The inquest into the death of a 49-year-old woman who died days after an online GP appointment has found that her care would have been the same even if the consultation had been face-to-face.
Michelle Michala Voutt, from Heacham, died in hospital in April 2021, 11 days after she spoke to her doctor via a video call about pains she was suffering in her arm, as well as a migraine.
She was advised to get back in contact if symptoms worsened.
When they did, Ms Voutt, who had suffered from a blood clot as a teenager, attended an in-person appointment at the surgery five days later.
She was immediately referred to a specialist unit at the Norfolk and Norwich University Hospital, where scans showed she had developed a blood clot.
She underwent surgery the following day but died five days after being admitted to hospital, having been transferred to Addenbrooke's, in Cambridge.
At an inquest into her death, medical negligence lawyers representing Glynn Hopkinson – Ms Voutt’s partner of more than 25 years - raised concerns over delays to her treatment and questioned whether clues were missed during the online consultation.
But Professor Philip Stather, a consultant vascular surgeon at the NNUH, said that while it was “likely” the blood clot got bigger during the five before she had an in-person appointment, the "investigation and procedure" would have been the same.
Area coroner Yvonne Blake recorded a short-form verdict of natural causes.
TEENAGE CONDITION
The hearing heard that Ms Voutt had suffered from a splenic thrombosis as a teenager.
The condition, in which a blood clot forms in a blood vessel, meant she had her spleen removed in 1994.
She later had a stroke and was prescribed the anticoagulant drug warfarin for life for her condition, to help prevent clots.
At the inquest, a statement from her GP at Heacham surgery, Dr Adrian Clifton, was read out.
She had been a patient there since 1998 and regularly attended its anticoagulation clinic.
Dr Adrian Clifton described Ms Voutt, affectionately known as “Our Shell” and “Shelly” to her loved ones, as “one of the best-controlled warfarin patients at the practice”.
When she became unwell, on April 15, 2021, she called the non-emergency medical helpline 111, complaining of discomfort in her right arm and armpit, as well as a “heavy sensation” in her arm, a cold wrist, and a migraine.
Less than an hour later, she had an online appointment with a GP who, after a video triage, advised her to call back if the symptoms persisted or worsened.
The in-person appointment was held on April 20, after which she was admitted to hospital for surgery.
Despite showing positive progress immediately following the surgery, by the afternoon of April 23 she began to experience worsening symptoms. More scans revealed subsequent clots had developed, prompting the need for further medical intervention.
On the evening of April 24, she suffered from an ischaemic stroke due to a blockage cutting off the blood supply to her brain.
She was eventually sent to Addenbrooke's Hospital after being put on life support, where the family were told she had experienced a further stroke which was “devastating and incompatible with life”.
Ms Voutt died on April 26.
Yunesh Yeeranah, from law firm Simpson Millar, which represented Mr Hopkinson, said he hoped the inquest would “help to shine a light on the circumstances and treatment”.
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