Prevention of Future Deaths reports · 2013

Horace Cottom

Regulation 28 report to prevent future deaths, reference 2013-0351, 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
Reference2013-0351
DeceasedHorace Cottom
CoronerNigel Meadows
Coroner areaManchester City
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.

NIGEL S MEADOWS
H.M. SENIOR CORONER

Manchester City Area

Email: coroners@manchester.gov.uk
www.manchester.gov.uk/coroners

The Rt Hon Jeremy Hunt MP

H.M. CORONER’S OFFICE

PO Box 532
Manchester Town Hall
Albert Square, M60 2LA
(Visitors please use postcode M2 SBR)

Telephone 0161 219 2222
Fax 0161 274 7329

Secretary of State for Health
Richmond House

79 Whitehall

London

SW1A 2NS

3 December 2013

Dear Secretary of State,

Re: Horace Cottom (deceased)

Letter written in accordance with paragraphs 37/38 — Chief Coroners
Guidance No 5

The above named, who was born on 25th September 1939, died at HMP
Manchester on 21st June 2012 as a serving prisoner. He suffered from a number
of chronic health conditions, and in particular ischaemic, hypertensive and valvular
heart disease. He also suffered with a chronic lung condition. Following his death,
| ordered a post mortem as well as toxicology tests.

! was able to resume the inquest on 27th November 2013 without having to sit with
a jury as provided by the Coroners and Justice Act 2009 because the evidence
suggested that pathologically the deceased died from natural causes and there
was no other reason to sit with a jury.

! found that he died from:
la Pneumonia
tb Ischaemic, hypertensive and valvular heart disease with
pseudomembranous colitis

| recorded a conclusion of death by Natural Causes.

During the course of the evidence, it became clear that he had very significant
levels of pain relief medication in his system, including opiates, which without
further explanation would suggest that he received excessive amounts and/or a
massive overdose. However, expert toxicological evidence established that the
results were due to his body failing to metabolise (process, break down and
excrete) the drugs. Furthermore, in or about March of 2012 after undergoing x-
rays in an NHS hospital, he was diagnosed with lung cancer, but was generally too
unwell to undergo additional investigations. When he died, it was discovered that

he did not have lung cancer at all, but there was reasonable evidence for the
treating doctors to form that opinion. He had a number of admissions prior to his
death, the last of which was for several weeks.

At the conclusion of the inquest, | was satisfied that my duty to make a Regulation
28 Prevention of Future Deaths Report under paragraph 7 of Schedule 5 to the
Coroners and Justice Act 2009 was not established.

However, the inquest did establish that following his last discharge, it took about 10
days for any discharge information/report to be received at the prison from the NHS
hospital. Further enquiries revealed that this was quite common and locally in
Manchester the prison service tried to get the discharging doctor to write out in
manuscript form discharge information. This is not always successful and results
in delay, as well as incomplete discharge information.

Recently, HMPS changed from using the NHS EMIS GP recording system and
introduced what is known as ‘System One’. This means that it is certainly easier
for a prisoner who moves within the HMPS estate to have their GP records
accessed immediately within the prison system.

Locally in Manchester, they also try to use an email system to collect discharge
information, but this is not without problems itself. From what | was told at the
inquest, it seems that some NHS information can be transmitted directly onto the
System One, but for some reason discharge information is not sent.

HMPS caters for an increasing number of older prisoners with chronic health
problems who have to attend outside NHS hospitals for investigations and
treatment. It is vital that the healthcare professionals in prison have timely and full
discharge information so that they can manage the care of the patient prisoner
once they are returned to custody. One would hope that there is a simple and
user-friendly way in which discharge information could be relayed to all prison
healthcare establishments via the NHS. Whilst this has been highlighted as a local
issue, | anticipate that it actually will be replicated nationwide. Accordingly, | am
writing this letter under paragraph 37 & 38 of the enclosed Chief Coroner's
Guidance No. 5 to bring this to your attention.

| appreciate that it will involve a number of others who can assist in resolving the
position and therefore | am also going to send a copy of this letter to the Chief
Executive of the NHS, the Minister for Prisons, the Director General of HMPS, the
Governor of HMP Manchester, as well as the Medical Directors of the major NHS
Trusts in Greater Manchester. | sincerely hope a solution can be found.

Yours sincerely

ae

HM Senior Coroner for Manchester City Area

Related reports

Other reports by Nigel Meadows

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Hospital Death (Clinical Procedures and medical management) related deaths

See every Prevention of Future Deaths report matching Hospital Death (Clinical Procedures and medical management) related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.