A delay in the diagnosis of a rare heart infection “did not more than minimally contribute” to the death of ex-footballer Kevin Campbell, a coroner has found.
Mr Campbell was said to be fit and well until around January 2024 when he was first admitted to MRI for seven weeks.
An inquest in Manchester heard that tests showed he was suffering from severe heart and kidney failure but following treatment, including dialysis, he was deemed healthy enough to be discharged.
Mr Campbell lost weight during his hospital stay from 124kg to 98kg but it had plummeted to just 59kg when he was readmitted two months later on May 17.
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Area Coroner for Manchester, Zak Golombek, said Mr Campbell was “very unwell” at that stage and medics felt there was some continuation of the heart and kidney failure, with signs of an infection of unknown cause.
His condition continued to deteriorate as further investigations and tests in early June confirmed a diagnosis of infective endocarditis. Medical treatment then continued until his death from multi-organ failure.
An internal investigation by the hospital accepted the infection – caused by bacteria entering the blood and travelling to the heart – could have been diagnosed earlier and that “more curiosity” should have been shown by clinicians over Mr Campbell’s significant weight loss.
But the inquest was also told that Mr Campbell would “almost certainly” not been been fit enough to undertake “high risk” open-heart surgery if the infection had been detected earlier during his final admission.
The inquest heard there was no evidence the infection – said to be “difficult” to identify – was present during his first hospital admission or at a follow-up outpatient appointment with a cardiologist on April 26.
Recording a conclusion of death by natural causes, Mr Golombek said: “While it is my finding that there was delay in diagnosing infected endocarditis during that second admission to hospital, it also my finding that the delay did not more than minimally contribute to Kevin’s death on the balance of probabilities.
“Kevin died from a naturally occurring illness which very sadly on June 15 reached its natural end.”
Giving evidence, MRI consultant Dr Robert Henney said: “Unfortunately he had two completely separate and unrelated insults to his heart in a short space of time, so he was desperately unlucky.”
The inquest heard an earlier diagnosis of infected endocarditis would probably not have altered the “very sad outcome”.
Mr Campbell was said to have complained of fevers and “feeling tired” before his first admission.
Dr Henney said a CT scan showed evidence of a stroke which “likely” caused a clot found in his heart and that it was felt a viral infection may be the cause of his illness.
He needed further treatment for his heart when his condition deteriorated as his blood pressure dropped, the court heard.
Dr Henney said: “I think when Kevin came in he was already desperately unwell.
“I think it’s probably fair to say that many people would not have survived to the point he did. It’s probably true that his physical health and fitness enabled him to get that unwell before going to hospital.”
Areas of damage to his left kidney were also discovered but no virus was found, he said.
Dialysis and antibiotics followed as his kidney function stabilised to the point where he was walking independently and he told medics he was “managing OK”, the inquest heard.
Towards the end of his initial admission there were concerns raised about Mr Campbell’s feet and particularly signs of skin necrosis that had developed but it was treated accordingly, with a course of follow-up treatment, and there was no evidence of ongoing infection.
Dr Henney told the inquest that Mr Campbell had a weakened heart and could require further kidney dialysis but he was “essentially getting better” and the expectation was he would continue to rehabilitate and “get stronger” and gain weight, but that did not happen.
The inquest heard that Mr Campbell attended an outpatient cardiology clinic on April 26 in a wheelchair after “sudden onset facial and left limb weakness”.
But MRI cardiologist Dr Colin Cunnington said there were no new symptoms with his heart and his weight was recorded at 87kg.
The medic told the inquest the “most likely route” of the endocarditis infection was the long-standing damage to his skin on his feet which was at “constant risk of organisms entering the body”.
Mr Campbell complained to his sister about pain in his feet shortly before the second admission to MRI and she saw he was unable to look after himself.
Dr Henney said Mr Campbell was treated for an infection but the source was not clear, although it was thought it may be from the toes which had become gangrenous.
MRI consultant physician Professor Peter Selby formed part of the hospital’s multi-disciplinary team that effectively investigated Mr Campbell’s death, the coroner heard.
He told Mr Golombek that medics not showing more curiosity about Mr Campbell’s condition was “not necessarily an egregious error”.
Prof Selby said: “There are some symptoms that we associate with infective endocarditis.
“Apart from the fact that he was unwell and he had lost weight, that can be due to a variety of conditions. There was no flashing light to say this was infective endocarditis.”
The coroner ruled Mr Campbell’s multi-organ failure was due to the rare heart infection and also to pneumonia he contracted in hospital. Other significant contributory factors were heart failure, chronic kidney disease and an ischemic stroke, he said.
No family members were present at Manchester Coroner’s Court but Mr Campbell’s brother, Harold, and sister, Lorna, followed the proceedings remotely.
Harold Campbell told the hearing that his brother was the family “superstar”.
He said: “Kevin was very loved as a football professional, in the media and especially by the fans of the clubs he played for. He was very, very loved by everyone.
“From a family point of view, he was our superstar from his start in football at 13 years old.
“Everyone loved him, not only as a professional footballer but as a normal person. His football career was successful but after his retirement, I think everyone sort of got more in tune with his personality – a normal person and he was very, very loved.”
Mr Campbell scored 59 goals in 224 games for Arsenal and, alongside the 1990/91 league title, he also won the FA Cup, League Cup and European Cup Winners’ Cup at Highbury.
He spent three years at Nottingham Forest after joining them in 1995 and had a one-season stop at Trabzonspor in Turkey before moving to Everton in 1999.
He stayed at Everton until 2005, where he spent time as captain under Walter Smith, and ended his career with spells at West Brom and Cardiff.
Mr Campbell worked in the media after his playing career and was a member of the Black Footballers Partnership, which works to increase the voice and influence of black footballers.
A spokeswoman for Manchester University NHS Foundation Trust, which runs MRI, said: “We once again offer our deep condolences to the family and friends of Mr Campbell for their very great loss.
“It is clear from the inquest that everyone did their best to care for him, and there is no evidence that Mr Campbell’s death could have been avoided.
“We are committed to constantly improving the quality of care we provide to our patients.
“Whilst there are aspects of Mr Campbell’s care that could have been improved, the coroner has found that these did not more than minimally contribute to his sad death.
“We have already taken learning from Mr Campbell’s care and made improvements across the trust, and we are committed to ongoing learning and improvement for all our patients.”