Tristianna Mahana was admitted to Bassetlaw District Hospital on July 10 2020 after she was found lying in the beer garden of the Roman’s Rest pub at Celtic Point in Worksop by paramedics, but her condition deteriorated and she died in intensive care two days later.
A two-day inquest into the 31-year-old’s death held at Nottingham Coroner’s Court that concluded this afternoon (Friday, May 28 2021) heard that Tristianna, who suffered from a number of mental illnesses and had a history of self-harm and alcohol dependency, left her supported living facility in Ollerton at around 9am on July 9.
At 5pm that day, she emerged at Bassetlaw Hospital but left around 20 minutes later without seeing a doctor.
The 31-year-old wasn't seen again until 5am the next day when she was found in a distressed state at the Roman’s Rest – her whereabouts before that time are unconfirmed.
She was later admitted to Bassetlaw Hospital with multi-organ failure where she was treated for paracetamol poisoning, but sadly did not respond and ‘passed away peacefully’ on the morning of July 12.
Tristianna had told paramedics she had been raped two days prior to being found, but a subsequent police investigation did not identify a suspect and there was no forensic evidence found during a post-mortem examination to suggest this.
During the inquest, Miss Burrell raised concerns about the police search to find Tristianna after she went missing, asking why officers were not deployed to Bassetlaw Hospital when she first appeared there.
Giving evidence on behalf of Nottinghamshire Police, Superintendent Sukesh Verma said: "The was because Tristianna, being around doctors and nurses in a hospital, was deemed to be in a place of safety."
But he also admitted that it would have been more appropriate for Tristianna to have been graded as a ‘medium risk’ person by officers when she went missing, when instead she was deemed ‘as of no apparent risk’.
However, Superintendent Verma did not believe this would have changed the outcome of the search, which he referred to as ‘like trying to find a needle in a haystack’ due to the large radius in which Tristianna went missing.
He added: “This case is part of the learning process - as a police force we need to be more sighted about vulnerability, levels of which are currently on the rise.”
Assistant coroner Fiona Gingell concluded that Tristianna had died from the effects of paracetamol.
She said there were a number of reasons Tristianna could have taken the paracetamol in the lead up to her death, including for pain-relief or self-harming, but added she was unable to determine Tristianna’s state of mind or intention at the time.
“Tristianna suffered with long-standing mental healh difficulties for which she was receiving appropriate treatment and support,” said Miss Gingell.
“I am satisfied that there were no suspicious circumstances or third party involvement.
"I am also satisfied that there were no acts or omissions by any agency involved that contributed to Tristianna’s death.
“I would like to offer my sincere personal condolences to Miss Burrell. It is clear that Tristianna is deeply missed by her family. I am very sorry for your loss.”