An open verdict means there is insufficient evidence to determine exactly how the death came about and is open to subsequent evidence, but the medical cause of death was given because of the “combined toxic effects of morphine, gabapentin, diazepam, zopiclone, diphenhydramine, cyclizine, promethazine and amitriptyline”.
The court was told that the inquest opened on 6 December 2019, and HM Procurer Megan Pullum KC said proceedings had “unfortunately taken longer to conclude than is ordinarily desirable” due to the pandemic and “medical complexities” in the case.
Ms Bacon received surgery in May 2010. The surgical wound healed but five months later the scar tissue “broke down” and complications, which lasted for nine years until her death, persisted from that point.
She was prescribed a “significant amount of pain medication” and received repeated care, including more surgery and community care, both on and off island.
It was noted that Ms Bacon remained positive about life but was struggling with a perception that little assistance was given to alleviate the stress triggered by protracted complications and pain.
Prior to her death Ms Bacon had obtained various prescriptions from her GP. The GP described the series of medicines she was on as a “significant cocktail of analgesics”.
Pictured: Ms Bacon had been prescribed numerous drugs to help manage her persistent pain.
Three independent experts were commissioned by Guernsey law officers after the family raised concerns about the surgical care and prescriptions dispensed.
Surgical care was found to have been appropriate and pain management approaches appropriate and proportionate to the long-term condition.
Uncontrolled pain may have resulted in accidental ingestion of excess medicine, but limited evidence meant a conclusion could not be drawn.
HM Procurer concluded that there was no evidence of “any systemic failings in the care” of Ms Bacon.
Despite this, Ms Bacon’s sister read a statement to the court before the verdict was delivered to make sure her voice was “heard and represented”.
She said that Ms Bacon felt as though she never received the “human support” and care needed throughout the ordeal and that she felt “humiliated” by the way some healthcare professionals had addressed her.
Despite this she continued with her day-to-day life despite it being turned “upside down” which meant she was unable to go out enjoying herself as any young women should as she had become nocturnal.
She was described as a “lovely and caring young lady” who is deeply missed by all her extended family. “None of this is seen in clinical cold notes.”
Judge Gary Perry, closing the hearing, expressed his “deepest sympathy” to family and friends who he said had “acted with dignity” throughout the investigations.