There are countless factors that can lead to your death.
As senior coroner, I deal with nearly 4,500 fatalities a year.
LESLEY SHARP: The coroner can make
any inquiries necessary to find a cause of death.
The police act on behalf of the coroner.
If the coroner asks, then we do it.
We need to be alert to the fact
that there could be something more sinister in this.
With unprecedented access,
we follow the coroner's full investigation...
It does make you realise how fragile life is.
Let's start and just work our way up.
Forensic medicine is all about being very suspicious.
...from the moment of arrival in the mortuary
to the final conclusion of the inquest.
All rise.
I'm sorry that you're attending court under these circumstances,
and I appreciate that the evidence
that you will hear today may be distressing.
I never thought I'd ever find myself in a coroners' court.
You shouldn't have to organise a funeral for your children.
If you die here, if it's violent, unnatural or of an unknown cause,
it's my job to find out how.
A man has collapsed at a homeless accommodation site in Blackburn.
The man was found without a pulse.
Despite attempts to resuscitate him,
he was pronounced dead shortly afterwards.
So, this morning, I'm dealing with the death
of a 36-year-old Polish gentleman by the name of Robert Blonski.
Robert's death's been referred to the coroner by Lancashire Police.
Robert was complaining
of a two-day history of severe headaches.
The day before his death,
he was brought to Royal Blackburn Hospital.
He was booked into urgent care, but unfortunately,
before he's been seen or had any treatment,
he's left the hospital of his own accord.
24 hours later,
police officers found him suffering from some chest pain.
The police officers brought Robert back to hospital,
but unfortunately, once again,
Robert has discharged himself prior to treatment.
It would appear that following that,
he's then returned to his home address.
Ancl then another resident at the site
has found him unresponsive.
He was transferred to Royal Blackburn Hospital
but sadly died shortly afterwards.
Robert has been transferred to the mortuary,
and a formal identification has taken place.
The background to his death is that two months ago,
Mr Blonski was admitted to hospital following assault.
I understand that during that assault,
he was kicked in the head and had half his ear bitten off.
There's a number of issues at the moment.
Firstly, we've got the assault a couple of months ago.
That still is uppermost in my mind as to what has happened then.
Then we've also got two separate hospital admissions
in the 24 hours leading up to his death,
but then discharges himself before any treatment.
One of the first questions that we will have to answer is
whether or not the assault
has caused or contributed to his death.
This would determine whether or not it is a police investigation
or whether the accident and emergency staff
have ruled out significant injury,
in which case this may not have contributed to his death,
and it becomes a coroner's investigation.
The scans taken at the time of Robert's assault two months ago
must now be reviewed by a consultant.
Mr Robert Blonski came to us accompanied by the police officer.
And he came at 23:49.
So, he was then triaged at that time,
and he came with a head injury.
He was assaulted by somebody,
and he was punched and kicked in the head.
And he was bleeding from the left ear,
and the left ear was apparently bitten off.
He had a significant amount of time that he was unconscious.
That prompted us to do the CT scan for his head
to make sure there's nothing in the head
which could be, you know, life-threatening.
At that time, the CT scan showed no evidence of any bleeding.
This showed no evidence of any swelling in the brain.
And there was no evidence of any broken bones
on the head or the skull.
There was nothing abnormal found in Mr Blonski on the CT scan.
The coroner has received the report from the hospital
and can now begin his investigation,
starting with an external examination.
So, Robert's 72 kilos.
Ancl he's 1 metre 70.
Posterior lividity, and his rigor mortis is present.
A section on the outside of the left ear has been removed.
Actually, it's quite a chunk.
It's been confirmed that the assault
neither caused nor contributed to Robert Blonski's death.
As a result, we'll now proceed
with the CT postmortem scan and toxicology.
Because given his complicated past medical history,
his multiple hospital attendances,
we need to sort out what has happened here,
what the sequence of events are and what has caused his death.
Because at the moment, we don't know what's happened.
LESLEY SHARP: The coroner is investigating the sudden death
of 36-year-old Polish national Robert Blonski,
who died after collapsing in Blackburn.
