A 12-year-old Midlands schoolgirl who died just weeks after being sectioned under the Mental Health Act was suffering from a treatable physical brain condition, a coroner's court has heard.
Mia Lucas from Nottingham was admitted to a specialist mental health unit after her family took her to the emergency department at Queen's Medical Centre (QMC) on December 31, 2023. The inquest at Sheffield Coroner's Court was told the youngster had tried to get knives from the kitchen and fought her mother who attempted to stop her.
A Psychosis Driven by Physical Illness
The jury heard how Mia was experiencing severe hallucinations and hearing voices that told her she needed to 'go to heaven' or something would happen to her family. Doctors at QMC initially decided there was no underlying physical cause for her psychosis and she was sectioned.
Mia was transferred to the Becton Centre, part of Sheffield Children's Hospital, on January 9, 2024. Just weeks later, on January 29, 2024, she was found unresponsive in her room and died.
Definitive Diagnosis Comes Too Late
Much of the inquest has focused on whether Mia had autoimmune encephalitis, a treatable inflammation of the brain that can cause extreme psychiatric symptoms. Professor Marta Cohen presented new evidence from blood tests which she said conclusively confirmed Mia was suffering from the disorder at the time of her death.
Professor Cohen stated the medical cause of death was 'compression of the neck' caused by 'acute psychosis', which was in turn caused by 'autoimmune encephalitis'. The revelation caused Mia's mother, Chloe Hayes, to burst into tears in court.
Following this new evidence, consultant paediatric neurologist Dr Mike Taylor, who had previously only said it was 'possible' Mia had the condition, was recalled to the witness box. He told the jury it was now 'definitive' that she had autoimmune encephalitis and this was the cause of her psychosis.
Missed Opportunities and Clinical Challenges
The inquest heard that Mia had a virus in December 2023, a known though rare trigger for autoimmune encephalitis. Dr Taylor said that in light of her symptoms, he would have wanted to conduct further tests beyond the MRI scan performed in Nottingham, including a lumbar puncture and an EEG brain wave scan.
He described it as 'quite concerning' that these tests were not obtained at QMC, but acknowledged the difficulties clinicians faced. He explained that autoimmune encephalitis is a 'complex and rare presentation' that is very difficult to diagnose, and that extreme psychosis is itself very rare in 12-year-olds.
Dr Taylor also noted that treatments for the condition can have severe side effects, and treating her for it based on the evidence available at QMC could have 'caused her significant harm'. He concluded it was 'not unreasonable' for the Nottingham team to have had a low level of suspicion for the disorder.
Mia's mother previously paid tribute to her daughter, describing her as a girl interested in singing, drawing, crafts, and horse riding, who dreamed of opening a beauty salon or becoming a vet.
