A 20-year-old university student who died after being injured in a rugby match and acquiring an infection in hospital lay in agony on the pitch for more than five hours while she waited for an ambulance, an inquest has heard.
Maddy Lawrence, who sustained a dislocated hip when she was tackled during a game for UWE Bristol, could be heard screaming and crying during 999 calls made by a physiotherapist desperately trying to get help who was told an ambulance would take “several hours” because the city was so busy.
After she finally arrived in hospital, Lawrence did not think nurses initially took the pain she was in seriously enough, the inquest at Avon coroner’s court was told. She developed an infection, had a leg amputated, and died of multiple organ failure 16 days after being injured.
The inquest, due to last two weeks, is to examine the response of South Western ambulance service NHS foundation trust as well as how Lawrence was cared for and how signs of infection were monitored at Southmead hospital, Bristol.
Lawrence injured her left hip when she was tackled a few minutes into a game that kicked off at 3pm on 9 March 2022 in Bristol.
The physiotherapist Paul Tompkins, who was providing pitch-side medical support, told the inquest it had been a “big tackle” and it was instantly clear that Lawrence had sustained a “nasty injury”. Play had been moved to a different pitch so she could be helped.
Four calls between Tompkins and the emergency services were played, with Lawrence’s cries and screams clearly heard in the background.
The first was made at 3.24pm, about 15 minutes after she was hurt. Tompkins told the operator she was in a “lot of pain”, cold, and could not be moved. The call handler informed him: “We are very busy at the moment”, and it could be “several hours” before an ambulance got to her.
Tompkins rang back at 4.45pm and said Lawrence was in “massive pain”. He was told: “Bristol is very busy.” He rang again at 5.50pm and said he thought she was going into shock.
At 6.05pm a paramedic phoned Tompkins. When he asked whether the student’s pain was mild, moderate or severe, Tompkins replied: “Ten out of ten.” The paramedic told him that the wait could still be a long one. The ambulance eventually arrived at 8.30pm.
Lawrence was initially assessed as a “category three” case, meaning the average time for an ambulance to reach her should have been one hour.
Caroline Tonks, the quality lead for South Western ambulance service NHS foundation trust, said on that day the average response to category three incidents had been nine hours.
Later Lawrence was escalated to category two, meaning the average time for an ambulance should have been 18 minutes. That day the average response time was just under two hours.
Tonks said there had been “unprecedented demand” for ambulances in March 2022. At the time of the match there were 54 people waiting for an ambulance in Bristol, north Somerset and Gloucestershire.
She said there were enough ambulances and paramedics on duty but many had been waiting outside hospitals to hand over patients.
The student’s father, Simon Lawrence, said when he saw her at Southmead hospital in Bristol the day after she was hurt she seemed in “good spirits”.
But the next day she appeared to deteriorate and was in more pain. She told him the nurses “had not been nice to her” and thought she had been making a “big deal” of her discomfort.
Over the coming days, Simon Lawrence said his daughter continued to be in pain, was struggling to sleep, and at times hallucinated. She was moved to the intensive care unit and her family was told she had an infection.
Lawrence had a number of operations and one of her legs was amputated. On 25 March, family members had been at her side when her respirator was switched off and she “faded away”.
In a statement, Simon Lawrence told the inquest Maddy had been a “wonderful” daughter: loving, warm, caring and looking forward to the rest of her life with “immense enthusiasm”.
When she went to UWE Bristol, where she studied interior design and architecture, she joined the rugby club and had loved the game and the camaraderie.
The inquest continues.
