Prevention of Future Deaths reports · 2014

Carol Walker

Regulation 28 report to prevent future deaths, reference 2014-0361, written 4 Aug 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Aug 2014
Reference2014-0361
DeceasedCarol Walker
CoronerDavid Hinchliff
Coroner areaWest Yorkshire (Eastern)
CategoryHospital Death (Clinical Procedures and medical management) 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.

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:

Medical Director
Harrogate District Hospital
Lancasier Park Road
Harrogate

North Yorkshire

HG2 7SX

1 | CORONER

| am David Hinchliff, Senior Coroner, for the coroner area of West Yorkshire (Eastern)
Area

2 | 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.

3 | INVESTIGATION and INQUEST

On 26" November 2013, | commenced an Investigation into the death of Carol Lynne
Walker, aged sixty-eight years. The Investigation concluded at the end of the Inquest on
18" July 2014. The conclusion of the Inquest was Carol Lynne Walker had suffered a fall
causing a hairline fracture of her left ankie and for a plastercast to be applied. Mrs
Walker’s death was confirmed at her home address, 3 Avon Court, Leeds at 0958 hours
on 19" November 2013 as a consequence of her developing a pulmonary
thromboembolism because of deep vein thrombosis of the left leg which was a
complication of her left ankle fracture. A short form conclusion of accidental death was
recorded.

4 | CIRCUMSTANCES OF THE DEATH

1. Carol Lynne Walker fractured her ankle on 25" September 2013. Mrs Walker
was taken by a relative to Harrogate District Hospital on Friday, 25" October
2013 where an x-ray examination revealed that she had suffered a hairline
fracture to her left ankle.

2. This was treated by a back slab plastercast. Mrs Walker was discharged after
fracture clinic follow-up had been arranged.

3. Mrs Walker was mobilising quite well on hand crutches and was receiving daily
help and support from her family.

4. It transpired that from Mrs Walker’s previous medical history that she had
suffered a pulmonary embolism. It is not clear whether this was communicated
to those treating Mrs Walker at the hospital but there was no record made of

this. Quite clearly, there was an elevated risk of venous thromboembolism.

5. On Monday, 18” November 2013, Mrs Walker informed her family that she was
well and that there was no need to visit. At 0930 hours on Tuesday, 19
November 2013 she was discovered by her daughter-in-law in a collapsed state.
Paramedics attended who confirmed her death at 0958 hours on 19" November
2013.

6. A Coroner's Post Mortem examination reveals the cause of death to be 1(a)

Pulmonary thromboembolism due to (b) deep vein thrombosis of left leg due to

(c) left ankle fracture.

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. | understand that at the time it was not standard practice in either the
Orthopaedic Department or the Emergency Department at Harrogate District
Hospital to routinely administer Chemical Thrombo Prophylaxis to patients with
conservatively treated lower limb injuries immobilising cast considered to be at
low risk of venous thromboembolism.

2. Nor was it standard practice in the Trust for a formal venous thromboembolism
risk assessment to be undertaken in this patient group.

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.

It is my concern that by the very nature of Mrs Whitworth’s injury and the fact that her
mobility would have been reduced she would have been at risk of venous
thromboembolism. In her case the risk would have been heightened by the previous
history of pulmonary embolism.

| consider that it should be standard practice, both in the orthopaedic and the
emergency departments for patients to be risk assessed in respect of the administration
of Chemical Thrombo Prophylaxis to patients with lower limb injuries who are
immobilised in a cast, who may be considered at low risk of venous thromboembolism.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 29" September 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
Ihave s y report to the Chief Coroner and to the following Interested
Persons Medical Director, Harrogate District Hospital.

| 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.

[DATE [SIG BY.CORONER]
C/

1

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