Woman who died in Derbyshire river suffered sudden cardiac arrhythmia
An inquest into the death of 39-year-old Kellie Poole, who died in April last year, has been taking place at Chesterfield Coroner's Court
The inquest into the death of a woman who died in the River Goyt has found she died due to sudden cardiac arrhythmia, which was triggered by immersion in cold water. The court heard this likely became 'unsurvivable' due to her undiagnosed, pre-existing heart condition.
Kellie Poole, 39, died on April 25 last year after suffering a "sudden cardiac death" believed to have been triggered by the cold water during an immersion session in the River Goyt in Whaley Bridge, Derbyshire.
The session was run by Breatheolution, led by Kevin O'Neill, who also gave evidence at the inquest at Chesterfield Coroner's Court on Tuesday.
The 39-year-old, from Droylsden in Tameside, Greater Manchester, had been attending the session with two friends when she went into cardiac arrest and was later pronounced dead at the scene by paramedics.
At an inquest into her death, a doctor said the temperature of the water - recorded as just 10.7C - was "relevant".
Giving evidence, Dr Damian Kelly, a consultant cardiologist, said Ms Poole's death was a "tragic case" and that the cold water could have caused arrhythmia which "incapacitated" her.
When asked by Senior Coroner, Peter Nieto, whether he thought it was more likely than not that cold water could have triggered a cardiac arrest, Dr Kelly said: "Yes, I think that is what has happened.
"It is difficult not to see it as relevant."
A post-mortem examination, carried out by consultant pathologist Dr Abed Zaitoun, recorded her cause of death as sudden cardiac death, caused by left ventricular hypertrophy, a thickening of the walls of the lower left heart chamber.
Giving his evidence, Dr Zaitoun said Ms Poole was obese according to her body mass index, and her heart was heavier than expected, which could have contributed to her death.
He said: "In my opinion, it is all related to the weight. The larger the weight of the body, the harder the heart has to work for that body.
"That in time increases the weight of the heart.
"(Cold water) might have had an effect on the cardiac function and might link to sudden death."
Dr Zaitoun said he could not be certain that cold water had caused the sudden cardiac event, as this would change based on temperature and how familiar a person was with being in cold water, but agreed it could have contributed.
The immersion session was booked by Ms Poole's friend, Victoria Fielding.
Giving evidence, Ms Fielding said it was a "mild" day but that the group were "shivering" prior to entering the water due to being in bathing suits.
She said she did not recall being asked to sign a waiver form but was instead asked questions by Mr O'Neill, and she, Ms Poole and another friend completed around 15 minutes of breathing exercises prior to entering the water.
She said: "I booked it, I thought 'did we fill in a waiver form?', I knew that we hadn't.
"He (Mr O'Neill) went up to each of us individually and asked if we had any medical conditions."
Ms Fielding said that Ms Poole was "enjoying" the session and "laughing and giggling", but later complained she had a headache in the front of her head.
She was advised to splash cold water onto her face by Mr O'Neill, who also scooped some water over the back of her head.
In her statement, Ms Fielding said Ms Poole then fell forward into the water, with Mr O'Neill - who will give evidence later on Tuesday - then beginning CPR.
After the court heard from an environmental health officer that the activity is not regulated, Ms Poole's mother, Diane Service, called for more to be done.
She said: "I can't believe that these activities are not regulated.
"I know it is nobody's fault, but I just can't believe it.
"It is a change that needs to come very soon.
"It is too late for Kellie, but not for someone else."
At the end of Tuesday's hearing, Ms Poole's father, Frank Service, accused Mr O'Neill of "not giving it 100%" to look after his customers and said he "needs to put more effort in".
Giving his evidence, Mr O'Neill said he did not have paper waiver forms at the time of Ms Poole's death, but equally was not expecting people to bring the forms with them.
He now has paper waiver forms for those who take part in his sessions but also called for regulation of the activity.
He said: "There is not enough regulation, I wholeheartedly agree with that.
"I have witnessed every reaction possible in the cold in the last three years and it does need regulating."
When asked by his solicitor, Jennifer Ferrario, whether he believed anything could have been done to save Ms Poole, Mr O'Neill said: "No, I don't think there is anything anybody could have done."
Pauline Forrester, an environmental health officer for High Peak Borough Council, who investigated the "tragic incident", told the court that she found "no guidance" for cold water immersion.
She also said that due to Mr O'Neill being a sole trader, while risk assessments did have to be completed, there was no legal requirement for written risk assessments.
She said: "I think this is maybe something following this case, maybe you the coroner can make some recommendations that there is some guidance published about the risks.
"There is nothing published by the Health and Safety Executive for these kinds of things."
While Mr O'Neill has completed a first aid course and written risk assessments since the incident after advice from environmental health officers, Ms Forrester added these were also not legal requirements.
Speaking after the evidence, Peter Nieto, senior coroner for Derby and Derbyshire, said that the cold water exposure likely contributed to Ms Poole's death "on the balance of probabilities".
He said: "I don't see how it would have been possible for Mr O'Neill to foresee that Kellie would get into the difficulty she did and sadly die on the riverbank.
"Quite simply, he did not know that she had a very serious cardiac condition and she did not know herself, so I don't think it is possible to say her death could have been avoided.
"I can certainly see there would be a benefit in regulation, not specifically because of Kellie's death but more generally."