Prevention of Future Deaths reports · 2014

Redmond Johnson

Regulation 28 report to prevent future deaths, reference 2014-0279, written 20 Jun 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Jun 2014
Reference2014-0279
DeceasedRedmond Johnson
CoronerPeter Dean
Coroner areaSuffolk
CategoryHospital Death (Clinical Procedures and medical management) related deaths · State Custody 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
THIS REPORT IS BEING SENT TO:

a. FS Head of Health in the Justice System, NHS England

2. EES Head of Health and Justice, East Anglia Team, NHS
England

3. Mr Jeremy Wright MP, Minister for Prisons

CORONER

| am Dr Peter Dean, senior coroner for the coroner area of Suffolk

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 the 25" of November 2011 | commenced an investigation into the death in custody of
Redmond Johnson, aged 67. The investigation concluded at the end of the inquest on
the 13" of May 2014. The conclusion of the inquest was that Mr Johnson died from
natural causes, the cause of death being 1a Acute heart failure due to 1b Recent
myocardial infarct due to 1¢ Occlusive coronary artery atheroma with contributory
causes of Ischaemic heart disease, chronic renal failure and diabetes, however there
were matters that became evident which gave significant cause for concern.

CIRCUMSTANCES OF THE DEATH

Mr Redmond Johnson was a 67 year old gentleman who received a | custodial sentence
at Ipswich Crown Court and was admitted to HMP Norwich on the 4" of October 2011.
He had very significant medical problems including diabetes, obstructive sleep apnoea
necessitating overnight assistance, hypertension, congestive cardiac failure, atrial
fibrillation, cerebro-vascular disease and transient ischaemic attacks, mild dementia,
loss of the right eye, glaucoma of the left eye and laser treatment awaited due to
bleeding in the eye, mobility issues due to loss of a toe, chronic kidney disease and
carotid artery occlusion. He was transferred back to Ilpswich Crown Court on the 25" of
November 2011, suffered a cardio-respiratory arrest on arrival and sadly, despite
attempts to resuscitate him by escort staff, passed away following transfer to Ipswich
Hospital. The Prisoner Escort Record for that transfer back to Ipswich Court, had
deemed him fit to be transferred and recorded that he had ‘no known medical risks’,
having been completed at 03.00 that morning by a healthcare professional who had not
actually seen Mr Johnson. It was apparent that there were significant failures in the
system in place at that time for conducting the assessments themselves, a situation
made worse by apparent repeated late notification to the prison of which detainees
would require court transfers the next day, and that there had also been failures, in
respect of Mr Johnson’s general healthcare in custody, to liaise with his community
healthcare providers and follow up his external specialist medical appointments, to
ensure that tests requested in the prison were conducted, to manage his complex
prescription needs and to monitor and record the management of his complex medical
needs in an appropriate manner.

CORONER’S CONCERNS

In a person with the medical problems from which Mr Johnson suffered, there is always
the risk of a sudden tragic cardiac event and death occurring so whether and, if so, to
what extent the failures that became apparent during this investigation contributed to
this very sad death could not be established in this individual situation, however, 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) If a detainee has a history of significant medical problems, healthcare professionals
undertaking the initial reception assessment should request further information from the
General Practitioner and, where necessary, hospital doctors normally involved in the
detainee’s care to enable appropriate care planning while that detainee is in the custody
of the prison service.

(2) Reception healthcare should ask about any outstanding hospital or other healthcare
appointments and rebook these if necessary.

(3) Medication reviews should be conducted, with appropriate pharmacy input if
required, if there are complex medication issues that need resolving or clarifying.

(4) If medical tests or investigations are requested, there must be clear and adequate
documentation to confirm that those investigations have actually been conducted and
the results seen by a healthcare professional.

(5) There must be a robust and clearly documented process in place when assessing a
detainee’s fitness to transfer, together with clear arrangements made in respect of any
medication that the detainee needs to take while out of the prison’s care.

(6) Information about which detainees are going to be transferred to court or other
locations needs to be delivered to the individual prisons in enough time for a thorough
assessment of the detainee’s fitness to be transferred (including a face to face
assessment if required) to be conducted.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths. The changes in the
provision and commissioning of healthcare in custody are recognised but | believe that
the health and prison services 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 the 15" of August, 2014. |, 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 Mr Johnson’s family.
| 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.

20-6-14 Dr Peter Dean

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