Prevention of Future Deaths reports · 2013

John William Wright

Regulation 28 report to prevent future deaths, reference 2013-0285, written 31 Oct 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Oct 2013
Reference2013-0285
DeceasedJohn William Wright
CoronerGail Elliman
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedNorth Middlesex University Hospital NHS Trust
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.

ANNEX A 

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 

THIS REPORT IS BEING SENT TO: 

1. 

 Head of Patient Safety, North Middlesex University 

Hospital NHS Trust 

1 

CORONER 

I am Gail Elliman, Assistant Coroner, for the Coroner area of Inner North London 

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. 

3 

INVESTIGATION and INQUEST 

On 23 April 2013 I commenced an investigation into the death of John William Wright. 
The investigation concluded at the end of the inquest on 4 October 2013. The findings at 
the inquest were that the medical cause of death was bronchopneumonia, caused by or 
as a result of Chronic Obstructive Pulmonary Disease (COPD) and a fractured spine and 
left  humerus  and  the  conclusion  as  to  his  death  was  that  he  died  as  the  result  of  an 
accident. 
CIRCUMSTANCES OF THE DEATH 

4 

Mr Wright had a history of paranoid schizophrenia and COPD but in February 2013 his 
mental health appeared stable. He lived in sheltered accommodation and was admitted 
to  the  North  Middlesex  Hospital  on  28  February  with  pneumonia.  Despite  precautions 
such as side bars on his bed, he had a fall from his bed that same day with no apparent 
adverse effects and a further fall at around 8am on 1 March 2013. At around 9:30am on 
1 March 2013 he fell in the corridor but the exact cause of the fall was not clear as it was 
only barely observed by the doctor who was passing. There was no obvious cause and 
the only observation was that his pyjama trousers were ‘round his knees’. It was noted 
that  he  had  a  left  shoulder  deformity,  an  open  fracture  of  the  humerus  but  no  obvious 
head injury. He was stabilised and taken to the Intensive Care Unit and then transferred 
to  the  Royal  London  Hospital  where  he  was  treated  conservatively.  He  suffered 
recurrent chest infections from which he died on 15 April 2013 at 18:45. 

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  will  occur  unless  action  is  taken.  In  the 
circumstances it is my statutory duty to report to you. 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 The MATTERS OF CONCERN are 
 as follows.  –  

1.  There was no investigation of the cause or potential cause of the fall (whether there 
were any external factors involved – water on the floor, over-cleaning or any other 
high risk matter) so as to ensure that further falls could be prevented if necessary. 
Even  if  it  transpired  that  the  cause  could  not  be  determined,  the  fall  should  have 
been  treated  as  a  Serious  Untoward  Incident  that  warranted  some  kind  of 
investigation. The North Middlesex University Hospital NHS Trust Serious Incident 
Policy defines as ‘serious’ an ‘Accident while in hospital’ and I consider that such a 
fall  should  be  considered  to  be  an  accident.  The  policy  then  details  actions  that 
should be taken by staff dependent on the urgency of the incident and the evidence 
that  I  was  given  confirmed  that  the  appropriate  electronic  records  were  not  made 
following the incident.  
It was not at all clear from the evidence whether the training on falls policy and the 
protocols related to the recording of witnessed falls extended to the doctors as well 
as nurses and it is clear that, as a fall may be witnessed by any staff member at a 
hospital, the proper protocols should at least be known even if access to electronic 
means of recording an incident is limited for reasons of confidentiality. 

2. 

6 

ACTION SHOULD BE TAKEN 

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

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 26 December (or the nearest working day thereafter). 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 

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 or the publication of your response by the Chief Coroner. 

9 

Ms G. Elliman  
Assistant Coroner 
Inner North London 

31 OCTOBER 2013                                            

2

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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