tiny jump. 208 00:13:25,560 --> 00:13:30,255 So, I know Mum would be very proud if we carry on doing those. 209 00:13:34,440 --> 00:13:37,015 You're finding it tough, aren't you? Yeah. 210 00:13:37,040 --> 00:13:39,215 Yeah. Missing your mum, aren't you? 211 00:13:39,240 --> 00:13:40,735 Yeah. Yeah. 212 00:13:40,760 --> 00:13:44,895 Mum took good care of you, didn't she? Yeah. 213 00:13:46,760 --> 00:13:48,975 Now it's my job, innit? 214 00:13:49,000 --> 00:13:50,295 Yeah. Yeah? 215 00:13:50,320 --> 00:13:53,975 And we're soldiering on, aren't we? Yes. 216 00:13:55,560 --> 00:13:57,735 And you have your good days and your bad days. 217 00:13:57,760 --> 00:14:01,695 But having animals and kids keeps you going, doesn't it? 218 00:14:01,720 --> 00:14:03,095 WHISTLES 219 00:14:03,120 --> 00:14:04,375 And Mandy were a doer. 220 00:14:04,400 --> 00:14:06,615 She weren't one for wallowing around. 221 00:14:06,640 --> 00:14:08,895 It were, like, "Come on, let's get on, let's get on.” 222 00:14:08,920 --> 00:14:10,535 And that's what she'd want us to do - 223 00:14:10,560 --> 00:14:13,895 just get on and make her proud, so that's what we are doing. 224 00:14:23,080 --> 00:14:25,575 Sudden adult death syndrome is rare. 225 00:14:25,600 --> 00:14:28,895 To determine if Mandy has a genetic condition, 226 00:14:28,920 --> 00:14:31,455 she must undergo an invasive postmortem. 227 00:14:31,480 --> 00:14:33,615 Her heart will be taken for examination 228 00:14:33,640 --> 00:14:36,255 to a specialist in London, 229 00:14:36,280 --> 00:14:40,015 and her spleen sent to Manchester for DNA analysis. 230 00:14:44,680 --> 00:14:48,495 There's about 500 cases per year in the UK 231 00:14:48,520 --> 00:14:50,895 of youngish, healthy, previously quite fit people 232 00:14:50,920 --> 00:14:53,095 who just keel over and die, 233 00:14:53,120 --> 00:14:55,455 and there's no other cause identified. 234 00:14:57,080 --> 00:15:00,215 In cases where people die suddenly and unexpectedly 235 00:15:00,240 --> 00:15:02,855 and we think it might be a sudden cardiac death, 236 00:15:02,880 --> 00:15:06,375 then the heart's removed intact and sent to Professor Mary Sheppard. 237 00:15:06,400 --> 00:15:09,215 She works at St George's Hospital, London. 238 00:15:09,240 --> 00:15:11,575 We will also be sending some tissue off 239 00:15:11,600 --> 00:15:15,015 to Manchester for genetic testing. 240 00:15:15,040 --> 00:15:17,175 It's thought that there is a genetic cause 241 00:15:17,200 --> 00:15:19,575 in quite a lot of these cases. 242 00:15:19,600 --> 00:15:22,175 I think we're done anyway, aren't we? We are, yeah. 243 00:15:24,200 --> 00:15:28,055 The testing is key in this. If there's only 500 cases like this 244 00:15:28,080 --> 00:15:33,095 in the UK every year, then a pathologist like me 245 00:15:33,120 --> 00:15:34,815 working in a district general hospital 246 00:15:34,840 --> 00:15:36,655 might only see one or two cases a year. 247 00:15:36,680 --> 00:15:40,895 That's no way to get any expertise in a specialised subject. 248 00:15:40,920 --> 00:15:46,055 This is why cases like this now are centralised 249 00:15:46,080 --> 00:15:49,135 and sent to expert centres. 250 00:15:49,160 --> 00:15:51,455 We need to sort out exactly what this lady's died from, 251 00:15:51,480 --> 00:15:53,695 because we don't know at this moment in time 252 00:15:53,720 --> 00:15:56,215 exactly what's happened to her. 253 00:16:04,040 --> 00:16:08,055 At Royal Preston Hospital in the Coroner's Office, 254 00:16:08,080 --> 00:16:09,735 Alice is dealing with a new case 255 00:16:09,760 --> 00:16:12,135 that's very close to home for the team. 256 00:16:12,160 --> 00:16:14,615 So, we received a referral from St Catherine's Hospice 257 00:16:14,640 --> 00:16:17,975 in relation to a lady called Irene Wright. 258 00:16:18,000 --> 00:16:20,775 Irene was a police officer for 30-plus years. 259 00:16:20,800 --> 00:16:23,295 But for the last ten years of her service, 260 00:16:23,320 --> 00:16:24,935 she was a coroner's officer here 261 00:16:24,960 --> 00:16:26,815 at Royal Preston Hospital in this office. 262 00:16:26,840 --> 00:16:30,015 This job is difficult dealing with death every day 263 00:16:30,040 --> 00:16:31,855 and dealing with bereaved families, 264 00:16:31,880 --> 00:16:33,295 but it becomes more difficult 265 00:16:33,320 --> 00:16:36,095 when it's somebody that you know and that you've worked closely with, 266 00:16:36,120 --> 00:16:38,375 and you have that personal relationship with that person. 267 00:16:42,920 --> 00:16:46,055 Dealing with Irene is different. 268 00:16:46,080 --> 00:16:50,775 Irene comes with memories, with feelings. 269 00:16:50,800 --> 00:16:53,615 This is one of ours. 270 00:16:53,640 --> 00:16:55,055 It's a personal death. 271 00:16:58,080 --> 00:17:02,855 Irene was one of the first two coroner's officers I recruited. 