The daughter of a Norfolk grandmother said multiple concerns about transporting her mum 280 miles away were "dismissed" as an inquest into how she came to die in an ambulance on the M11 got under way.
The inquest of Peggy Copeman, who died on December 16 2019, while being transported back to Norfolk was reopened by Jacqueline Lake, senior coroner for Norfolk on Monday.
Mrs Copeman, 81, was a resident at St Mary's Residental Care Home, in New Buckenham, and had received treatment for schizophrenia over her lifetime.
In December 2019, she required a mental health assessment after experiencing a significant deterioration in her health. Concerns were raised as she was refusing medication, food and drink and acting out against staff - actions described as "out of character".
The court heard that the Norfolk and Suffolk NHS Foundation Trust (NSFT) carried out the assessment on December 11, with transport arranged to take her to Cygnet Hospital, in Taunton, on December 12, as no beds were available in Norfolk or Suffolk.
In a statement read out to the court, her daughter, daughter Maxine Fulcher, said the family raised with NSFT and other care bodies that they were concerned about her being transported out of the county.
Mrs Fulcher said: "I was shocked to hear this.
"It is 280 miles from her home. I responded my mum has never been out of Norfolk, it was too far for her to travel."
The family had wanted to see Mrs Copeman before she travelled to Somerset but learned she had left earlier than planned.
Mrs Fulcher said: "We didn't get the chance to say anything."
Mrs Copeman was transported to Cygnet Hospital by VKL Healthcare Ltd in a people carrier upright in a wheelchair, not an ambulance on a stretcher as requested.
The family spoke to staff on Swift Ward at the hospital, but Mrs Fulcher said she felt they were not given the full picture of her mother's health.
The family was told she had a water infection on December 14 and that she was not fit to travel.
She added: "We reported these concerns numerous times. These concerns were dismissed."
Mrs Fulcher said on December 16 the family received a call to say her mum was being transported to Julian House, but had "not been consulted".
In the afternoon the family received a call to say the ambulance driven by Premier Rescue Ambulance Service, had pulled over at the side of the motorway - but received no further information.
At 2.30pm they were told another ambulance had been called and the family thought the ambulance transporting Mrs Copeman had broken down as they had not been told what happened.
"We were concerned and thinking the worse," said Mrs Fulcher.
A call to Julian House at 4.45pm found there had been no further information, until a call at 5pm from Cygnet House asking the family "what we were aware of".
The inquest heard the family had frantically rang around hospitals in the surrounding area in attempts to learn what had happened - but were unsuccessful.
They were then informed by Cygnet at 7.20pm that Mrs Copeman had died at the scene, later learning she had died four hours earlier at 3pm.
Mrs Fulcher said she believed her mum's basic needs were not cared for by "negligent" Cygnet and NSFT.
She added the loss of her mum had "torn their family apart" and had caused her to lose her love of Sundays, the day she would visit her mum.
Mrs Fulcher said: "Losing her in the most horrific circumstances has been devastating for myself and my family. We had been looking forward to her coming back to Norwich and visiting her at Christmas. I had bought her presents and looking forward to giving them to her. It was her favourite time of year."
Matthew Rushmere, NSFT community mental health nurse, was among that said Mrs Copeman required hospital treatment.
In his statement, he said Cygent requested a physical examination be completed but this was challenged by NSFT service leads.
The inquest heard conversations between Cygnet staff and the bed management team at NSFT agreed not to move Mrs Copeman until December 16 - after a press enquiry was made into her being sent out of county.
Adil Al-Mousawi, psychiatrist at Cygnet, said the 81-year-old had completed two of the three-day course of antibiotics for a urinary infection and the transfer was being carried out by a service the hospital had used before and there had been no concern for her phsyical health.
The consultant psychologist said following Mrs Copeman's death the hospital now requests all referring units to provide a formal physical health assessment prior to admission. He added that it had also updated its discharge referral so a full physical examination is taken prior to discharge.
In addition, all out of area referrals units are asked to provide written consent from patient's families or next of kin.
The inquest heard from Simon Baugh of the AMHP team Norfolk County Council about the signing off of Mrs Copeman's transportation,
He said the risk of sending her away had to be weighed against the length of time she would have to wait for a bed to become available locally.
He added the council was not notified of the transport back.
The inquest continues.
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