Prevention of Future Deaths reports · 2013

Agostino Costa

Regulation 28 report to prevent future deaths, reference 2013-0322, written 3 Dec 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 Dec 2013
Reference2013-0322
DeceasedAgostino Costa
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedWhittington 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.

Regulation 28:  Prevention of Future Deaths report 

Agostino COSTA (died 12.05.13) 

THIS REPORT IS BEING SENT TO: 

1.  Dr Yi Mien Koh 
Chief Executive 
The Whittington Hospital NHS Trust 
Magdala Avenue 
London  N19 5NF 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

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

3 

INVESTIGATION and INQUEST 

On  12  May  2013,  one  of  my  predecessor  coroners,  Sean  McGovern, 
commenced an investigation into the death of Agostino Costa, aged 80. I 
concluded  this  investigation  at  the  end  of  the  inquest  on  28  November 
2013.  

4 

CIRCUMSTANCES OF THE DEATH 

I concluded that Mr Costa died as a consequence of a terminal disease, 
though his death was hastened by an accidental fall in hospital at 6.40pm 
on Sunday, 12 May 2013. 

I recorded a medical cause of death of: 
1a  acute on chronic subdural haemorrhage 
1b  minor trauma in an individual with chronic idiopathic myelofibrosis. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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. 

The MATTERS OF CONCERN are as follows.  

1.  There was confusion among the staff as to whether Mr Costa was 
classified as red (high risk) or green (low risk) in terms of falls. 

2.  There  was  confusion  among  the  staff  as  to  whether  a  patient 

walking with a frame presents a high risk of falls. 

3.  There was confusion among the staff as to whether a patient with 
myelofibrosis  and  blood  transfusions  presents  a  high  risk  of  falls.  
This confusion was also present in the hospital root cause analysis 
conducted after Mr Costa’s death. 

4.  The junior doctor  present did not know how  to deal with a patient 
post  fall  on  the  ward,  though  he  had  dealt  with  patients  in  the 
emergency  unit  who  had  fallen  in  the  community.    He  had  not 
attended the hospital training seminar on falls. 

5.  The  hospital  root  cause  analysis  was  not  shared  with  all  relevant 
members  of  staff,  though  it  was  signed  off  at  the  beginning  of 
August.  Thus learning points from it were completely lost to some. 

I heard that a great deal of work is being done in your trust to attempt to 
prevent falls and appropriately to treat patients when falls have occurred, 
but attendance at one of the monthly seminars run by the lead doctor for 
falls is not mandatory for all staff. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you and your trust 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 28 January 2014.  I, the coroner, may extend the 
period. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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 following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
 

son of Agostino Costa 

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 
interest.  You  may  make 
he  believes  may 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

03.12.13 

3

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