272 00:17:02,880 --> 00:17:06,095 She was a comms officer, she was brilliant to talk to, 273 00:17:06,120 --> 00:17:07,615 she was great with families. 274 00:17:07,640 --> 00:17:09,615 Hi, Justine. 275 00:17:09,640 --> 00:17:11,855 Hey. Can I speak to you about Irene? 276 00:17:11,880 --> 00:17:13,535 Yeah. OK. 277 00:17:13,560 --> 00:17:17,895 Between her and Justine, they basically wrote the book 278 00:17:17,920 --> 00:17:19,535 on how to do the job. 279 00:17:19,560 --> 00:17:23,295 They invented it from scratch, and they became superb. 280 00:17:24,520 --> 00:17:25,895 Living in the location, 281 00:17:25,920 --> 00:17:28,335 you obviously deal with a lot of people that you do know. 282 00:17:28,360 --> 00:17:31,455 I know when I lost my mum, I worked with Irene at the time, 283 00:17:31,480 --> 00:17:34,935 and she was a brick. And now she's passed, it's just... 284 00:17:34,960 --> 00:17:39,135 I think because she was known to a lot of people here. 285 00:17:39,160 --> 00:17:41,735 I know Dr Adeley's upset about it. 286 00:17:41,760 --> 00:17:46,055 And it's just difficult to deal with when it's somebody you know, 287 00:17:46,080 --> 00:17:47,855 somebody who you was close with 288 00:17:47,880 --> 00:17:51,215 and worked very closely with for ten years. 289 00:18:00,760 --> 00:18:02,935 We need to go and have a drink and raise a glass. 290 00:18:02,960 --> 00:18:04,695 Yeah, definitely. Definitely. 291 00:18:04,720 --> 00:18:06,335 We'll have a few. we will. 292 00:18:06,360 --> 00:18:07,735 Cocktail, though, 293 00:18:07,760 --> 00:18:10,335 cos we had some amazing cocktail afternoons with Irene. 294 00:18:10,360 --> 00:18:13,255 We did. Good times, good memories. They are. 295 00:18:23,240 --> 00:18:26,175 Irene first became ill six months ago. 296 00:18:28,840 --> 00:18:32,055 Last summer, she said she felt like she wasn't herself. 297 00:18:32,080 --> 00:18:34,255 There was something not right with her head, 298 00:18:34,280 --> 00:18:39,375 like really lethargic and not feeling well at all, 299 00:18:39,400 --> 00:18:41,375 so she went to the GP. 300 00:18:41,400 --> 00:18:44,655 They referred her to the ENT department, 301 00:18:44,680 --> 00:18:47,135 because she'd been having this sort of whooshing sound 302 00:18:47,160 --> 00:18:51,015 in her ears, so they said, "We'll do an MRI scan.” 303 00:18:51,040 --> 00:18:55,255 Then she went back for the results of that scan, 304 00:18:55,280 --> 00:18:59,815 and she came back here and said, "It's not good.” 305 00:18:59,840 --> 00:19:02,935 And I said, "What do you mean?" "They think I've got a glioma.” 306 00:19:02,960 --> 00:19:05,655 And I said, "well, what's a glioma?" She said, "It's a tumour.” 307 00:19:05,680 --> 00:19:07,775 And that's when my stomach just went woof. 308 00:19:09,560 --> 00:19:12,455 Irene's glioma was in her brain. 309 00:19:12,480 --> 00:19:15,815 To find out if this tumour was benign or cancerous, 310 00:19:15,840 --> 00:19:19,815 a biopsy was arranged by a consultant neurosurgeon. 311 00:19:19,840 --> 00:19:22,895 This brain tumour exists in three different places. 312 00:19:22,920 --> 00:19:26,735 The back, the middle and what we call the insula. 313 00:19:26,760 --> 00:19:30,295 These front two locations 314 00:19:30,320 --> 00:19:34,815 are in critical brain areas where any complications 315 00:19:34,840 --> 00:19:37,015 or any attempts to do a biopsy 316 00:19:37,040 --> 00:19:40,975 can be met with severe risks and consequences. 317 00:19:41,000 --> 00:19:43,495 And therefore, we chose to take a biopsy 318 00:19:43,520 --> 00:19:47,175 from the posterior part of the brain. 319 00:19:47,200 --> 00:19:50,055 When Irene managed to go home successfully, 320 00:19:50,080 --> 00:19:53,335 we were all satisfied. 321 00:19:53,360 --> 00:19:57,015 She came out on Good Friday, and she'd done really well, 322 00:19:57,040 --> 00:19:59,495 she was really upbeat. 323 00:19:59,520 --> 00:20:01,975 But then on the Wednesday, she was sitting on the side 324 00:20:02,000 --> 00:20:03,895 of the bed and she was holding her head. 325 00:20:05,520 --> 00:20:09,455 I said, "What's up?" She said, "My head, it's just unbearable.” 326 00:20:23,720 --> 00:20:25,095 DOOR BUZZER 327 00:20:26,360 --> 00:20:29,135 Hello? Hi. I let you in. 328 00:20:30,680 --> 00:20:32,015 Hello. Hiya. 329 00:20:32,040 --> 00:20:33,175 Are you OK? 330 00:20:33,200 --> 00:20:35,095 LESLEY SHARP: The coroner is investigating 331 00:20:35,120 --> 00:20:38,575 the unexplained death of 52-year-old Mandy Lewis, 332 00:20:38,600 --> 00:20:42,455 whose heart suddenly stopped whilst at her local swimming pool. 333 00:20:42,480 --> 00:20:45,495 Mandy is the first person from Lancashire 334 00:20:45,520 --> 00:20:47,495 to be referred for a trial scheme 335 00:20:47,520 --> 00:20:50,415 which will look for any genetic faults in her DNA. 336 00:20:51,840 --> 00:20:54,255 The cause of death at this time is unknown, 337 00:20:54,280 --> 00:20:57,615 but the cause of death is important both for Mandy 338 00:20:57,640 --> 00:21:01,495 and also for her family, who may have a genetic component 339 00:21:01,520 --> 00:21:03,895 and may be at risk of this disease. 