A teenager who died from sepsis on a school trip was “clearly very unwell” shortly before she collapsed, her friend told an inquest.
Ana Uglow, 17, a student at Bristol Grammar School, collapsed in her hotel room and was pronounced dead at Mount Sinai West hospital on December 19 in 2019.
Avon Coroner’s Court has heard that Ana, a senior prefect who aspired to attend Oxford University, was on a school history trip to Washington, Philadelphia and New York at the time.
Her parents, David and Natalia Uglow, claim Ana told teachers she may have a chest infection and asked to see a doctor two days before her death but this was “refused”.
However, the two teachers Rory Hambly and Ellice Clare have insisted that Ana only complained of feeling tired and having a blocked nose, and did not directly ask to see a doctor.
A report by the chief medical examiner of the city of New York concluded that Ana, of Redland, Bristol, died from bronchopneumonia and sepsis complicating an influenza upper respiratory infection.
In statements read to the inquest, Ana’s friends Katie Meredith and Jenny Burgess described how she had a “cold” during the trip to New York and complained of being “tired”.
Ana was off school with cold-like symptoms for two days before the trip but felt better and set off to Washington from Bristol with eight other pupils, Mr Hambly and Mrs Clare, early on December 14.
Miss Meredith said: “I am aware that Ana was off school before the trip with what was described as flu and found out later that she had a bad cold.
“She had this cold throughout the trip and was pale compared to her usual colour.
“This was especially noticeable during the last couple of days.
“As part of this Ana had a cold.
“She would sometimes cough during the morning but it was more noticeable at night.
“Ana did not get much sleep as she was coughing all the time and was complaining that she was not getting enough sleep.”
On December 15, the group did a walking tour of Washington and Ana complained of being tired from the long journey, Miss Meredith said.
The following day, Ana asked to stay at the hotel while the group went to the National Museum of African American History and Culture but came along after speaking to her teachers.
Miss Burgess described how she saw Ana sitting on a bench at the museum and she chatted to her but she was “tired”.
On December 17, the group travelled from Washington to Philadelphia and Ana called her mother during the journey, telling her she was worried she had a chest infection, felt much worse and had a fever and cough.
Mrs Uglow told her daughter, who complained of feeling “out of breath” and unable to keep up with the group while walking, to speak to her teachers and ask to see a doctor.
The teachers advised Ana to take paracetamol, adding that she could go to a pharmacist in Philadelphia and they could take her to a doctor in New York if she felt worse.
Both Mr Hambly and Mrs Clare insisted Ana had not directly asked to see a doctor and they would not refuse such a request.
Dr Chris Danbury, a consultant in intensive care medicine, previously told the inquest that Ana would not have suffered a cardiac arrest if she had been treated with antibiotics on December 17 or 18.
Ana was sick overnight on December and asked the teachers if she could stay in her hotel room but came on a walking tour as they could not leave her alone.
Miss Meredith said: “Ana was grumpy about it during the tour but still came and seemed fine during the tour and at lunchtime.
“Ana did look pale and clearly had a bad cold.”
In the afternoon, Ana and Miss Burgess went shopping on Fifth Avenue.
Miss Burgess described how Ana had a “bad cold” and had to sit down while in one shop.
“I recall Ana saying she had felt ill or a bit tired,” Miss Burgess said.
That evening, the group went to the Empire State Building and Ana was seen coughing and retching into a bin.
On December 19, she awoke Mr Hambly at about 6am saying she felt unwell, her heart was racing, she felt anxious and had difficulty sleeping.
Mr Hambly and Mrs Clare described giving Ana a banana to eat before taking some painkillers, and calmed her down before walking her back to her room so she could get some sleep.
Miss Meredith and Miss Burgess, who were sharing a room with Ana, awoke at about 7.30am to find that she had suffered a nose bleed.
“Ana’s breath was very hard and gaspy,” Miss Burgess said.
“She was very pale and her eyes were bulging.
“There was blood on the bed.”
She said Ana sometimes struggled to “form her words” and “would make a noise as if in pain”.
Ana told her friends: “I think I’m going mad” and “I can’t feel anything”.
Miss Burgess added: “Anna didn’t seem like herself and I was scared.”
Miss Meredith, who described Ana as “very pale”, fetched the teachers and told how Ana asked Mr Hambly: “Why is this happening to me?”.
“Sometimes when we were asking questions that morning she would not answer them too quickly and was clearly very unwell,” Miss Meredith said.
Mr Hambly previously told the hearing that Ana was “lucid, responsive and articulate” when he went to the room.
“She mentioned ‘I want to give my mum a call, I just want to tell my mum I’m doing OK’,” Mr Hambly said.
“I basically said ‘Your mother isn’t worrying about you, you don’t need to call her’.
“That was pretty much the last thing she said because at that point her nose started bleeding.
“Her eyes glazed over and she slumped on the bed.
“Seconds before we had been talking pretty normally.
“It was shocking.”
Mr Hambly called the emergency service and performed CPR on Ana until paramedics arrive to take her to hospital.
The inquest continues.