Scabies death woman 'let down by agencies' in Hackney
A woman with Down's syndrome who died from scabies complications was "let down by the agencies that should have supported her", a report has said.
The condition the 38-year-old, who has not been named, was only properly diagnosed a day before her death.
A review said the woman and her mother "were left isolated by poor and ineffective use of resources".
Feryal Clark, from Hackney Council, said there were "vital lessons for all agencies involved" from the review.
The independent Safeguarding Adults Review, carried out by Ian Winter CBE, said the woman was seen by a variety of different agencies, with her mother being reliant on them to help meet all of her care needs.
As reported by the Local Democracy Reporting Service, the woman was diagnosed in August 2013 with probable crusted scabies.
However, when it re-occurred in 2015 her history of eczema led various GPs to misdiagnose her condition, with the review finding that it appears that scabies was "not considered".
She died in hospital on 10 March 2017.
The report raised concerns that if different agencies could have worked together better, the woman's death may have been avoided, or her pain analysed better and clinical engagement sought sooner.
"[She] was let down by the agencies that should have supported her health and care, and so too was her mother," Mr Winter said.
"[Her] care was not impaired by the lack of resources, rather she (and her mother) were left isolated by poor and ineffective use of resources.
"It is difficult not to conclude that her learning disability played a part in these gaps and omissions, and so too perhaps the assumed social standing of her mother."
Ms Clark, council cabinet member for health, social care, leisure and parks said: "There are vital lessons for all agencies involved including the council about ensuring health and social services do not fail our most vulnerable residents."
She said the council and its partners had carried out individual reviews.