340 00:21:03,920 --> 00:21:09,415 The cause of death provides a way of detecting these conditions 341 00:21:09,440 --> 00:21:12,095 and possibly assisting other family members 342 00:21:12,120 --> 00:21:13,815 that they don't suffer the same fate. 343 00:21:22,920 --> 00:21:27,415 Mandy Lewis's heart has also been sent to cardiac specialists 344 00:21:27,440 --> 00:21:29,695 at St George's University of London. 345 00:21:29,720 --> 00:21:32,055 The research centre currently holds data 346 00:21:32,080 --> 00:21:36,255 for over 8,500 hearts from across the UK. 347 00:21:36,280 --> 00:21:38,855 So, this is a 52-year-old female. 348 00:21:38,880 --> 00:21:43,335 They've got no medical history, and she was not on any medication. 349 00:21:43,360 --> 00:21:47,335 The heart weighs 416 grams, 350 00:21:47,360 --> 00:21:50,735 so we would consider this a normal heart weight in a female. 351 00:21:50,760 --> 00:21:53,855 Our heart beats 70 times a minute 352 00:21:53,880 --> 00:21:56,055 for an average of 70 years of our life. 353 00:21:56,080 --> 00:21:59,655 That electrical activity has to be very tightly controlled, 354 00:21:59,680 --> 00:22:02,735 and if it goes wrong, it results in the heart stopping, 355 00:22:02,760 --> 00:22:04,895 as tragically happened in this case. 356 00:22:06,320 --> 00:22:10,735 In addition to the investigations carried out on Mandy's heart 357 00:22:10,760 --> 00:22:13,095 when she was admitted to hospital, 358 00:22:13,120 --> 00:22:15,935 Mary Sheppard's team will conduct a full examination. 359 00:22:18,280 --> 00:22:22,415 So far, the coronary arteries are very clean. 360 00:22:23,560 --> 00:22:26,775 At this point, I'm going to examine the upper chambers of the heart, 361 00:22:26,800 --> 00:22:31,255 and I'm looking to see whether there might be any blood clots 362 00:22:31,280 --> 00:22:32,815 or anything along those lines. 363 00:22:33,960 --> 00:22:36,935 And we consider this to be a normal heart. 364 00:22:39,120 --> 00:22:42,375 It's not a classic example 365 00:22:42,400 --> 00:22:44,495 of any particular condition we're aware of. 366 00:22:46,840 --> 00:22:52,095 We'll wait for the histology with a microscopic detailed examination, 367 00:22:52,120 --> 00:22:56,855 which, hopefully, will help us to get a specific diagnosis. 368 00:22:56,880 --> 00:23:00,935 We want to rule out any other possible conditions 369 00:23:00,960 --> 00:23:03,375 that could have resulted in this lady dying 370 00:23:03,400 --> 00:23:05,615 before we make a diagnosis of something 371 00:23:05,640 --> 00:23:07,535 that potentially may be genetic. 372 00:23:09,280 --> 00:23:11,695 Along with Mary Sheppard's assessment, 373 00:23:11,720 --> 00:23:14,855 the DNA taken from Mandy's spleen 374 00:23:14,880 --> 00:23:17,055 will undergo analysis in Manchester 375 00:23:17,080 --> 00:23:19,935 to look for any genetic abnormalities. 376 00:23:21,840 --> 00:23:24,375 From the dead, we learn about the living. 377 00:23:24,400 --> 00:23:27,135 You have to determine the cause of death, 378 00:23:27,160 --> 00:23:30,455 if we don't know the causes, how can we cure them? 379 00:23:33,640 --> 00:23:37,015 We will hope that a diagnosis will be made 380 00:23:37,040 --> 00:23:41,535 which will save other direct members of Mandy's family 381 00:23:41,560 --> 00:23:43,855 from getting a sudden cardiac death. 382 00:23:44,960 --> 00:23:47,695 I do want to get the answers because I want to get to the bottom 383 00:23:47,720 --> 00:23:50,935 of it for all the family, for the grandchildren 384 00:23:50,960 --> 00:23:53,055 and my nieces and nephews. 385 00:24:03,680 --> 00:24:06,855 I'm hoping that they don't find anything with any of us, 386 00:24:06,880 --> 00:24:09,695 but I think it's a good thing that it should be done. 387 00:24:12,760 --> 00:24:15,775 You know, why does it happen to somebody that's a nice person 388 00:24:15,800 --> 00:24:17,375 that loved everybody? 389 00:24:17,400 --> 00:24:20,615 We enjoyed life together, right up to the very end. 390 00:24:20,640 --> 00:24:22,535 We spoke every day. 391 00:24:22,560 --> 00:24:25,295 She were brilliant, fantastic sister. 