Tattoos, he has right shoulder, right forearm.
Medical interventions, he's got an IO needle in his right shin.
Robert Blonski has had a number of involvements
with both the health care services and the police
over the preceding weeks.
Ancl he also has a history of homelessness and alcohol abuse.
On the evening of his death, before he is brought in collapsed,
he has attended accident and emergency,
complaining of a severe headache for two clays.
On the clay before his death,
he called the ambulance because he had severe chest pain.
But by the time the ambulance got there, the pain had gone.
Ancl we're not sure how each of these, if at all,
relates to his current collapse and death.
Initially, we will do toxicology and a CT scan,
which may give us a cause of death.
So, we're going to try and take some samples for toxicology.
Unfortunately, there's no urine,
so we're trying to get some blood samples.
And we are actually managing to get a really good blood sample.
Yeah. That's plenty.
We'll label those up,
and we'll send them off so they can be analysed
and see if there's anything in his system that's untoward.
Robert was homeless
and had been helped by a government-funded program me,
which supports vulnerable adults facing issues,
including addiction and mental illness.
One of the things that we've set up in Blackburn
is our homelessness pods.
Robert had come to the attention of our single homeless team,
and he was rough sleeping.
They made the decision to offer Robert one of the homelessness pods
so he had a stable base and somewhere to keep him safe.
We were told that he'd been living in a tent for about four years.
He'd clearly been living quite a complex lifestyle
for a significant period of time.
He was a lovely person.
Despite his own adversities and his own challenges,
always trying to make people smile and amazing sense of humour.
But I think what really struck me was,
even though he didn't have anything,
he was such a warm, kind-hearted, caring person,
really thankful for any support that was offered to him.
Ancl I got the impression that he'd not maybe had that before.
In Preston, police have been called
to the home of a 25-year-old woman called Shannon jump.
She has been found unresponsive in bed.
Somebody who's 25,
to have a short history of cough and cold,
to suddenly deteriorate to such an extent so that they die
is really quite unusual.
Due to the concerns surrounding the death of such a young person,
the police are looking into anything that may have occurred
that warrants further investigation before we can make a decision
as to what type of postmortem is appropriate.
So, this morning, we've had a call from the ambulance service.
Just after ten o'clock.
Police have attended,
and there are a few questions surrounding the death,
which we just need to investigate a little bit further.
Clearly, there are a number of hypotheses
in relation to this young lady's passing.
One, it could be medical.
Two, it could be down to alcohol or drugs
because that picture is unknown at the moment.
Or thirdly, it could be at the hands of another third party.
So that, again, is to be further investigated.
Ancl we'll see where that takes us.
Whilst the police continue to investigate the circumstances,
Shannon has been transferred to the mortuary
at Royal Preston Hospital.
Coroner's officers are looking into her medical background.
PHONE RINGS
Hello, is that Angela? 'Yes. Speaking.'
Hi, Angela. It's Becky at the coroner's office.
I believe that Sharon's clad passed away quite recently.
What did he die from, if you don't mind me asking?
'Cardiac arrest. High blood pressure.'
Ancl how old was he? '47.'
It's just so we can make a note
to check whether or not there could be anything hereditary.
'The heart condition is because his clad passed of his heart.
'His mum's got heart failure as well.
'She's on medication for it.'
Right. 'So, it runs in both sets of families.'
Detective inspectors Steve Munk needs to update the coroner
on the police investigation into Shannon's sudden death.
'Hello, Steve.' Good afternoon.
We've now conducted a number of enquiries.
We've got a statement off her partner
that was in the flat overnight with her.
And we've got some CCTV,
which does corroborate what her boyfriend says,
that he went and took the dog for a walk in the morning,
came back, and that's when he's found her deceased in bed.
So we are still in that situation where there's nothing still
to indicate why she may have passed away.
But it's not looking like anything criminal.
'OK. If we get to the stage where the CT scan shows up something,
'and they go, "Not happy with that," we'll give you another shout.'
OK. OK, thank you.
With the police investigation into Shannon's death concluded,
an external examination can now take place.
