A formerly fit and healthy young man from Staplehurst passed away in hospital after a series of illnesses that medical experts could never get to the bottom of, an inquest has heard.
Mark Hollands, 33, died in Maidstone Hospital on November 19 last year from respiratory sepsis and hepatic encephalopathy - damage to the brain caused by liver malfunction.
The father-of-two had been admitted after his partner, Georgina Stevens, found him collapsed on the floor of their home in Gybbon Rise, Staplehurst, and called an ambulance.
His troubles began in 2014, when he reported to Staplehurst Health Centre suffering from pain in his lower back, possibly as a result of his work as a gardener. He was prescribed painkillers and anti-inflammatory tablets.
The following year he was diagnosed with inflammatory bowel disease. Mr Hollands became addicted to the painkillers, such that his GP Dr Robert Rumfeld tried to ration his prescriptions, but suspected Mr Hollands was supplementing his supply elsewhere.
Mr Hollands went on to suffer a range of conditions from ulcers to sepsis, fractures from falling, to a bleed on the brain. He was several times suspected of having Crohn's Disease or possibly a very rare inherited condition related to an intolerance of certain amino acids called Maple Syrup Urine Disease.
He developed mental health problems and perhaps not unsurprisingly suffered from depression. As a result of his illnesses, he began to waste away, losing half his body weight.
He had several stays in hospital, some in the intensive care unit.
But Mr Hollands had an aversion to hospitals and whenever he was well enough he would often discharge himself, frustrating the medics who were trying to care for him.
Hospital consultant Michael Browning told the inquest: "All we could do was firefight his acute problems. He never stayed around long enough to engage with the specialist centres that might have been able to get to the underlying cause of his troubles, if indeed there was one underlying cause.
"We were all very frustrated that he wouldn't let us do more to help him."
On one occasion, the doctors did use a Deprivation of Liberty Safeguards (DOLS) order to compel him to stay in hospital, but questioned by Miss Stevens as to why that was not used on other occasions, Dr Browning explained. "We can only use that when the patient is assessed not to have the mental capacity to make decisions for himself."
'You can't treat someone against their wishes'
"We can't compel a patient to stay in hospital if he has capacity and simply chooses not to take our advice."
Coroner Geoffrey Smith said: "This was a complex medical case where Mr Hollands' symptoms were constantly changing. The doctors treated all they could see, but without Mr Hollands' engagement with one of the centres of excellence, it was difficult to find a causal connection and his case remained an enigma.
"A contributory factor to his death was that on frequent occasions, Mr Hollands did not co-operate with his doctors, but you can't treat someone against their wishes."
He concluded the death was from natural causes.
After the hearing, Mr Holland's mother, Angela Walsh, said that her son had needed psychiatric help to overcome the problems that led to his aversion to hospitals.
She said: "There needs to be far more mental health provision and it needs to be linked up with the other health services."
Mr Hollands leaves his partner and a son of 11 and daughter of six.