392 00:24:28,040 --> 00:24:29,815 I just try and get on with my day... 393 00:24:31,640 --> 00:24:34,495 ...best I can. Keep busy. 394 00:24:36,960 --> 00:24:41,975 Yeah. I think about her every day. I do. 395 00:25:03,560 --> 00:25:06,415 That was at Giant's Causeway. Yeah. 396 00:25:06,440 --> 00:25:09,335 And then that big trek back up the hill. 397 00:25:10,520 --> 00:25:12,935 And this was her birthday last year. 398 00:25:12,960 --> 00:25:15,375 I remember she said she liked it. Mm-hm. Yeah. 399 00:25:15,400 --> 00:25:16,455 Yeah, it was good. 400 00:25:18,040 --> 00:25:23,215 Friendship and family were two very important things for her. 401 00:25:23,240 --> 00:25:24,495 It's black or white. Yeah. 402 00:25:24,520 --> 00:25:26,495 "You're my friend, you're my family." 403 00:25:26,520 --> 00:25:29,455 If she was your friend, then you were very, very lucky. 404 00:25:31,680 --> 00:25:35,655 It didn't matter where I was, she was there. 405 00:25:38,360 --> 00:25:41,055 That was at a Valentine's dinner dance. 406 00:25:41,080 --> 00:25:45,655 Oh, right, and that was the top she said she was going to bin. 407 00:25:45,680 --> 00:25:48,415 All the sequins fall off it. Yeah. 408 00:25:48,440 --> 00:25:50,815 She loses more and more every time she wore it. 409 00:25:50,840 --> 00:25:52,175 THEY CHUCKLE Yeah. 410 00:25:54,320 --> 00:25:58,295 When her and Justine started work for Dr Adeley, 411 00:25:58,320 --> 00:26:00,495 the pair of them said, 412 00:26:00,520 --> 00:26:04,095 "I didn't know you could die from so many ways", you know? 413 00:26:04,120 --> 00:26:07,255 But I think that in the end, the fact that she did know... 414 00:26:08,640 --> 00:26:13,415 ...all the ways that you can die and the way it affects people, 415 00:26:13,440 --> 00:26:16,615 not only how you die, 416 00:26:16,640 --> 00:26:20,855 but what happens to your body leading up to it. 417 00:26:20,880 --> 00:26:23,375 I think that was what she was afraid of. 418 00:26:26,360 --> 00:26:29,415 Irene had been diagnosed with a brain tumour 419 00:26:29,440 --> 00:26:32,775 and had a biopsy to determine if it was cancerous. 420 00:26:32,800 --> 00:26:36,935 She was terribly stressed after she was told that it was a tumour. 421 00:26:38,640 --> 00:26:40,735 She said, "I don't wanna die." 422 00:26:42,400 --> 00:26:44,575 She'd seen so many deaths. 423 00:26:44,600 --> 00:26:47,855 The files come across her desk, she'd work with the families, 424 00:26:47,880 --> 00:26:51,495 she'd learn the history of the person, knew what had gone on, 425 00:26:51,520 --> 00:26:54,815 and also, I think, knowing what's coming. 426 00:26:57,920 --> 00:27:00,255 She was just terrified, absolutely terrified. 427 00:27:00,280 --> 00:27:03,575 Ands that's when she came out with a Zimmer frame. 428 00:27:03,600 --> 00:27:05,615 You wouldn't think it was the same person. 429 00:27:05,640 --> 00:27:09,495 Gosh, the difference. I know. Yeah. Bless her. 430 00:27:09,520 --> 00:27:12,695 She said, "If it was anywhere else in my body, I would be able to cope, 431 00:27:12,720 --> 00:27:17,335 "the fact that it's in my brain is harrowing."” 432 00:27:21,960 --> 00:27:24,215 Irene started to have hearing problems, 433 00:27:24,240 --> 00:27:25,935 and went to see her GP 434 00:27:25,960 --> 00:27:29,375 who referred her for a scan, which diagnosed a tumour. 435 00:27:29,400 --> 00:27:33,975 And to see what type of tumour it is, they needed to do a biopsy. 436 00:27:34,000 --> 00:27:37,175 Now, the biopsy was straightforward, 437 00:27:37,200 --> 00:27:40,415 but there was unfortunately, complications from surgery. 438 00:27:41,680 --> 00:27:44,455 Three weeks after Irene's biopsy, 439 00:27:44,480 --> 00:27:47,815 she became unconscious and was rushed back to hospital. 440 00:27:49,080 --> 00:27:53,055 A repeat scan shows that the whole side of the brain 441 00:27:53,080 --> 00:27:55,255 had swollen up including the tumour, 442 00:27:55,280 --> 00:27:57,495 and that is generally quite bad news. 443 00:27:57,520 --> 00:28:02,055 Irene had suffered a sudden increase in the pressure inside her skull, 444 00:28:02,080 --> 00:28:05,015 which had caused her to lose consciousness. 445 00:28:05,040 --> 00:28:07,855 She had a CT scan of her brain, which showed 446 00:28:07,880 --> 00:28:11,095 that there was a large amount of swelling and increased pressure, 447 00:28:11,120 --> 00:28:13,415 and she had a decompressive craniectomy, 448 00:28:13,440 --> 00:28:15,895 and that's where the side of the skull is removed 449 00:28:15,920 --> 00:28:18,095 to allow the brain to swell and reduce the pressure 450 00:28:18,120 --> 00:28:20,135 inside the skull itself. 451 00:28:20,160 --> 00:28:22,735 After that, she was admitted to the intensive care unit. 452 00:28:26,360 --> 00:28:30,255 We managed to rush through the tumour processing, 453 00:28:30,280 --> 00:28:32,935 and it unfortunately came back 454 00:28:32,960 --> 00:28:36,095 as a malignant cancerous brain tumour called a glioblastoma. 