Newstead, Mark Graham

51y · Male·metastatic small round cell malignancy (Ewing's Sarcoma)

Mark Graham Newstead, a 51-year-old man with schizophrenia and untreated hepatitis C, died from metastatic small round cell tumour (Ewing's Sarcoma) while in custody. He presented with urinary retention and lower limb weakness in January 2018, underwent urgent spinal decompression surgery, and was subsequently diagnosed with advanced metastatic cancer. Palliative care was provided until his death in March 2018. A forensic medical review found the healthcare provided was appropriate and the malignancy could not have been predicted from early symptoms. The clinical lesson is that rapid investigation and treatment of acute neurological presentations in custody settings should proceed as in the community, and early MRI imaging may be warranted when infection cannot be excluded in immunocompromised patients with unexplained symptoms.