Listeria outbreak at hospital linked to meat processing firm, inquest hears

The source of a listeria outbreak involving the death of two women was traced to a food processing firm supplying meat for chicken mayo sandwiches for NHS patients, an inquest has heard.

Retired nurse Beverley Sowah, 57, and mother-of-five Enid Heap, 84, were given the sandwiches on successive days while they were patients at Manchester Royal Infirmary (MRI) in 2019.

The women, who had underlying health problems, died within days and the “primary hypothesis” was that they suffered listeria infections from the sandwiches, a joint inquest heard at Manchester Coroner’s Court.

Their deaths were part of a nationwide alert over the listeria outbreak which affected nine people in other hospitals, including in Liverpool, Leicester and Derby.

Listeria can cause an illness called listeriosis, which can be fatal for people with weakened immune systems.

Tina Potter, head of incident at the Food Standards Agency regulator, told the inquest the outbreak was escalated to a high-priority incident.

She said the meat supplier, North Country Quality Food (NCQF), which supplied the chicken for sandwich firm the Good Food Chain (GFC), was found to be the earliest point in the supply chain where listeria matching the outbreak strain was detected.

Jamaican-born Mrs Sowah was admitted to MRI on April 15 2019 as she was suffering from advanced breast cancer. Two days later she was given the chicken mayo sandwich and she died on April 26.

Mrs Heap, a retired chemist shop assistant, was admitted to MRI on March 25 2019 and was served the same type of sandwich on April 18. She died on May 6.

The sandwiches were supplied by the GFC to Sodexo, which is contracted to the NHS to supply meals at the MRI.

Ms Potter said that after investigations, the source of the listeria was thought to have originated in the cooked chicken supplied to the GFC by NCQF, based in Salford.

The Good Food Chain, based in Stone, Staffordshire, made up to 40,000 sandwiches a day, supplying around 70 hospitals.

The inquest heard there are safe levels of listeria and it is a widespread, common bacteria with various strains, with the maximum legal limit of 100 colony-forming units per gram (cfu/g).

A month after the women’s deaths, as public health officials investigated, a sealed bag of chicken products supplied by NCQF to GFC was tested and found to have an “unprecedented high level” of the strain of listeria involved in the outbreak, Ms Potter said.

The level found in the diced chicken bag was 1,000 cfu/g – 10 times the legal limit.

Ms Potter said investigations immediately linked the two MRI deaths because they were at the same hospital and both patients had eaten the same sandwiches.

They worked backwards to trace the sandwich supplier and which firm had supplied the meat.

Zak Golombeck, Manchester city coroner, said: “You were able to conclude that the source of the listeria contamination was the cooked chicken?”

Ms Potter said: “That’s correct. We drew that conclusion because that was the product that patients had consumed.”

Another customer had a supply of bacon from NQCF which was found to have the strain of listeria involved in the hospital deaths.

Ms Potter added: “So having a pathogen genetically related in two food products within the same business would lead us to a likely hypothesis that there’s an environmental contamination that’s persisted.

“It’s really difficult once it takes a foothold in a business to get rid of it.”

The meat supplier and the sandwich maker have since gone into liquidation.

The hearing was adjourned until Friday morning.