455 00:28:39,760 --> 00:28:44,015 Despite our best attempts, including surgical means, 456 00:28:44,040 --> 00:28:47,015 medical means, and keeping her asleep, 457 00:28:47,040 --> 00:28:49,615 we weren't able to keep the pressure low enough 458 00:28:49,640 --> 00:28:51,335 for the brain to be happy. 459 00:28:54,680 --> 00:28:58,175 The brain is a unique organ, it's who we are, 460 00:28:58,200 --> 00:29:02,015 it defines what we do, and when that no longer works, 461 00:29:02,040 --> 00:29:03,815 the person is no longer there. 462 00:29:03,840 --> 00:29:05,495 And the family understood, 463 00:29:05,520 --> 00:29:09,055 and they agreed to make Irene comfortable. 464 00:29:11,440 --> 00:29:14,415 Irene was transferred to St Catherine's Hospice 465 00:29:14,440 --> 00:29:16,375 for end of life care. 466 00:29:16,400 --> 00:29:20,455 She sadly passed away ten days later. 467 00:29:20,480 --> 00:29:22,655 Best thing for her was to withdraw treatment. 468 00:29:23,880 --> 00:29:27,815 And... let her die with dignity. 469 00:29:33,400 --> 00:29:37,135 You know, they took her off the ventilator, and thankfully, 470 00:29:37,160 --> 00:29:39,415 she didn't regain consciousness. 471 00:29:42,880 --> 00:29:45,895 It's so much better than watching her die 472 00:29:45,920 --> 00:29:49,015 from the usual course of a glioblastoma. 473 00:29:49,040 --> 00:29:54,295 Possibly the personality changes, the loss of physical function, 474 00:29:54,320 --> 00:29:57,095 she would have hated it. 475 00:29:57,120 --> 00:29:59,895 She would have absolutely hated it. 476 00:29:59,920 --> 00:30:03,775 So, yeah, I'm thankful that... 477 00:30:03,800 --> 00:30:06,055 that's... that's gone. 478 00:30:07,760 --> 00:30:12,455 It's a shock for everybody that knew her, you know? 479 00:30:12,480 --> 00:30:16,055 Cos we've got to get used to her not being here, 480 00:30:16,080 --> 00:30:20,215 and she was such a huge part of so many people's lives. 481 00:30:21,960 --> 00:30:24,975 She was a very kind person, and very generous. 482 00:30:25,000 --> 00:30:27,695 She'd do anything for anybody. 483 00:30:27,720 --> 00:30:31,255 She was brilliant. She really was. 484 00:30:43,200 --> 00:30:47,175 The results from Mandy Lewis' heart examination in London 485 00:30:47,200 --> 00:30:49,535 have been sent to the coroner. 486 00:30:49,560 --> 00:30:54,215 Professor Sheppard says that Mandy Lewis' heart is normal. 487 00:30:54,240 --> 00:30:56,415 But she goes on to say 488 00:30:56,440 --> 00:30:58,615 that there are a number of other conditions 489 00:30:58,640 --> 00:31:02,495 that you need to screen the family for in life, 490 00:31:02,520 --> 00:31:04,495 to detect these conditions, 491 00:31:04,520 --> 00:31:07,895 which would assist in determining Mandy's cause of death. 492 00:31:07,920 --> 00:31:09,935 Until we have all the pieces, 493 00:31:09,960 --> 00:31:11,895 we can't give the family the answers they need. 494 00:31:18,480 --> 00:31:22,175 'I'm a little bit gutted that Mary Sheppard didn't find anything. 495 00:31:22,200 --> 00:31:25,455 '| was hoping for an answer.' 496 00:31:25,480 --> 00:31:27,655 We do need to find out what's happened 497 00:31:27,680 --> 00:31:29,935 cos I wouldn't want it happening to my brother 498 00:31:29,960 --> 00:31:31,735 or any other family member, or even myself, 499 00:31:31,760 --> 00:31:33,855 cos it's just not nice on people that you leave behind. 500 00:31:36,120 --> 00:31:39,015 It's over there, look, where your mum is. 501 00:31:39,040 --> 00:31:41,815 Can you see the picture? Yeah. Yeah. 502 00:31:44,360 --> 00:31:46,655 So, this is gonna get put on the network. 503 00:31:46,680 --> 00:31:51,215 We're gonna get a plaque made for underneath here in memory of Mandy. 504 00:31:52,880 --> 00:31:55,215 And the thing is with here is, 505 00:31:55,240 --> 00:31:56,975 it's quite a big show centre - 506 00:31:57,000 --> 00:32:01,055 some weekends, there might be 150, 200 horses come. 507 00:32:01,080 --> 00:32:03,775 So there's a lot of people around. So, you never know, 508 00:32:03,800 --> 00:32:06,815 at some point, it might be needed. 509 00:32:09,360 --> 00:32:14,135 With what happened with Mandy having a cardiac arrest, 510 00:32:14,160 --> 00:32:17,055 this could be here to save somebody's life. 511 00:32:17,080 --> 00:32:18,375 You know, you just never know. 512 00:32:20,080 --> 00:32:23,295 We chose here cos it's close to the family's heart, 513 00:32:23,320 --> 00:32:25,855 and it's in memory of Mandy. 