Tattoos and piercings.
Polych romatic tattoo, left ankle and foot.
Yeah.
She's got three piercings
to... the right ear.
Yeah. Ancl then two to the left.
OK. Medical intervention?
None seen.
She came around on the Monday,
she were feeling a bit unwell, coughing.
We thought nothing of it, she was having a laugh
in the front room with her sisters, and then she went home.
Ancl then the clay after, I got a text just saying that,
"I've got the doctor's at half past ten".
They just said that she had a chest infection.
Nothing serious.
I just feell should have rung her to see how she was,
but I thought she'd be feeling a lot better in the morning.
Because she was such a young person, all she had was asthma,
she had no other medical conditions.
'I got the phone call about five to ten the next morning
'saying that she'd passed away.'
Ancl part of me feels I wish I'd rung her
because I feel that...
...that I hope she didn't think I didn't care.
So, it is...
it's really hard knowing that she's not here any more.
There are certain cases that get to me more.
Even though how awful it is losing a relative at any age,
I think the ones that I take on personally
are the ones that are, like, a similar age to me, maybe,
or children, or, like, a sudden death.
Ancl we know that we're taking care of that patient the best we can.
It is a privilege.
36-year-old Robert Blonski, who died after collapsing
at a homeless accommodation site in Blackburn,
has arrived at Royal Preston Hospital
for a postmortem CT scan.
So, we have with us today Robert Blonski.
We'll definitely be looking for things like evidence
of any skull fractures.
We're also looking for evidence of any bleeds on the brain.
They, usually... they would appear white
as opposed to the sort of grey colour of the brain tissue.
So, at the minute, there doesn't appear to be
anything glaringly obvious.
So we'll go on to scan his heart now in a bit more detail.
We will get all these images sent across to our radiologist,
who'll finalise a report and then send that onto the coroner.
The police have traced Robert's family.
They live in Poland and do not speak any English.
Coroner's officer Debbie Stewart must call the next of kin
with the help of an interpreter.
'Please speak the name of the desired language.'
Polish.
Good morning. My name is Debbie Stewart,
and I'm going to be ringing the brother
of a deceased gentleman that I'm dealing with.
His name is Daniel Blonski.
When you have the death of a foreign national,
there are number of things you have to take care of.
There is an international treaty that requires us
to notify the Polish authorities
that one of their nationals has died in our country.
Liaising with the next of kin is much more difficult.
The Coroner's Service is unique
to places that have had English law -
places like Canada, New Zealand, Australia.
So trying to explain to a family,
who may never have come across a coroner's service
and may have no equivalent in their own country,
is its first challenge.
Robert's postmortem CT scan is being reviewed by a radiologist
in an attempt to reveal his cause of death.
Obviously, history of previous assault,
but we know the CT at the time was normal.
Equally as important,
there's no evidence that he sustained
any significant injury within the brain in the meantime.
Then we look through the abdomen.
History of alcoholism here, so important to look at the liver
because alcoholics frequently get liver disease.
No, there's no gross evidence here
that the patient's got alcoholic liver disease.
I think it's unlikely that it's directly relevant
in terms of his cause of death.
So, now we're looking through the chest and the heart here,
and there is a history of chest pain.
He's a relatively young man, but that doesn't mean to say
that he couldn't have coronary artery disease.
And, in fact, if you look here
at the main coronary artery on the left side,
there are definite areas of significant calcification.
The CT has ruled out several other potential causes.
You know, we can rule out trauma, for example.
So what I would be saying to the coroner in this case is
toxicology is important because of the history,
and the coroner will make a decision on cause of death
once we have those results available.
There are a number of concerning features about this case.
The difficulty with this is that Mr Blonski uses alcohol
to a significant excess, and he may have alcoholic poisoning.
But we don't know whether or not this has got any relation
to what has caused his death at this point in time.
LESLEY SHARP: The investigation is continuing
into the death of a 36-year-old man, who was found collapsed.
Robert Blonski is a Polish national
who is living in the UK and is homeless most of the time.
He has a history of alcoholism.
He has been to hospital on a number of different occasions.
