Nurse dies 24 hours after being diagnosed with Victorian disease

A healthy nurse who tragically died from tuberculosis should have been warned about her exposure to the disease months earlier when she was volunteering on an NHS ward, according to a shocking report by a coroner.

Carrianne Franks, 30, discovered that she had contracted TB less than a day before she passed away. Her heartbroken parents, Chris and Bev Franks, are now urging for more measures to be taken to safeguard those who care for us in hospitals across the country.

Carrianne, an RAF sergeant, had been working as a flight nurse for a decade and was stationed at London’s Chelsea and Westminster Hospital for three years when the Covid pandemic struck. It was here in November 2020 that she worked on the same ward as a patient with TB. Carrianne was later treated at both Lincoln Hospital and Bassetlaw Hospital in Worksop over a nine-week period, but she was tested for TB so late that her life could not be saved, reports The Mirror.

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Her parents told the Mirror that they want the guidelines of NICE (National Institute for Health and Care Excellence) to be updated to prevent any other healthcare worker from dying. The current guidelines state that only those who have been in contact with a TB patient for eight hours should receive a letter warning them about the risks.

Carrianne’s mum, who is a schoolteacher named Bev, said: “It’s the NICE guidelines that need to change. The hospital used the NICE guidelines to risk assess whether she should have been told. She did two shifts on that ward but because she wasn’t the patient’s nominated nurse she wasn’t given a Warn and Inform letter.”

The day before she passed away, Carrianne sent a worried text to her parents after she was finally diagnosed. It read: “Mum, they found out what I have. I’ve got TB.” Her family couldn’t say goodbye as she was quickly placed in a coma in intensive care, where she died.

This week, after a coroner released a Prevention of Future Deaths Report, her mum Bev spoke to the Mirror. She said: “The coroner filled us with a new level of confidence, it felt that she was on Carrianne’s side.” She also shared how the inquest revealed that Carrianne could have lived if the procedures had identified her contact with the TB patient and therefore being at risk of having contracted the disease.

“The expert told us if she had been diagnosed right up to two weeks before she died, she would have survived, ” Bev explained. “They gave her covid meds because they were convinced it was that, despite negative lateral flows and PCR tests, those drugs lowered her immune system.”

dad Chris, who is a site manager, sadly said: “It’s just so sad to talk about, she told her mum ‘I’m going to die’. They had loads of opportunities to save her life, the jury heard there were so many missed chances. It was a catalogue of errors but we have lost our daughter, they don’t realise the impact it has had on our family.”

Nurses who might be exposed to diseases like TB should get a “Warn and Inform” letter. This way, they and anyone treating them in the future would know what symptoms to look out for. However, despite being on the ward at Chelsea and Westminster in November 2020 when a patient with TB was there, Carrianne wasn’t considered the “named nurse”. Also, she hadn’t been in “close contact for eight hours” with the individual, so she didn’t receive this letter. This rule follows the current NICE guidelines.

Laurinda Bower, the coroner, made a Prevention of Future Deaths report after looking into the case. The jury recorded a narrative cause of death. The report stated: “Carrianne was not classed by the hospital as a ‘close contact’ of the infected patient, so she did not benefit from contact tracing, a Warn and Inform letter, or any education on the signs of TB infection to look out in the coming months.”

“By the time Carrianne became unwell with respiratory symptoms in June 2021, neither she, her GP, nor the RAF’s Occupational Health Department had been informed that she had been working on a hospital ward where a patient had tested positive for TB.”

Carrianne (second right) served for 10 years in the air force

The coroner explained that if the doctors had known Carrianne was in touch with someone who had TB, they would have tested her sooner. She said: “They would have conducted tests to seek to rule the condition in or out, and in this case, would have arrived at a diagnosis far sooner and in time to start treatment that would have prevented her death. The lack of knowledge of her heightened risk of TB because of occupational exposure…significantly delayed her diagnosis and treatment, which in turn contributed to her death.”

The coroner also made an urgent call for change, which Carrianne’s parents hope will lead to better safety rules. She warned: “In my opinion there is a risk that future deaths could occur unless action is taken.”

Miss Bower suggested that safety guidelines should protect all medical workers, not just those caring for sick patients. She mentioned: “I heard evidence from an expert who told me of cases of medical professionals contracting the condition despite no known direct contact with the patient but having spent time in a corridor containing an air vent leading from the infected patient’s room.”

“I cannot see a good reason for restricting the Warn and Inform letter process, rather than applying the same broadly to all staff who worked on the unit at the relevant time. Carrianne’s case highlights the importance of warning all staff of TB cases on their wards, so that if they do become symptomatic in the coming months, and it may be many months later, they will be equipped with the necessary information to share with their treating clinicians.”

Carrianne’s parents are still fighting for change to protect her fellow nurses. To mark what would have been their daughter’s 33rd birthday they organised a 33km charity walk last Saturday, and were joined by her friends and family. They have so far raised more than £7,000 for the charities TB Alert and the RAF Benevolent Fund.

Dr Nick Mallaband, acting executive medical director at Doncaster and Bassetlaw Teaching Hospitals, said: “This was a complex and atypical case, and while the coroner praised the trust on our policies and guidance, we acknowledge that there were missed opportunities which, potentially, could have led to an earlier diagnosis.”

She volunteered to help during covid

A spokeswoman for United Lincolnshire Hospitals NHS Trust said: “We would like to offer our deepest and most sincere condolences to the family and friends of Carrianne Franks. We hope that the response by the coroner in issuing a Prevention of Future Deaths Notice to national agencies will help to further raise awareness about tuberculosis.”

“The management of respiratory illnesses including tuberculosis is a core knowledge area for respiratory specialists and the Trust ensures that this specialist team is available to other clinicians for advice and guidance. Physicians undertake annual continuing professional development which for respiratory specialists would include the management of respiratory illnesses and this is monitored through medical appraisal.”

A Chelsea and Westminster Hospital NHS Foundation Trust spokeswoman said: “We are deeply saddened by the loss of a valued and supportive member of the nursing team and we offer our heartfelt condolences to Carrianne’s family, friends and colleagues. We strive to provide the safest possible environment for our staff to work in and we have reviewed our TB policy and have taken actions to ensure that all staff are aware when they are working on a ward where TB patients are cared for. Our thoughts remain with Carrianne’s family and friends.”