514 00:32:38,880 --> 00:32:43,735 With examinations of Mandy's heart revealing no abnormalities, 515 00:32:43,760 --> 00:32:46,175 the family now hope the genetic tests 516 00:32:46,200 --> 00:32:50,175 at St Mary's Hospital will give them the answers they're looking for. 517 00:32:50,200 --> 00:32:54,495 Today is a joint consultation, so we'll sort of talk about 518 00:32:54,520 --> 00:32:57,135 the genetics side of the appointment 519 00:32:57,160 --> 00:33:00,895 and the cardiac assessment side of what we can offer you guys. 520 00:33:00,920 --> 00:33:04,215 If we know that someone has this increased risk, 521 00:33:04,240 --> 00:33:09,015 there is management and treatment to keep people safe and lower the risk. 522 00:33:09,040 --> 00:33:13,815 Whilst the lab analyses Mandy's DNA for any genetic defects, 523 00:33:13,840 --> 00:33:18,855 the family undergoes ECG tests and ultrasound scans 524 00:33:18,880 --> 00:33:21,735 to look for any cardiac abnormalities. 525 00:33:21,760 --> 00:33:24,695 I need you to turn on your side facing that way. OK? 526 00:33:24,720 --> 00:33:27,135 Bit of cold jelly on your chest now. 527 00:33:31,960 --> 00:33:33,775 That's your heart there. How weird. 528 00:33:35,280 --> 00:33:38,455 So, I'm basically just looking at the structure of your heart, 529 00:33:38,480 --> 00:33:40,815 make sure everything is working as it should. 530 00:33:40,840 --> 00:33:44,455 Doing all this is helping me personally 531 00:33:44,480 --> 00:33:47,335 with my grieving process - it still hasn't sunk in with me. 532 00:33:49,000 --> 00:33:51,655 It's comforting that something's being done, 533 00:33:51,680 --> 00:33:53,695 and I just hope it's not hereditary 534 00:33:53,720 --> 00:33:56,255 and it's not been passed down the genes. 535 00:33:56,280 --> 00:33:57,935 That's what I'm hoping for as a father, 536 00:33:57,960 --> 00:34:00,775 that's probably the best outcome of a sad situation. 537 00:34:04,360 --> 00:34:07,615 It's four months since the sudden death 538 00:34:07,640 --> 00:34:10,095 of 52-year-old Mandy Lewis. 539 00:34:10,120 --> 00:34:12,695 Her family are receiving the results 540 00:34:12,720 --> 00:34:15,575 of the DNA analysis of Mandy's spleen 541 00:34:15,600 --> 00:34:17,015 to discover whether 542 00:34:17,040 --> 00:34:19,215 there is a hereditary condition in the family. 543 00:34:20,720 --> 00:34:22,535 PHONE RINGS 544 00:34:22,560 --> 00:34:23,815 Hello. 545 00:34:23,840 --> 00:34:25,615 Hi, it's Kim Clarke phoning 546 00:34:25,640 --> 00:34:28,975 from Manchester Centre for Genomic Medicine. How are you? 547 00:34:29,000 --> 00:34:31,255 'I'm all right, Kim." OK, so... 548 00:34:31,280 --> 00:34:34,535 Richard, we didn't identify any changes 549 00:34:34,560 --> 00:34:38,095 within any of Mandy's genes analysis that would account for why 550 00:34:38,120 --> 00:34:40,335 she passed away suddenly and unexpectedly. 551 00:34:40,360 --> 00:34:41,815 Right, OK. 552 00:34:41,840 --> 00:34:44,815 'OK? So, we didn't identify an underlying 553 00:34:44,840 --> 00:34:47,415 'inherited cardiac condition.' 554 00:34:47,440 --> 00:34:49,855 Right. Right. 'OK.' 555 00:34:49,880 --> 00:34:52,895 So what this means is there isn't any further genetic testing 556 00:34:52,920 --> 00:34:57,855 we can offer to the kids or to Mandy's mum or sister. 557 00:34:57,880 --> 00:34:59,775 Yeah, yeah. 'OK?" Yeah. 558 00:34:59,800 --> 00:35:02,535 'Because we haven't identified an underlying genetic cause.' 559 00:35:02,560 --> 00:35:05,575 That's ultimately the outcome I was hoping for, 560 00:35:05,600 --> 00:35:07,815 and I think the family were. 561 00:35:07,840 --> 00:35:10,615 Although we haven't identified an underlying genetic cause, 562 00:35:10,640 --> 00:35:14,455 it doesn't exclude it - there is still a small chance 563 00:35:14,480 --> 00:35:16,735 there is an inherited cardiac condition. 564 00:35:16,760 --> 00:35:19,215 Hopefully, everybody's fit and well, and... 'Yeah.' 565 00:35:19,240 --> 00:35:22,415 ...ultimately, I suppose it's a freak of nature 566 00:35:22,440 --> 00:35:25,015 of why Mandy passed. 567 00:35:25,040 --> 00:35:26,575 Thanks for your time, Kim. 568 00:35:26,600 --> 00:35:28,735 "Bye.' Bye-bye. 569 00:35:31,840 --> 00:35:34,175 No, it's positive, it's definitely positive. 570 00:35:34,200 --> 00:35:36,615 We've got to look at it, it's a positive. 571 00:35:36,640 --> 00:35:39,135 Nobody else has got the same thing. 572 00:35:39,160 --> 00:35:42,015 It's just hard getting your head round. 573 00:35:47,480 --> 00:35:52,135 Mandy has suddenly died of a cardiac death. 574 00:35:52,160 --> 00:35:55,775 There is no abnormality in her heart. 575 00:35:55,800 --> 00:35:58,775 She has also undergone genetic testing to see 576 00:35:58,800 --> 00:36:03,215 whether or not there is a marker for any type of genetic disease 577 00:36:03,240 --> 00:36:06,175 within her heart, and that is negative as well. 578 00:36:06,200 --> 00:36:09,935 It doesn't happen very often, there is usually an inkling 579 00:36:09,960 --> 00:36:13,655 on one test or another, but in this case, 580 00:36:13,680 --> 00:36:18,255 there is nothing that we can find to say what she's died of. 581 00:36:18,280 --> 00:36:21,055 It's rare that it happens, but it's happened in this case. 582 00:36:22,360 --> 00:36:25,375 It's very sad, it's very unsatisfying, 583 00:36:25,400 --> 00:36:28,255 both from our side and the family, 584 00:36:28,280 --> 00:36:30,895 but that's the state of medical knowledge at this time. 585 00:36:37,120 --> 00:36:39,935 You haven't got an answer still at the end of it, have you? No. 586 00:36:39,960 --> 00:36:41,615 As to why it happened. 