On 25 and 26 September 2023, an inquest into the death of Kellie Poole at Chesterfield Coroners Court raised significant interest all over the country. This is most likely due to the fact that this tragic death could have happened to any one of us, because when Ms Poole died, she had no idea that she had had a pre-existing heart condition and could have suffered a cardiac arrest at any time. Ms Poole died during a cold-water therapy session in the river Goyt, Whaley Bridge, Derbyshire in April 2022.
The Press have accurately reported that the Coroner concluded that Ms Poole died from sudden cardiac death triggered by cold water immersion, caused by left ventricular hypertrophy (for us lay persons that means she had a significantly abnormal heavy heart and had a fatal heart attack). Dr Kelly a Consultant Cardiologist said that it was likely that Ms Poole had inherited this condition and no-one knew about it including Ms Poole herself. Dr Kelly’s view was that any event that took Ms Poole’s heart rhythm outside of its normal rhythm would likely prove fatal, and the cold-water immersion had triggered such an event. Unfortunately, when Ms Poole suffered a cardiac arrest whilst at shoulder height in the water, she did not regain consciousness.
My client is Kevin O’Neill, the cold-water therapy instructor. He told the inquest that over the years he has taken thousands of people into cold water without incident. On the 25 April 2022, he made sure, as he always does before taking clients into cold water, that no-one present had any medical conditions that would place them in any danger. He checked the temperature of the river to ensure that it was not too cold, led breathing techniques on dry land and then slowly walked them into the water until they were shoulder height. The friends were enjoying themselves when Ms Poole suddenly lost consciousness and before her head was immersed into the water, she was taken to the river bank and Mr O’Neill carried out CPR until the paramedics arrived. Tragically she was declared deceased on the riverbank.
The Coroner, having heard the evidence said that Mr O’Neill did not contribute to the death. Ms Poole was unaware of her heart condition and had told Mr O’Neill that there were no medical reasons that placed her in any danger by entering cold water. The Coroner concluded that Ms Poole and her friends took a risk by going into the water as do people all over the country when they take part in cold water activities.
When the Coroner decided to issue a report to try and prevent future deaths occurring in similar circumstances, he told the inquest that his decision was not connected Mr O’Neill or to Ms Poole’s death, but arises out of a general concern that this type of activity is not regulated. None of the witnesses, including the Environmental Health Officer from the local authority knew whose umbrella the regulation would potentially fall under and the Coroner said that he will most likely write as a starting point to the Health and Safety Executive.
My client told the inquest that he would welcome regulation for the cold-water therapy industry as he is passionate about a safe environment for participants. Mr O'Neill travels the country teaching breathing techniques to clients both on dry land and in cold water to aid with physical and mental health conditions and has helped an enormous amount of people in recent years. He was incredibly upset about the tragic death of Ms Poole and is determined to continue to raise awareness about practising cold water safely and effectively and quite separately, will be advocating that screening occur more often for potentially inherited heart conditions.
There is clearly a balance for us all to strike. On the one hand we should not avoid extreme activities just in case we might have a pre-existing medical condition that could prove fatal because we need to live our lives to the full. On the other hand, we should think carefully before engaging in these activities if we have any reason to suspect that we may be exerting too much pressure on ourselves, particularly if we are overweight or unfit. Having instructors such as Mr O’Neill ought to assist because if they practise safely as Mr O’Neill does, they will ask the right questions and only proceed with the activity if they consider it safe to do so.