Prevention of Future Deaths reports · 2013

Elsie May Treece

Regulation 28 report to prevent future deaths, reference 2013-0376, written 16 Dec 2013. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Dec 2013
Reference2013-0376
DeceasedElsie May Treece
CoronerAndrew Haigh
Coroner areaStaffordshire (South)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

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.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

Mrs Helen Ashley, Chief Executive, Queen’s Hospital, Burton Upon Trent

CORONER

| am Mr Andrew Haigh Senior Coroner for the Coroner area of Staffordshire South.

CORONER’S LEGAL POWERS

| 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.

[INVESTIGATION and INQUEST

On 5 August 2013 | commenced an investigation into the death of Elsie May Treece
aged 95. The investigation concluded at the end of the Inquest on 11 December
2013. The conclusion of the Inquest was accidental death.

CIRCUMSTANCES OF THE DEATH

On 18 July 2013 Mrs Treece had a fall in the care home where she lived, attended
Queen's Hospital in Burton and was returned home. On 24 July she had another fall
and this time was admitted to Queen's Hospital with a broken arm and an inoperable
bleed to her brain. The head injury caused her death at the hospital on 2 August.

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) | received information from the family that on the afternoon of the 26 July 2013,
following difficulties in moving Mrs Treece, for a while hospital staff left one of Mrs
Treece’s daughters (aged 70) supporting her mother. One of them then returned
with a blue lifting bag with handles but she was not properly supported and_fell back
heavily on the bed with some force. Investigation has been carried out by
HR the Ward 6 manager and | received a report which indicates there is no record
of any such incident either in paper records, electronic records or from speaking to
staff on duty. | did not investigate this incident fully because on balance it is unlikely
to have been significant so far as the death is concerned. However the view | took
on the evidence | did hear was that there had been an incident which should have
been reported and may well not have been. j therefore write to you to enquire if
staff need to be reminded or may need further training regarding the requirement to
report inappropriate incidents even if no major harm seems to come to the patient

involved.

(2) While writing to you perhaps you could also find out for me the reasons why Mrs
Treece did not have a CT scan of her head following the attendance on the 18 July
2013. This is not strictly a matter for this formal report but an answer would be
appreciated.

ACTION SHOULD BE TAKEN

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

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this
report, namely by 10 February 2013. |, 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.

IL.
COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coro wing Interested
Persons: (— daughter of Mrs Treece, — Legal Services
Manager, Queen’s Hospital and — Manager, St Mary's Mount
Residential Home. | have also sent it to Mr Derek Winter — HM Senior Coroner for
the City of Sunderland and the Care Quality Commission who may find it useful or of
interest.

| 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.

16 December 2013

An I My

Andrew A Haigh
HM Senior Coroner
Staffordshire (South)

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 Burton Hospitals NHS (PDF)
IAT - 13

Burton Hospitals NHS|

NHS Foundation Trust

Our Ref: HA/CS/ELS |
Queen's Hospital
Belvedere Road
31 January 2014 Burton Upon Trent
5 Staffordshire
PRIVATE & CONFIDENTIAL Hy : DE13 ORB
Mr A Haigh
HM Senior Coroner Telephone:

Coroner’s Office

No. 1 Staffordshire Place
Stafford

$T16 2LP

Dear Mr Haigh
Re: Elsie May TREECE (Deceased)

In response to the HM Coroner's Prevention of Future Death Report received by the Trust
following the inquest of Elsie May Treece [B332952].

In relation to incident reporting, | can confirm that training has always been provided for staff
in relation to the reporting of incidents. This training has been delivered by the Clinical Risk
Team in collaboration with the Learning and Development Team. Registers of attendance
are collated by the Learning and Development Team and entered against the annual training
requirements for each staff member and uploaded onto the ESR system.

Currently training is provided at Trust induction days, mandatory update training days, online
training and ad hoc sessions in ward and department areas and provided for medical staff in
different forum. Ad hoc training is provided as requested, and in light of this request for
information from HM Coroner, we have arranged to provide additional training and support
for Ward 6.

More recently, we have linked in with the University to raise awareness with student nurses
surrounding the importance of incident reporting and the feedback mechanisms which occur.

Whilst it has been acknowledged that there was a period of downtime for the HISS computer
system which occurred during the time of Mrs Treece’s admission, contingency plans were
put in place which instigated the use of paper based documentation, and including paper
based incident forms. Those paper incident forms received during and following the
downtime were manually entered into the electronic system.

With regard to point 2 of concern, as sons why Mrs Treece did not have a CT scan.
Please find attached letter from outlining the reasons why a CT scan was not
appropriate.

Yours sincerely

be A

Helen Ashley
Chief Executive:

Att.

WKZ025A

° Burton Hospitals INHS|

NHS Foundation Trust
Queen’s Hospital
Belvedere Road
Burton upon Trent
Staffordshire
DE13 ORB

Our ref JAC/EG

23 January 2014

Legal Services Manager
Queen's Hospital

Dear Bridget

Re: Elsie May Treece
DoB: 2/6/1918 eeu puget ee sweet

Mr Haigh has asked the Trust to look at the case of Mrs Elsie Treece who attended
the Emergency Department on 18 July 2013 at 0317hrs. His specific question was
to find out why Mrs Treece did not have a CT scan on that day.

She was seen by a Foundation Year 2 Doctor at 0400hrs, after having routine
triage, which showed that she was alert with normal observations. The Doctor who
assessed her noted that she was suffering from a head injury, following a fall from
her bed, where she landed on the floor. She sustained a laceration to the right
forehead, without any evidence of loss of consciousness, vomiting or reduction in
her normal conscious level. He also noted that she was not on Warfarin and was
alert and comfortable on examination.

! have also looked at the West Midlands Ambulance Service documentation
regarding her transfer to the Emergency Department and again, this corroborates
the Doctor's notes where there was no evidence of loss of consciousness and also
she was alert with a normal conscious level.

Her symptoms and signs were not consistent with a significant head injury and
therefore we would not have proceeded to do a CT scan as per NICE head injury
guidance. There was no indication to carry out a CT scan at the time.

Many thanks

Yours sincerely

scp In —— Medicine

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