587 00:36:41,640 --> 00:36:43,255 And I find that hard. 588 00:36:43,280 --> 00:36:45,055 Oh, yeah, I think about it every day, 589 00:36:45,080 --> 00:36:47,535 and I just think why did it happen when she was swimming? 590 00:36:47,560 --> 00:36:50,295 Would it have happened if she hadn't have gone swimming? 591 00:36:50,320 --> 00:36:54,655 Results from the cardiologist showed that Mandy's son and sister 592 00:36:54,680 --> 00:36:58,255 both presented with a mild heart-valve condition 593 00:36:58,280 --> 00:37:00,895 that will require future monitoring. 594 00:37:00,920 --> 00:37:03,495 Cos it must be hard for Harry 595 00:37:03,520 --> 00:37:07,415 to process everything and try and move on a bit and... 596 00:37:07,440 --> 00:37:08,975 Not just Harry, but Annabel as well. 597 00:37:09,000 --> 00:37:11,135 But Harry, he's away on respite. 598 00:37:11,160 --> 00:37:13,095 While packing his suitcase, he went, 599 00:37:13,120 --> 00:37:15,255 "Oh, I want to wear my red love-heart top," 600 00:37:15,280 --> 00:37:17,055 so meaning the British Heart one, 601 00:37:17,080 --> 00:37:19,855 and he were like, "I want everyone to see my mum." 602 00:37:19,880 --> 00:37:23,335 He wears it with, like, supreme pride. 603 00:37:26,000 --> 00:37:28,575 Just sad. Mm, it is. 604 00:37:45,760 --> 00:37:47,935 LESLEY SHARP: At the coroner's court, 605 00:37:47,960 --> 00:37:52,535 Dr Adeley has a final conclusion on Irene Wright's death. 606 00:37:52,560 --> 00:37:54,735 At Irene's original biopsy, 607 00:37:54,760 --> 00:37:57,295 there was a small bleed after the operation. 608 00:37:57,320 --> 00:38:00,575 That's not unusual for biopsies in the brain. 609 00:38:00,600 --> 00:38:02,455 She recovered, she went home. 610 00:38:02,480 --> 00:38:05,455 But then, very quickly, she lost consciousness, 611 00:38:05,480 --> 00:38:08,895 and what we were worried about was that the bleed has extended. 612 00:38:08,920 --> 00:38:11,895 In this case, it is not the bleed extending, 613 00:38:11,920 --> 00:38:15,295 but the tumour has suddenly expanded. 614 00:38:15,320 --> 00:38:18,695 Tumours of this type have this particular feature, 615 00:38:18,720 --> 00:38:21,455 and that is what has caused her loss of consciousness 616 00:38:21,480 --> 00:38:24,415 and the rise in inter cranial pressure that led to her death. 617 00:38:24,440 --> 00:38:27,935 It's nothing to do with the original operation, 618 00:38:27,960 --> 00:38:31,535 and consequently, because this is a natural death 619 00:38:31,560 --> 00:38:35,015 from the tumour misbehaving, there is no inquest. 620 00:38:43,880 --> 00:38:46,495 Irene can now be returned to her family, 621 00:38:46,520 --> 00:38:49,495 and funeral arrangements can be made. 622 00:38:49,520 --> 00:38:53,015 DIALLING TONE 'Hello. Jo-Ann Telford.' 623 00:38:53,040 --> 00:38:56,895 Hi, Jo, it's Alice Swarbrick, coroner's office manager at Preston. 624 00:38:56,920 --> 00:38:59,335 'Hello, hi.' Hi, how are you? 625 00:38:59,360 --> 00:39:00,895 'I'm all right, thank you.' OK. 626 00:39:03,360 --> 00:39:04,575 I just wanted to call 627 00:39:04,600 --> 00:39:07,095 to let you know everything's been authorised by the coroner, 628 00:39:07,120 --> 00:39:09,295 everything's been sent over to the registrars. 629 00:39:09,320 --> 00:39:11,455 The funeral directors will have been notified, 630 00:39:11,480 --> 00:39:13,055 they'll have the relevant paperwork, 631 00:39:13,080 --> 00:39:15,535 so they can go and collect Irene for you. 632 00:39:17,440 --> 00:39:19,615 So, yeah, everything should be in hand. 633 00:39:19,640 --> 00:39:21,855 '0OK, marvellous. Thank you so much, Alice.' 634 00:39:21,880 --> 00:39:24,295 No problem. Any problems at all, give me a call. 635 00:39:24,320 --> 00:39:25,615 'All right.' All right, then. 636 00:39:25,640 --> 00:39:27,095 Take care. 'Bye-bye.' Bye-bye. 637 00:39:45,000 --> 00:39:48,095 It's time to go and say goodbye to Irene. 638 00:39:48,120 --> 00:39:50,335 How are you getting to the crematorium? 639 00:39:50,360 --> 00:39:52,215 I'm driving myself. OK. 640 00:40:04,360 --> 00:40:08,415 Today is saying goodbye to Irene 641 00:40:08,440 --> 00:40:11,575 and the person that she was. 642 00:40:15,400 --> 00:40:17,095 What this job teaches you 643 00:40:17,120 --> 00:40:20,615 is there are deaths that do affect you emotionally. 644 00:40:20,640 --> 00:40:23,335 You can see similarities between your life 645 00:40:23,360 --> 00:40:26,615 and somebody who's lost theirs in tragic circumstances. 