He was brought in earlier on the evening of his death by the police
and left before being seen.
He is then found collapsed in his homeless pod shelter.
Robert had received help from a government-funded program me.
Robert was heavily in addiction.
When you're in addiction, it consumes everything.
It takes over your life, it becomes your priority.
So your basic needs, such as your food, your shelter,
they're not a priority any more,
and that has a profound impact on someone's physical health.
We tried to guide him and steer him towards making better choices.
Ancl that's, really, I think,
at that point in Robert's life, all we could offer him
because he wasn't ready to address any issues himself.
In Robert's case, because he was such a likeable person,
services were really upset
when they found out that he'd passed away.
Coroner's officer Debbie
needs to update Robert's next of kin in Poland
with the help of an interpreter.
Daniel, I now have the results from the CT postmortem scan.
What the scan has shown
is calcification in the left coronary artery.
What has also happened is a sample of Robert's blood
has been sent for toxicology testing.
It may take a few weeks
before we get the results of those tests.
You will be able to do that now.
The coroner has authorised that Robert can be released
so that his funeral can go ahead.
Robert's repatriation to Poland may take several weeks,
so he will remain at Royal Blackburn Hospital.
In the meantime, we're gonna move him out
into our long-term storage so we can look after him out there
whilst they're finishing the arrangements.
So I'm just going to record in my register that I'm moving him
so that we know where he's located.
The specialist storage facility
is kept at a lower temperature than the mortuary.
Anyone staying for longer than 30 days is moved there.
Whether or not this case goes to inquest
will be determined by what the toxicology shows.
And if it shows acute alcoholic poisoning,
an inquest will be required.
Equally, if it doesn't show anything,
this will be a natural death due to his heart disease.
But at the moment, until the results come back,
I can't make that decision.
The coroner is also investigating the sudden and unexpected death
of 25-year-old Shannon jump, who was found dead at home.
A postmortem CT scan has been ordered.
Shannon jump is a 25-year-old woman
who lives at home with her child and partner
and has had a three- or four-day history of cough and cold.
Her partner has last seen her alive
at approximately one o'clock in the morning
and the next day finds her dead in bed with no apparent cause.
There is some family history of heart disease,
but it's uncertain whether or not it's connected to Shannon.
So, we'll start off by scanning Shannon top to toe.
We'll scan her whole body through.
Ancl then, because of her age, we'll do an angiogram of her heart
where we'll inject some contrast into the catheter
that has been placed by the mortuary staff
and hopefully get a bit more detail for the radiologist.
Someone this young,
you wouldn't usually expect them to pass away
from just having a chest infection.
It does seem quite strange.
This area of white here is the contrast,
and you can see the tiny vessels all filled with white,
so they're all filled nicely with contrast.
Shannon's partner is not the father of her child.
Hello. Are you coming? Grandma.
Are you coming? Come on, then. Oh.
Shannon's mum is now bringing up her granddaughter.
Hello. Say hello.
JOSIE: Cheeky.
JOSIE BABBLES Who is it?
That's Mummy. Is that Mummy?
Give Mum a kiss.
That's your mummy.
Shannon doted on her daughter, Josie, who's 16 months old.
Everything she did was for her.
She worked all the hours just to provide for my granddaughter.
Just so hard knowing that she's not gonna be here any more
or walk in thorough the door and saying, "Hiya!"
So, when I got the phone call about Shannon passing away,
it was only four months after my husband passing.
I have questions about why Shannon passed,
whether it was linked to her clad, heart conditions.
Did Shannon have any of it? Was it hereditary?
There was no signs of it going to happen.
She still should be here.
I'm taking each clay as it comes,
doing everything I can forjosie so she doesn't forget her mum.
We're such a close family.
Everybody's found it really hard that she's passed.
So it's in memory of Shannon
and that she knows that we're doing our best
and will keep Josie safe.
She's just been took way too soon.
Shannon's postmortem CT scan
will now be reviewed by a consultant radiologist.
We've got the background history, and we move onto the scan.
So, looking through the brain,
it doesn't really fit with this history,
but there's no acute abnormality in the brain or the head.
