A patient who died at a private hospital after suffering a fall was unlikely to have done so had she received appropriate supervision, a coroner has ruled.
Tamsin Woolsey-Brown, from Norwich, died from a traumatic brain injury after falling on the ward as she recovered from a knee replacement operation. She was 78.
An inquest into her death finished on Friday with area coroner Samantha Goward concluding she had died by accident.
But on the final day of the hearing, Mrs Goward said the evidence had shown the tragedy was "unlikely" to have occurred had she been better supervised by hospital staff.
The court heard that on the day of the incident, a physiotherapist had recommended that Mrs Woolsey-Brown be supervised by two members of staff when moving around her room.
But this information was not relayed to night staff at Spire Hospital and at the time she was being accompanied to the toilet by a single nurse - who did not witness her fall.
Norfolk Coroner's Court (Image: Newsquest)
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It later emerged the retired nursery teacher had suffered a traumatic brain injury in the fall, from which she died the following morning on June 3, 2023.
Mrs Goward said: "Based on the assessments of two experienced physiotherapists, I find that had two people been with her at the time, she is unlikely to have fallen backwards.
"I agree that it is not possible to say what caused Tamsin to fall."
Meanwhile, the court was told Spire Hospital Norwich had been left to rue breakdowns in communication between members of staff responsible for her care.
Her death sparked the hospital to carry out a root cause analysis to investigate the circumstances surrounding the incident and identify where improvements are needed.
This found that communication between the ward staff and on-call consultants was "suboptimal" and delayed further investigations into her condition and emergency care.
However, Mrs Goward accepted the evidence of neurologist Richard Mannion, from Addenbrooke's Hospital, who believed swifter investigations after her fall would not have changed the outcome.
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