Prevention of Future Deaths reports · 2014

Aimee Varney

Regulation 28 report to prevent future deaths, reference 2014-0249, written 2 Jun 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Jun 2014
Reference2014-0249
DeceasedAimee Varney
CoronerTom Osborne
Coroner areaBedfordshire & Luton
CategoryHospital Death (Clinical Procedures and medical management) 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.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

NOTE: This form is to be used after an inquest. 

THIS REPORT is being sent to: 

Ms Pauline PHILIP 
Chief Executive 
L & D University Hospital 
Lewsey Road 
Luton 
LU4 4DZ 

1 

CORONER 

I  am  Mr  Tom  OSBORNE,  Senior  Coroner  for  the  Coroner  Area  of 
Bedfordshire and Luton. 

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. 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5 

3 

INVESTIGATION and INQUEST 

On  the  19th  June  2013  I  commenced  an  Investigation  into  the  death  of 
Aimee Sarah VARNEY aged 21 years. The Investigation concluded at the 
end of the Inquest on 19th May 2014. The Conclusion of the Inquest was 
that between January 2012 and April 2013  the deceased was undergoing 
investigation  for  epilepsy  at  the  Luton  &  Dunstable  Hospital.    She  died 
following  a  seizure  on  16th  June  2014  at  her  home  address 

 Dunstable, Bedfordshire.  The medical cause of death being: 

I (a)  Sudden Unexpected Death in Epilepsy 

4 

CIRCUMSTANCES OF THE DEATH 

Aimee  Sarah  VARNEY  had  undergone  investigations  for  epilepsy 
between  January  2012  and  April  2013.    She  was  seen  at  the  Luton  & 
Dunstable  Hospital  on  22nd  April  2013  following  which  a  referral  was 
made  for  her  to  be  seen  by  a  Specialist  at  the  Royal  Free  Hospital  in 
London. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 The failure to refer her urgently, or at all, to a Specialised Unit resulted in 
a lost opportunity to diagnose and further treat her condition.  She died 
following  a  seizure  from  Sudden  Unexpected  Death  in  Epilepsy  on  16th 
June 2013 at 22 Priory Heights, Dunstable, Bedfordshire. 

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.  That  the  NICE  Guidelines  for  referring  a  patient  with  suspected 

epilepsy to a Specialist Tertiary Centre were not followed. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion  action  should  be  taken  to  prevent  future  deaths  and  I 
believe  you,  as  the  Chief  Executive  of  the  Luton  &  Dunstable  University 
Hospital, 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 28th July 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 Person(s): 

The family 

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 
interest.  You  may  make 
he  believes  may  find 
representations  to  me,  the  Coroner,  at  the  time  of  your  response,  about 
the release or the publication of your response by the Chief Coroner. 

it  useful  or  of 

9 

Dated this 2nd day of June 2014                                        

                                                                   …………………………………… 
                                                                   Tom OSBORNE 
                                                                   Senior Coroner 
                                                                   Bedfordshire & Luton

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 Luton Dunstable University Hospital (PDF)
DUNSTABLE

Our ref: PMP/ams

28 July 2014

Mr P Smith email:

Coroner's Officer Direct tel

HM Coroner's Office
The Court House

Woburn Street

Ampthill

Bedfordshire

MK45 2HX

By ona: es

Dear Mr Smith

Inquest touching the death of Aimee Sarah VARNEY
Inquest held on 19" May 2014 at Coroner’s Court, Ampthill

Thank you for your Regulation 28 Report, dated 2"? June 2014, in response to the death of
Aimee Varney.

The Trust has considered the following matter of concern:

1) That the NICE (National Institute for Health and Care Excellence) Guidelines for
referring a patient with suspected epilepsy to a specialist tertiary centre were not
followed.

The Medical Director is responsible for ensuring every new NICE guideline is allocated to
the relevant speciality. The appropriate Clinical Audit and Effectiveness Committee (CAEC)
Lead, the Finance and the Clinical Director all receive copies for discussion and
dissemination. As for all NHS bodies there are occasions where the hospital cannot
immediately comply with NICE guidance. This can be due to resources and requires
negotiation with our commissioners to fund, for example, high value new drug therapies.

The allocations are recorded on a central database managed by the Clinical Quality
Department. They also record whether the relevant speciality has declared the guideline to
be non-applicable, applicable and implemented or applicable but the Trust is non-compliant.
A Risk Register is kept of all guidelines the Trust is not able to immediately comply with; this
is regularly monitored to ensure the relevant changes are made as soon as possible.

individual Clinicians have ready access to the relevant NICE guidelines via the Hospital's
Intranet. They can also gain access via the NICE website www.nice.org.uk/guidance

Luton and Dunstable University Hospital NHS |

Bea Fruncet ne Taagt

However it must be emphasised that they are guidelines, not tramlines that the treating
clinician must rigidly follow. NICE state “...health and social care professionals are actively
encouraged to follow our recommendations to help them deliver the highest quality care. Of
course, our recommendations are not intended to replace the professional expertise and
clinical judgement of health professionals, as they discuss treatment options with their
patients.” There will be individual patients where the treating clinician uses their own
judgement and does not follow the absolute guidance.

In this particular case the expert report was prepared by a clinician with a special interest in
epilepsy, from a specialist tertiary centre. Their report may not reflect what is considered
acceptable practice by a general neurologist, with a general neurology practice, that is
managing a patient with epilepsy. For this reason we are commissioning a further report,
from an independent general neurologist, to get assurance that the individual clinician’s
practice did not fall outside the threshold of reasonable practice.

| hope you are reassured that the Trust has appropriate systems for the logging and
disseminating of NICE Guidelines.

Yours sincerely

Pauline Philip
Chief Executive Officer

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