Then we look down through the chest.
Some people can have underlying cardiac abnormalities
that they're completely unaware of.
There's nothing abnormal
in terms of the radiological appearances of the heart.
Ancl if we change onto the windows that show us the lungs,
there's areas throughout this left lung that look abnormal.
So, for example, there's an area here
where we see a small cavity forming within the lung.
There's background areas of air space consolidation.
So, this area here, the dark-grey area,
is normal lung, effectively.
And when we compare, we can death; see
these patch areas within the left lung that are abnormal.
So, basically, we've got an abnormal left lung,
a clinical history of shortness of breath and chest pain
and recent diagnosis of chest infection.
If we put the two together,
I think it's fairly clear in this case, sadly,
that Shannon's passed away from pneumonia.
Shannon's CT postmortem results have come back.
She has got infiltrates in her lung.
She has got infection in her lung
spreading throughout, which is bronchopneumonia.
This is a significant infection,
and this is an infection that kills people, even at a young age,
and kills them very quickly.
Coroners' officer Becky )ones
must update the family with a cause of death.
PHONE RINGS 'Hello?'
Hi, Angela. It's Becky calling from the coroner's office at Preston.
I'm just giving you a call
to let you know that the CT scan results have come back now. 'Right.'
Ancl the scan has established a cause of death for Shannon. 'Right.'
So, the cause of death that has been found is pneumonia. 'Right.'
So for that reason, the coroner's reviewed the report,
and they don't believe that a further postmortem will be needed.
So Shannon can be collected from the hospital now
for your funeral arrangements.
CHILD BABBLES, ANGELA CRI ES
Shannon's only 25 years old.
We don't have many cases of young people dying of pneumonia,
and Mum's probably gonna find that quite hard.
She is also looking after Shannon's little one for her now as well.
We don't have medical training in this role, but we do learn,
and we learn what's not as common as well.
So, this is one that...
I've never dealt with before and I hope I don't have to again.
I think no matter what age a person is when they die,
it's still someone's mum or clad, or... Yeah, clad.
BOTH: Sister, brother. Yeah.
So it's always sad for everyone, no matter what age they get to.
But in terms of us, younger ones are harder to deal with.
Oh, yeah, definitely.
They're either closer, maybe, to our children or our friends. Yeah.
Sometimes, they, you know...
they've died in circumstances that could have... been avoided.
It does make you realise how fragile life is.
36-year-old Robert Blonski
died shortly after arriving at Royal Blackburn Hospital.
His cause of death is currently being investigated,
but the coroner has authorised his release back to his family.
So, the undertakers are coming to collect Mr Blonski from us today,
get him ready to repatriate him.
He'll be going back to Poland for his funeral.
So, this is Robert Mariusz Blonski.
'We've usually got one or two patients with us
'that have been here a little while.
'Either they haven't got families,
'or families are having difficulties making arrangements.
'So it's quite common for us to have one or two patients
'that have been with us a couple of months.'
The toxicology lab is looking to establish
whether drugs or alcohol
have caused or contributed to Robert's death.
In this case, Dr Adeley has asked us
to explore a number of different avenues.
We know that the gentleman was known to drink to excess,
so Dr Adeley would like us to exclude alcohol toxicity
because alcohol poisoning is a very common cause of death.
We're also going to explore the possibility
that the alcohol that may have been drunk by this gentleman
may have been contaminated with other alcohols.
Alcohol in alcoholic drinks is ethanol.
There are other more toxic alcohols
that may be contaminated in illicit sources of alcohol,
and that may be something like methanol, which is incredibly toxic.
So we will screen for all of the illicit compounds
as well as prescription medications
because it's important that we explore all avenues
in the cause of death in this case.
Toxicology has been returned,
and it will be necessary to go to inquest
to compare this against the findings of the CT scan
to determine a cause of death.
LINE BEEPS
AUTOMATED REPLY: 'Please hold for an interpreter.'
Good morning, Daniel.
Legally, the coroner now has to hold an inquest.
Once I have the date of the inquest, I'll send a further email.
