Prevention of Future Deaths reports · 2014

Julia Dell

Regulation 28 report to prevent future deaths, reference 2014-0021, written 17 Jan 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 Jan 2014
Reference2014-0021
DeceasedJulia Dell
CoronerAndrew Cox
Coroner areaCornwall
CategoryCommunity health care and emergency services related deaths
Organisation namedCornwall Partnership NHS Foundation 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. 
2. 
3.  Royal Cornwall Hospital Trust 
4. 

The Medical Centre, Stratton, Bude, Cornwall  

1 

CORONER 

I am ANDREW COX, Assistant Coroner, for the coroner area of Cornwall 

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 24 August 2012 I commenced an investigation into the death of JULIA SHIREEN 
DELL then aged 45.  The investigation concluded at the end of the inquest on Monday 
13 January.  The conclusion of the inquest was that was Mrs Dell took her own life.  She 
died of multiple injuries having been witnessed to jump from cliffs at Duckpool Beach, 
Kilkhampton, Bude in Cornwall 

4 

CIRCUMSTANCES OF THE DEATH 

I found that the cause of Mrs Dell’s death was multifactorial.  I found that the initiating 
and most significant event was the collapse and then liquidation of the family business.  
Other contributory features included: 

(A) 
(B) 

(C) 
(D) 
(E) 

(F) 
(G) 

An increasing realisation that her children were leaving home; 
The fact that her parents had recently informed her they intended to move to St 
Albans; 
Pressures relating to her work; 
A feeling of being controlled by family members; 
Confusion and/or a lack of compliance in taking the medications prescribed to 
her 
Difficulties in her marital relationship; 
The probability that she was suffering from a form of bi-polar disorder.  

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. 

At the inquest I found that the medical service Mrs Dell had received from primary care 
during the period from July 2011 until 4 April 2012 had been exemplary.  This included 
the period from mid December 2011 until mid April 2012 when responsibility for Mrs 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Dell’s care passed to Cornwall Partnership NHS Foundation Trust. 

I was told that on 4 April 2012 Mrs Dell decided to change GP within the practice and 
her care then passed to 
4 April until Mrs Dell’s death on 22 August there was only one further contact with 
primary care.   

who job share.  In the period from 

and 

At inquest, 
more involvement from primary care after April 2012”.  He indicated also that the surgery 
was unaware of Mrs Dell’s fluctuating mood from April until her death.  

conceded that: “it would have been nice for there to have been 

The MATTERS OF CONCERN are as follows.  –  

(1) 

(2) 

There appears to have been no formal hand over between 

to

 in early April 2012.   

On 19 April 2012 a care plan was received from the Community Mental Health 
Team following Mrs Dell’s discharge from their care back to primary care.  No 
action seems to have been taken upon its receipt.  It appears as though the 
doctors have accepted the reassurance of the CPN that Mrs Dell’s moods had 
stabilised on the medication prescribed to her not withistanding the fact that only 
three weeks previously on 22 March 2012 
to express his concerns over Mrs Dell’s wellbeing 

had contacted 

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.   

In particular, I would ask you to consider whether it is appropriate to have a formal 
handover where patients pass from one doctor to another within the surgery.  This would 
seem more relevant where there are urgent or ongoing medical problems.   

I would also ask you to consider whether it is appropriate, on all occasions, simply to 
place reliance upon a discharge letter and care plan without additional enquiry.  That 
seems to be particularly the case where a discharge takes place in circumstances that 
appear at odds with the knowledge known to the doctors within the surgery.   

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by Friday, 14 March 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 Interested Persons listed 
at the head of this letter.  

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 January 2014                                              Andrew Cox, Assistant Coroner 

2

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