Inquest: Tragic Sophia 'may have starved' after government axed her benefits, inquest hears

Sophia Yuferev was the latest in a series of patients whose inquests heard about problems with the short-staffed mental health trust NELFT (North East London NHS Foundation Trust).

Sophia’s care coordinator was supposed to “make regular contact with her" - but they went off sick and she was left “unallocated” for months.

By the time a new coordinator looked at her file, she is believed to have already been dead.

Sophia, 37, was found decomposing in her flat at Bridge Point, Hornchurch, on November 16, 2021.

She suffered from paranoid schizophrenia which sometimes caused her to distrust her family, so they relied on NELFT to keep her safe.

However, coroner Shirley Radcliffe said it was unclear whether earlier action by NELFT could have saved her.

In a statement, NELFT said it had learned from the failings in Sophia's case.

An inquest into Sophia Yuferev's death was heard at the East London Coroner's Court - at Barking Adult College - on Wednesday, July 20 (Image: Archant)

Acid

A pathologist found evidence of ketoacidosis – high levels of acid in Sophia’s blood – and initially ascribed this to diabetes.

But after the Recorder reported that Sophia’s medical records contradicted the pathologist’s finding, an inquest was ordered.

Held on Wednesday, July 20 at Barking Adult College, the inquest heard the pathologist had linked Sophia’s ketoacidosis to diabetes based on inaccurate blood test results.

There was in fact no evidence of diabetes.

The other common cause of ketoacidosis is high alcohol use, but this was ruled out as Sophia was teetotal.

Rarer causes of ketoacidosis, said experts, are severe infections or starvation.

A treasured photograph of Sophia when she was younger, which her mother Maria keeps in her living room (Image: Maria Stockdale)

Benefits

In January, Sophia's mother said she spent her final months surviving on one sandwich per day.

Her Personal Independence Payment (PIP) benefit was cut off in February 2021, when the Department for Work and Pensions (DWP) claimed she could “manage complex budgeting” and understand "complex written information”.

Yet months later, NELFT said Sophia had “poor insight” and was incapable of filling out a passport application.

Sophia appealed but her PIP was not reinstated until late October, by which time she may already have been dead.

In her final months, her mother Maria Stockdale said she was "completely broken".

NELFT records show that in June 2021 Sophia complained of fatigue. Months later, Mrs Stockdale had raised concerns about the PIP cancellation.

Barrister Andrew Perfect, representing Sophia’s family, said Sophia may have had no income.

The inquest heard Sophia had a normal BMI at the time of her death, but ketoacidosis could be caused by a short period of starvation.

Sophia Yuferev was found dead in her flat at Bridge Point, on Southend Arterial Road in Hornchurch, in November (Image: Google Streetview)

NELFT

Sophia was supposed to attend fortnightly appointments for anti-psychotic injections.

But after attending on October 12, she was not put on the list for her next appointment date, October 26.

Ordinarily, if a patient misses one of these appointments, it is flagged on the same day – but as Sophia was not on the list for October 26, nobody noticed when she didn't show up.

Meanwhile, she had been left with no care coordinator for three months due to staff shortages.

A new coordinator looked at her file on November 8, realised there was no record of Sophia attending on October 26 and began trying to reach her.

A week later she called police, who found Sophia’s body.

Irvine Muronzi, an assistant director at NELFT, testified that the trust was so short-staffed at the time that it had been flagged as a risk.

They were "relying on agency staff who probably sometimes don't understand our systems", he said.

Otherwise, he told the court: “Certainly, in this case, I think there would have been an earlier involvement of the police.”

Sophia Yuferev in her mother Maria Stockdale's Harold Hill living room (Image: Maria Stockdale)

Conclusion

“This is clearly a very puzzling death and very frustrating for the family, not being able to fully understand why their loved one has died,” Mrs Radcliffe said.

She recorded Sophia’s cause of death as ketoacidosis of unknown cause and wrote a narrative conclusion.

“Sadly, there is insufficient evidence to provide the answers the family are looking for and I am really sorry,” she said.

Afterwards, Sophia’s sisters Maria Mashiah and Yulia Tlili said they believed the likely cause of Sophia’s ketoacidosis was a lack of food.

Maria said she still wondered whether Sophia could have survived.

“If someone had turned up at the flat...maybe she could have been saved,” Maria said.

A NELFT spokesperson said: "We would like to offer our sincere condolences to Sophia’s family and loved ones.

"We have been working with the family to provide ongoing support and access to family liaison.

"As per our trust’s serious incident process, we have undertaken a review of the care delivered and are implementing learning as a result of this review."