INTERPRETER:
OK, thank you. Bye-bye now.
What I'm going to do now is request some other statements
that will assist the coroner.
There was a couple of witnesses at his home address
who he spoke to on the evening of his death
and, in fact, one of his neighbours who actually found him unresponsive,
so I'll be asking the police to obtain statements from them.
With no family living in the UK,
Robert's brother Daniel and partner Izabella
have travelled from Poland to attend the upcoming inquest.
IN POLISH:
From an early age,
both Robert and Daniel lived in a children's home in Poland.
LESLEY SHARP: It's the day
of 36-year-old Robert Blonkski's inquest.
Robert's brother, Daniel, and his partner, Izabella,
have travelled from Poland to attend.
Establishing the cause of death at the inquest
will be listening to the evidence.
Weighing it all in the balance to see whether or not
it is his coronary artery disease
or the amount of alcohol that he's drunk
that is the principal factor causing his death -
or whether it's a combination of the pair of them.
But it will only be after I have heard all of the evidence
that I can make up my mind and come to a decision.
Daniel, Izabella, I just wanted to explain to you
what's going to happen today when we go into court.
The coroner's asked for a number of witnesses to come and give evidence.
INTERPRETING
IN POLISH:
Yes.
WOMAN: All rise.
MAN: Could you tell me your occupation, please?
I work at the homeless pods.
Now, I believe you were on duty
on the evening that Robert Blonski is then found collapsed.
What can you remember, please? You could tell he'd had a drink.
I wouldn't say he was very intoxicated.
He opened his window and leant his arm out to have a cigarette.
About 20 minutes later, he was still in the same position.
I went to check on him. I couldn't see him breathing.
Couldn't find a pulse.
I'm going to deal now with the toxicology results.
These show that he had a blood alcohol concentration
of 329mg per decilitre,
which demonstrates potentially fatal intoxication.
Robert Blonski was smoking a cigarette
and was found collapsed in that position.
The difficulty that I'm faced with here
is that Robert Blonski has a high alcohol level
and also has coronary artery disease.
MAN: I'm a consultant in emergency medicine
at East Lancashire Hospitals NHS Trust.
The CT scan showed evidence of coronary artery disease,
which can cause a heart attack.
The fact that Robert was found in that position
makes me think that he had a very sudden cause for his death,
which is more likely to be, in my opinion,
explained by a heart attack rather than alcohol toxicity.
I accept the medical evidence
that the most likely cause of death is that of coronary artery disease.
Ancl consequently, this is a natural death.
My condolences are and remain with Mr Blonski's family.
IN POLISH:
In this inquest, there was always two possible causes of death -
there's the heart disease and the alcohol.
Ancl the alcohol remained a possible cause of death
right up to the point that we heard how he was found,
which allowed the accident and emergency consultant
to explain that this was a very sudden cause of death,
which makes it a cardiac and a natural cause of death.
IN POLISH:
It's been two months since 25-year-old Shannon jump's
sudden and unexpected death from bronchopneumonia.
Today, we've come to have tattoos clone
with Shannon's ashes in.
I'm having a pink rose put next to my husband's blue rose
with ashes in so they'll be together.
How that's feeling? That's fine.
Well, my husband was a big Everton fan...
so that's why his is blue.
Ancl Shannon, she just absolutely loved pink.
It doesn't seem real that she's... she's not here, to be honest.
I still expect her to walk through the door
or just ring me, saying, "Mum, do you wanna go shopping?"
You know, just little things like that.
She was so loud, bubbly.
She was just a fantastic person,
and Shannon, all she ever wanted to do was be a mum.
I've got a part of my husband,
and now I've got a part of my daughter with me,
no matter where we go.
Right, missus, you're clone.
There is no explanation as to why he's cited.
He's fit, he's well.
The death certificate from Egypt
shows no postmortem has been performed. OK.
All Lesley had came to us with was a copy of his passport
attached to the outside of his coffin.
Oh, he's on holiday. He can't have cited.
It's the furthest thought from your mind
that something this horrendous is ever gonna happen to you.