A VULNERABLE woman did not die as the result of eating an “improperly prepared” chicken sandwich, an inquest has concluded.

Jurors at Crook Coroners Court said that Olivia Rosemary Keenan had died from natural causes at the end of a three day inquest into her death.

The 58-year-old, who had Down’s Syndrome and dementia, died at the Middleton Lodge Care Home, near Darlington in March 2016.

She collapsed and died shortly after eating a chicken sandwich that was not prepared according to strict dietary guidelines, sparking suspicions that she may have choked on her food or that it otherwise contributed to her death.

Due to complications arising from dementia and Down’s Syndrome, Ms Keenan was at an increased risk of choking and as such, should have been supervised during meal times and fed a soft diet, with meat pureed and bread cut into 2cm pieces and soaked in sauce or gravy.

When preparing the sandwich, the home’s deputy manager Shona Bairstow failed to comply with the guidance, instead cutting the sandwich into four and neglecting to puree the meat, soak the bread or supervise Ms Keenan while eating.

Pathologists Dr Mark Egan and Dr Peter Cooper told the inquest that there was no post-mortem evidence to suggest that the improperly prepared sandwich had caused Ms Keenan’s death.

Following deliberations on Thursday, the jury unanimously concluded that Ms Bairstow’s mistakes had not contributed to Ms Keenan’s death and found that she died after choking on her own vomit.

Their verdict said: “Olivia Rosemary Keenan died from the effects of a blockage to her airways. Shortly before her death, she ate a chicken sandwich contrary to recommendations…On the balance of probabilities the above omissions did not cause or contribute to her death.”

Problems with the way the home operated were highlighted by the jury who suggested that “the roles and responsibilities of staff were not clear and there was insufficient management, oversight and support.”

Assistant coroner Oliver Longstaff recorded that Ms Keenan had died from natural causes as he offered condolences to her family.

Following the inquest, Ms Bairstow – who claims work related pressures and stress contributed to her mistakes - said the verdict came as an “immense relief”, adding: “I made mistakes, as I have said all along. The relief for me comes from the fact that those mistakes did not kill someone.”

She said that Ms Keenan’s family were foremost in her thoughts.