Prevention of Future Deaths reports · 2014

Sebastian Davies

Regulation 28 report to prevent future deaths, reference 2014-0139, written 28 Mar 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 Mar 2014
Reference2014-0139
DeceasedSebastian Davies
CoronerDavid Osborne
Coroner areaNorfolk
CategoryCommunity health care and emergency services 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.

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:

Service Manager,

Norvic Clinic,

Northside,

St Andrews Business Park,
Thorpe St Andrew, Norwich
NR7 OHT

CORONER

lam DAVID OSBORNE assistant coroner, for the coroner area of NORFOLK

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 an investigation was commenced into the death of SEBASTIAN
VAUGHAN DAVIES, 23. The investigation concluded at the end of the inquest on 25
MARCH 2014 held over two days with a Jury. The conclusion of the inquest Jury was
that the medical cause of death was 1a Cerebral ischemia, multisystem organ failure,
and developing bronchopneumonia and 1b Opiate excess and they gave a narrative
conclusion as follows: : :
“Sebastian died due to an excess of opiates obtained from an unknown source. We
believe that procedures operated at the Norvic Clinic could not have prevented his
death”.

CIRCUMSTANCES OF THE DEATH.

At the time of his death Sebastian Vaughan was a detained patient under the Mental
Health Act at the Norvic Clinic. On 24 July he was assessed suitable for unescorted
leave under a.s17 authority in place. On his return no illicit substances-were discovered
on his person. He retired to bed at 11:00pm. He was unresponsive but breathing the
following morning 25 July 2043. Paramedics attended and he was taken to the Norfolk
and Norwich Hospital. Sadly he remained unconscious and died at the hospital on 4
August 2013.

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. —

Evidence was given at the Inquest that there was a system of hourly observation checks
on patients in their rooms during the course of a night shift. These consisted of shining a
torch through the window in the door to the room and looking and listening for signs of
breathing. However it was not routinely part of such observations to check whether the
patient had moved or appeared to have remained immobile for an extended period
unless there was a particular concern which there was not in Sebastian's case. The
observations were done in pairs and shared between the staff nurse on duty and the
three support staff. However the same individuals did not carry out all the observations
on any particular patient. There was therefore a lack of continuity. It was confirmed it
was possible for a patient to be breathing but unconscious. Sebastian was heard to be
snoring. Sebastian when found to be unresponsive at around 08:30 hours had a crush
injury to his right arm. It was therefore apparent that he had been iying immobile on his
arm for some extended period of time.

Notwithstanding the Jury’s conclusion that the procedures at the Norvic Clinic could not
have prevented Sebastian's death | am nevertheless concerned that a failure to
specifically check whether a patient has moved or rather remained immobile for an
extended period on hourly observations (thereby indicating that perhaps they may have
fallen unconscious) could in the future give rise to a preventable death and therefore
there is a risk of future deaths occurring and that therefore a review may need to be
undertaken of the procedure for night time hourly observations to specifically include
whether a patient has moved or remained immobile for an extended period and whether
a system can be devised to give better continuity of those undertaking observations of
individual patients.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you and/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 23 MAY 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested
Persons:

| 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

| 28 March 2013 ISPR2K_

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