Prevention of Future Deaths reports · 2013

Mohammed Chaudhury

Regulation 28 report to prevent future deaths, reference 2013-0193, written 20 Aug 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Aug 2013
Reference2013-0193
DeceasedMohammed Chaudhury
CoronerAndrew Harris
Coroner areaLondon Inner (South)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)
NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

Re: Mohammed Mozammel Hussain CHAUDHURY, Dod: 10 July 2010, Case
number: 1774-10
Case Officer: and Tel no. iy

THIS REPORT IS BEING SENT TO:

1. Mr Tim Smart, Chief Executive, King’s College Hospital NHS Foundations
Trust

2. EE Deputy Director of Operations, Care Quality
Commission

3. Sir Mike Richards, Chief Inspector of Hospitals

1 | CORONER

! am Andrew Harris, senior coroner for London Inner South

2 | CORONER’S LEGAL POWERS

I make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013.

INVESTIGATION and INQUEST

On 10" July 2010 | opened an inquest into the death of Mohammed Mozammel
Chaudhury. The investigation concluded at the end of the inquest on 2™ August 2013.
The medical cause of death was 1a Overwhelming sepsis 1b Chest and other infection
1c Traumatic brain injury. The conclusion of the inquest was a narrative determination.

4 | CIRCUMSTANCES OF THE DEATH

Mohammed Chaudhury suffered multiple injuries from a traffic collision on 7" September
2009. He was cared for in Kings College Hospital initially in TU when he was immobile
due to fractured pelvis and was at high risk of bed sores due to minimal consciousness,
peripheral vascular disease, diabetes and PEG feeding. He was transferred to a step
down ward without pressure sores on 27" September. There he developed a number of
infected pressure sores, which were due to not being nursed on an air mattress for three
weeks and insufficient turning due to shortage of nursing staff. He was transferred to a
nursing home with five pressure sores between grades 2 and 4, which were septic.

5 | CORONER’S CONCERNS

During the course of the inquest the evidence revealed matters giving rise to concern. In
my opinion there is a risk that future deaths wiil occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

(1) Infected pressure sores may have been a cause of death and they were unusual in

extent and severity. Their development was prevented in ITU when he was most at risk
and considerable improvement was achieved in the nursing home after discharge. Their
development and deterioration related to nursing care on Murray Falconer ward in KCH

| between 27™ September and 9" December.

(2) Professional evidence confirmed that this was due to failure to turn regularly. 2 hourly
turning was required, although this was not prescribed by tissue viability nurses or
doctors. There were missing care plans, gaps in plans and delays in referral to TVN.
Waterlow scoring was not consistent. Days were recorded when there were only 2, 3, 4,
5 or 6 turns per day. NICE guidance was not being followed. Some improvements in
training and reporting have been reported since.

(3) Nursing rotas for the period were not available. Some days were reported as below
establishment. (8 by day and 6 by night for 31 patients of which at least a % were high
dependency). Not all bank shifts were filled.

(4) Although the ward has since been restructured and takes different cases, it was not
possible to conclude that current staffing levels in the hospital for unconscious patients
requiring regular turning were safe, as comparisons were difficult and the judgement
required professional and managerial opinion.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you
[AND/OR your organisation] have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by Tuesday 1“ of October 2013 |, the coroner, may extend the period,

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons

EE Solicitor Field Fisher Waterhouse LLP

NOK
Solicitor KCH Legal Services

| have also sent it to the following, who may find it useful or of interest.

Rt. y Hunt Secretary of State for Health
Fairlie Nursing Home
Community Tissue Viability Nurse

lam also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary
form. He may send a copy of this report to any person who he believes may find it useful
or of interest. You may make representations to me, the coroner, at the time of your
response, about the release or the publication of your response by the Chief Coroner.

[DATE] [SIGNED BY CORONE!

Qo Meg 8

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