Prevention of Future Deaths reports · 2013

John Morgan

Regulation 28 report to prevent future deaths, reference 2013-0372, written 17 Dec 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 Dec 2013
Reference2013-0372
DeceasedJohn Morgan
CoronerJohn Woolley
Coroner areaCardiff & the Vale of Glamorgan
CategoryMental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

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

REPORT TO PREVENT FUTURE DEATHS 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Mark Drakeford AM, Minister of Health, Welsh Assembly Government 
2. 

, Clinical Director, Community Mental Health Services 

for Older People, Llandough Hospital 

1 

CORONER 

I am Christopher John Woolley, Assistant Coroner, for the Coroner area of Cardiff and 
the Vale of Glamorgan 

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 9th September 2013 I commenced an investigation into the death of John Elvet 
Morgan aged 88. The investigation concluded at the end of the inquest on 26th 
November 2013. The medical cause of death was: 1A Pulmonary Embolism in a man 
with dementia of Alzheimer’s type, and the conclusion of the inquest was that the 
deceased died from natural causes. 

4 

CIRCUMSTANCES OF THE DEATH 

John Elvet Morgan was admitted to St Barruc’s ward, Barry hospital on 29th August 2013 
for respite care. He suffered from Alzheimer’s dementia. On admission a red DNR (Do 
not Resuscitate) star was allowed to remain against his name on the whiteboard (or 
PSAG “Patient status at a glance Board”) on the ward. In fact there had been no 
agreement that he was “DNR” and the red star had been left over by mistake from a 
previous patient’s entry on the whiteboard. On 30th August 2013 John Elvet Morgan 
collapsed on the ward. He was not resuscitated by staff on the ward as they relied on 
the red “DNR” star on the whiteboard. When the paramedics arrived no yellow DNR form 
was found in the notes as of course one did not exist.  The PM report showed that John 
Elvet Morgan had suffered a pulmonary embolism. 

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) The Whiteboard (or PSAG) is in use throughout Wales as a quick reference guide to 
the patients on the ward. It was introduced as part of the “Transforming Care at the 
Clinical Director for the University Hospital for 
bedside “TCAB” programme. Dr 
Wales Board, confirmed that the information which is put on the whiteboard is a matter 
for local discretion. While the red “DNR” star system has been removed from the 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 whiteboards in use in Cardiff and the Vale Local Health Board he could not say whether 
similar systems are not in use elsewhere in Wales. 
(2) The whiteboard system is a useful reference point for patient care but there is a 
danger that the information held on the whiteboard is relied upon instead of the patient’s 
notes. 
(3) Human error may mean that erroneous information is held on the whiteboard to the 
detriment of patient care. 
(4) A similar DNR “red star” system may be in use on whiteboards in other Health Board 
areas in Wales with the possibility that a similar chain of events may occur elsewhere in 
Wales. 

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 11th February 2014. 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 1. 
Cardiff and Vale University Health Board who may find it useful or of interest. 

. I have also sent it to 

Medical Director, 

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 

17th December 2013                                                 C J Woolley, Assistant Coroner 

2

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Welsh Government (PDF)
Mark Drakeford AC / AM IEE

Y Gweinidog lechyd a Gwasanaethau Cymdeithasol

a
Minister for Health and Social Services wy, wa

Llywodraeth Cymru
Welsh Government

Eich cyf/Your ref
Ein cyf/Our ref MB/MD/0220/14

Mr C J Wooley
Assistant Coroner
The Coroner’s Court
Central Police Station
Cathays Park

Cardiff [© February 2014
CF10 3NN

Deehy etl,

| write further to your Regulation 28 Report in relation to the inquest into the death of Mr
John Elvet Morgan.

| was extremely concerned to read the circumstances of Mr Morgan’s death whilst a patient
at Barry Hospital and offer my sincere condolences to his family.

As you describe in your report the Patient Status at a Glance (PSAG) board is useful as a
reference point for patient care. However, | am in agreement with you, the information
recorded must be accurate and staff must not rely solely upon this information when making
decisions about a patient's care and treatment. | expect Health Boards and Trusts to have
suitable systems in place to ensure the safety of patients at all times and within all clinical
areas.

Action

The incident was reported to Welsh Government under the Serious Patient Safety Incident
reporting process in September last year. The Chief Nursing Officer for Wales issued a
request to all Nurse Directors within Health Boards and Trusts requesting they consider the
circumstances of the incident and make changes to their systems as appropriate.

| have further requested the Chief Medical Officer and Chief Nursing Officer write to all
Health Boards and Trusts in Wales to remind them, where PSAG boards are in use, robust
systems must be in place to safeguard patient safety and prevent a similar incident from
happening again.

Bae Caerdydd « Cardiff Bay English Enquiry Line 0845 010 3300
Caerdydd « Cardiff Llinell Ymholiadau Cymraeg 0845 010 4400
CF99 1NA Correspondence.Mark.Drakeford @wales.gsi.gov.uk

Wedi’i argraffu ar bapur wedi’i ailgylchu ( 100%) Printed on 100% recycled paper

Welsh Government officials will also bring this to the attention of the 1000 Lives
improvement service, our national quality improvement programme, so that they can
reinforce the importance of healthcare staff using accurate information within any future
guidance they provide.

This is a very serious matter. | will ask the NHS Wales Quality and Safety Forum to discuss
this at their next meeting to reinforce the learning.

=) ows SH Cwre?

Mark Drakeford AC / AM
Y Gweinidog lechyd a Gwasanaethau Cymdeithasol
Minister for Health and Social Services

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