646 00:40:26,640 --> 00:40:29,775 But you need to be there for the families. 647 00:40:29,800 --> 00:40:32,855 You cannot afford to fall apart 648 00:40:32,880 --> 00:40:35,015 because otherwise, they're getting no service. 649 00:40:35,040 --> 00:40:38,375 With this, it is very different. 650 00:40:38,400 --> 00:40:40,255 This is our death, 651 00:40:40,280 --> 00:40:43,135 this is our friend, this is our colleague. 652 00:40:43,160 --> 00:40:47,975 So, yes, there will be more emotions today than there are normally. 653 00:40:56,440 --> 00:40:58,095 'Irene didn't suffer fools gladly. 654 00:40:59,320 --> 00:41:02,655 'Definitely a matriarch, huge personality.' 655 00:41:07,520 --> 00:41:11,015 She was somebody who was a great person in the world, 656 00:41:11,040 --> 00:41:12,375 was a queen. 657 00:41:36,120 --> 00:41:39,415 When I went to see Irene at the hospital after her first operation, 658 00:41:39,440 --> 00:41:42,095 her first words to me - "Justine, when I'm better, 659 00:41:42,120 --> 00:41:44,095 "we're gonna have a bloody big party.” 660 00:41:44,120 --> 00:41:46,295 And, yes, Irene, we are having a big party. 661 00:41:46,320 --> 00:41:48,215 Unfortunately, you're not here to join. 662 00:41:50,000 --> 00:41:53,655 She'd be looking down and saying, "Have a few cocktails on me." 663 00:41:56,800 --> 00:41:59,655 It was never gonna be easy, 664 00:41:59,680 --> 00:42:01,855 but Irene would have loved today. 665 00:42:01,880 --> 00:42:04,255 She'd have been absolutely overwhelmed 666 00:42:04,280 --> 00:42:07,375 at the amount of emotion from people 667 00:42:07,400 --> 00:42:10,775 and the sheer number of people that turned out. 668 00:42:10,800 --> 00:42:11,895 It's been lovely. 669 00:42:14,040 --> 00:42:17,495 I was her person, and she was my person, 670 00:42:17,520 --> 00:42:21,655 and I'm like, "Who's gonna be my person now?" 671 00:42:23,880 --> 00:42:25,575 I miss her all the time. 672 00:42:36,600 --> 00:42:39,255 ANNOUNCER: Good morning, ladies and gentleman. Welcome to Colne! 673 00:42:39,280 --> 00:42:40,975 Let's have a big cheer! 674 00:42:41,000 --> 00:42:42,135 CHEERING 675 00:42:42,160 --> 00:42:45,335 It's the Colne annual soap box challenge. 676 00:42:45,360 --> 00:42:46,415 I'm just gonna sit here. 677 00:42:46,440 --> 00:42:48,615 I'm number one, aren't I? So... Number one. 678 00:42:48,640 --> 00:42:52,215 And today, Richard is fund raising for charity in memory of Mandy. 679 00:42:52,240 --> 00:42:53,935 This is doing him good. 680 00:42:53,960 --> 00:42:56,295 He's a bit of an adrenaline junkie, is my dad, 681 00:42:56,320 --> 00:43:00,975 so I think going off this high ramp, I think he'll probably like it. 682 00:43:01,000 --> 00:43:06,055 He's not... He's not really taken a moment to sit. 683 00:43:06,080 --> 00:43:08,695 I think he's just keeping busy so he's not thinking about it. 684 00:43:12,520 --> 00:43:14,375 Although mum never went on holiday, 685 00:43:14,400 --> 00:43:16,535 it feels as though she's just gone on holiday 686 00:43:16,560 --> 00:43:17,855 and she'll be coming back. 687 00:43:17,880 --> 00:43:20,775 But if you just keep busy, 688 00:43:20,800 --> 00:43:23,935 it does distract your mind a little bit from reality. 689 00:43:27,520 --> 00:43:30,415 ANNOUNCER: Ladies and gentleman, we have our first car coming up now. 690 00:43:30,440 --> 00:43:31,575 CHEERING 691 00:43:31,600 --> 00:43:34,295 Yes, I wanna raise funds, but mainly awareness. 692 00:43:34,320 --> 00:43:36,255 If there's any way that they can detect it 693 00:43:36,280 --> 00:43:39,175 and stop it from happening to any other family in the future, 694 00:43:39,200 --> 00:43:41,375 then that's what I wanna try and achieve. 695 00:43:42,800 --> 00:43:45,615 ANNOUNCER: In three, two, one. 696 00:43:45,640 --> 00:43:47,895 Let's soapbox! AIR HORN BLARES 697 00:43:47,920 --> 00:43:50,015 There you go, right down. 698 00:43:55,160 --> 00:43:56,295 I miss Mandy immensely. 699 00:43:56,320 --> 00:43:58,375 And he goes right past that easy... 700 00:43:58,400 --> 00:44:02,255 We always talked about growing old together and, you know, 701 00:44:02,280 --> 00:44:05,175 just holding hands and walking on a beach somewhere 702 00:44:05,200 --> 00:44:08,295 and, you know, just doing what we were doing as a couple. 703 00:44:08,320 --> 00:44:09,615 I haven't got that now. 704 00:44:11,720 --> 00:44:14,495 The main thing is myself and the kids 705 00:44:14,520 --> 00:44:18,495 start adjusting to the new way of life, ultimately. 706 00:44:19,760 --> 00:44:21,935 And I'm hoping that, one day, I'll meet her again. 707 00:44:21,960 --> 00:44:24,095 Whether that happens, I don't know. 708 00:44:24,120 --> 00:44:25,895 I just hope it does. 709 00:44:30,240 --> 00:44:32,775 The love we had, it was special.