Prevention of Future Deaths reports · 2013

Tripta Rani Kumar

Regulation 28 report to prevent future deaths, reference 2013-0235, written 19 Sep 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report19 Sep 2013
Reference2013-0235
DeceasedTripta Rani Kumar
CoronerChinyere Inyama
Coroner areaLondon Eastern
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS(1) 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.

HOSPITAL). 

 (CHIEF EXECUTIVE, QUEENS 

1. 

I  am  Chinyere  Inyama,  senior  coroner  for  the  coroner  area  of  Eastern 
District Greater London. 

2.  CORONER’S LEGAL POWERS 

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

3. 

INVESTIGATION and INQUEST 

On  30th  August  2012  I  commenced  an  investigation  into  the  death  of 
Tripta Rani KUMAR,69 years. The investigation concluded at the end of 
the inquest on 4th September 2013. I concluded with the narrative  “The 
deceased undertook routine, planned vaginal hysterectomy and anterior 
repair on 21st August 2012 before being discharged on 23rd August. She 
was readmitted on the 24th August 2012 with overwhelming sepsis as a 
result of bowel perforation likely incurred during the procedures carried 
out  on  21st  August.  She  died  as  a  result.”  The  medical  cause  of  death 
was  1a.  Multiple  Organ  Failure,  1b.  Organising  Peritonitis,  1c. 
Perforation of Large Bowel (repaired), II. Old Empyema of chest 

4.  CIRCUMSTANCES OF THE DEATH 

1.  The  deceased  had  a  planned  hysterectomy  for  a  prolapse  on 
Tuesday 21st August and was discharged on 23rd August 2012. 

2.  She  was  readmitted  on  the  24th  August  2012  complaining  of 

abdominal pain and found to have a perforated bowel. 

3.  Hartmans procedure completed but she was septic by this stage. 
Maximum  treatment  continued  post  operatively  in  ITU  but  she 
suffered a cardiac arrest on the 25th August 2012. 

 
 
 
 4.  CPR was given but she died despite efforts made. 

5.  CORONER’S CONCERNS 

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

The MATTERS OF CONCERN are as follows:- 

In the emergency department, during the course of treatment given on 
the 24th August 2012, the deceased was attended to by an ST4, doctor 
in  Obstetrics  and  Gynaecology.  The  doctor  documented  the  likely 
diagnosis,  requested  an  urgent  CT  scan  and  prescribed  intravenous 
antibiotics  in  the  form  of  Tazocin.  Tazocin  contains  two  active 
ingredients,  Piperacillin,  which  is  a  penicillin  type  antibiotic  and 
Tazobactum  which 
from 
inactivating Piperacillin.  

is  a  medicine  that  prevents  bacteria 

Evidence  from  the  family  of  the  deceased,  confirmed  by 
(Consultant in Accident and Emergency), revealed that the notes clearly 
showed  that  the  patient  had  a  penicillin  allergy.  The  family  of  the 
deceased also confirmed in court that their mother was wearing a band 
on her wrist which confirmed the penicillin allergy. 
 further 
confirmed  that  the  entry  in  the  notes  that  said  ‘penicillin  allergy’  had 
been  crossed  out  and  the  note  ‘nil  allergies’  had  been  entered  instead. 
This  was  in  handwriting  but  with  no  signature  to  confirm  who  had 
written the note. 

The grave danger is that, although not relevant in this particular case, 
giving someone penicillin who was allergic to that penicillin could easily 
have resulted in anaphylactic shock which, in turn, could have resulted 
in death. 

6.  ACTION SHOULD BE TAKEN 

In  my  opinion  action  should  be  taken  to  prevent  future  deaths  and  I 
believe you/or your organisation have the power to take such action. 

It  is  clear  there  should  be  a  review  of  the  systems  in  place  that  are 
meant to ensure there is no risk of anaphylactic shock in such cases. In 
addition,  the  operation  of  the  system  should  be  audited  on  a  regular 

 
 
 
 basis  since  potential  consequences  of  absence  of  or  poor  operation  of 
such systems are potentially so serious. 

7.  You  are  under  a  duty  to  respond  to  this  report  within  56  days  of  the 
date of this report namely by 15th November 2013. I, 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. 

8.  COPIES and PUBLICATION 

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

 and 

I  am  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 of the publication of your response by the Chief Coroner. 

9.  19th September 2013.

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