An ambulance technician has been sacked after entering into a sexual relationship with a married 42-year-old mother who had attempted to take her own life and then died four days later.
The inquest into the death of Sarah Marshall heard that Nigel Robinson broke COVID-19 lockdown protocols in April 2020 to visit her home in Allenby’s Close, Sutton Bridge.
Mr Robinson was working for Jigsaw Medical, a third party company used by East Midlands Ambulance Service (EMAS).
A report by EMAS into Mr Robinson’s conduct said it believed he “encouraged the patient to contact him via Facebook so he could initiate sexual relations with her” on April 19 when she was admitted to hospital after taking an overdose.
Starting from when Mrs Marshall was still in hospital, the pair sent hundreds of messages and some pictures to each other through Facebook Messenger and arranged to meet on Wednesday, April 22.
The next day Mrs Marshall was found dead by a neighbour following concerns nobody had heard from her since the night before.
Her husband Howard, who was away looking after his father who had leukaemia, found the messages and alerted police after returning home later that day, the inquest heard.
Coroner Marianne Johnson delivered an open verdict as a pathologist had been unable to find the cause of Mrs Marshall’s death.
Toxicology reports showed that there was a “low” level of alcohol in her system and some evidence of prescription drugs but at a level “not likely to have caused or contributed to death.”
Mrs Marshall had lived in Sutton Bridge for six years and had a 16-year-old daughter who did not live with the family.
She was studying psychology at King’s Lynn College and the inquest heard after the April 19 overdose she’d told health staff she was considering handing in her notice at her care job and applying for another.
In his statement to the inquest, Mr Marshall said he’d last spoken to his wife at 5pm the night before her body was found.
“We discussed possible holiday plans, one of which was a holiday in the Lake District with Sarah’s parents,” said Mr Marshall who described the “loving relationship” his family had. “We planned to show them where we had our honeymoon and other places we had visited.”
He was returning with his father from a hospital appointment in Huddersfield when he heard of her death.
“I’m suffering and I’m finding it difficult to do normal everyday activities,” the statement continued. “I’m struggling to sleep at night and Sarah is never far from my thoughts.”
He stated he was “mortified” at seeing the messages and was left shaken and feeling physically sick.
“I’m completely devastated and just don’t know if I’ll ever recover from this,” the statement continued. “I’m concerned this might not be an isolated incident and he (the technician) may have formed relationships with other patients.
“What upsets me most is that somebody who was there to help her has taken advantage of her in her most vulnerable condition.”
The inquest heard that Mr Robinson had been given a six-month written warning in March 2019 after attempting to message a nurse on Facebook Messenger. Complaints that he’d given intimate details of his sex life in the back of an ambulance whilst making numerous leg brushes, were thrown out on the grounds of “insufficient evidence”, the EMAS report by senior quality manager for coroner service Sue Jevons states.
It stated that the first message was sent by Mrs Marshall after her overdose while she was still in hospital as she was at risk of a cardiac arrest due to being type one diabetic.
The report highlighted times where she expressed to Mr Robinson that she was feeling unwell but that he didn’t raise that with other health professionals.
In one such message Mrs Marshall had sent saying she was “starting to struggle”, he responded by asking if she “had a high sex drive.”
Mrs Jevons told the inquest: “I don’t think there’s anything we as a Trust could have done differently.
“I think it’s down to the individuals to have that professional responsibility.
“These are vulnerable patients that need going to hospital. They need the care in place and he (Mr Robinson) obviously had a lot of dialogue with Sarah and there were a lot of concerns he could have raised before Sarah passed away that he didn’t. For me, that’s his lack of professional responsibility.”
She told the hearing that extra training had been issued to staff as a result of the incident and that EMAS was in the process of reviewing its social media policy to include advice on what to do if patients send messages to staff members’ personal accounts.
Ms Johnson stated: “It’s such a shame that one individual can ruin the reputation of East Midlands Ambulance Service by his behaviour.”
She concluded: “This technician’s behaviour breached EMAS’s behaviour procedures in relation to improper relationships in entering into what was clearly a sexual relationship with Sarah Marshall.
“He also breached EMAS’s social media policy, endangered the staff and patients by breaching COVID-19 lockdown protocols and breached the trust values and policies with regards his inappropriate communications.
“He also failed to fulfil his duty of care to Sarah Marshall who was a vulnerable adult and more particularly brought the reputation of EMAS into disrepute.
“I’m aware the technician was not directly employed by EMAS but he was governed by the rules and guidance of EMAS themselves.
“EMAS is a service that should be trusted by the public to carry out their duties in a professional way, looking after those that are most vulnerable in their care.
“The service is in a position of trust and that trust in this particular issue was broken by that technician as a result of his behaviour, albeit I’m pleased to see that steps have been taken by the trust so that incidents such as this will never be repeated.
“They’ve also made a referral to the disclosure of barring service and I’m aware that the technician was in fact dismissed from the employment of the third party provider.”
Ms Johnson also expressed ‘concern’ that EMAS had not updated its social media policy in relation to patients contacting those working for it since the incident and didn’t plan to until June.
“In my mind it doesn’t seem that difficult in terms of an amendment to the existing policy to cover instances where a patient or a family member contacts EMAS or a third party provider,” Ms Johnson said.
An EMAS spokesman said the policy had been amended on February 23, the day after the inquest, to include that it is never appropriate to enter any form of relationship with a person who is or may be vulnerable.
Ben Holdaway, director of operations at EMAS, said: “I would like to offer my deepest condolences to Ms Marshall’s family, all of whom we understand have faced a deeply difficult and emotional time.
“We fully accept the coroner’s findings and conclusions. Patient care and safety is always our priority and we hold all trust and private ambulance service staff to a high standard.
“The behaviour of the private ambulance service technician was absolutely unacceptable.
“He was therefore immediately suspended while Jigsaw Medical (the technician’s employer) carried out a formal investigation, and his contract was subsequently terminated.”
Chris Percival, the CEO at Jigsaw Medical, said: “On behalf of Jigsaw Medical, I would like to offer our deepest condolences to Ms Marshall’s family at this very difficult time.
“At Jigsaw, we hold quality of care and safety in the highest regard when it comes to the service we provide to patients on behalf of EMAS, and we take extremely seriously the professional standards expected by the public of all ambulance clinicians, both inside and outside of the workplace.
“The conduct of the member of staff concerned falls far below the high standards we expect of our clinicians and immediately following this incident, the technician was suspended pending a formal investigation.
“At the conclusion of this investigation, we terminated our contract with the clinician as a result of their conduct and their serious breach of Jigsaw policy, professional standards and values.”
