Prevention of Future Deaths reports · 2014

Prevention of Future Deaths report 2014-0419

Regulation 28 report to prevent future deaths, reference 2014-0419, written 24 Sep 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report24 Sep 2014
Reference2014-0419
Coroner areaSunderland
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedCity Hospitals Sunderland NHS Foundation Trust
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.

Derek Winter
Senior Coroner for the City of Sunderland

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:
Mr Ken W Bremner
Chief Executive
City Hospitals Sunderland NHS Foundation Trust
Sunderland Royal Hospital
Kayll Road
Sunderland SR4 7TP

CORONER

I am Derek Winter, Senior Coroner for the City of Sunderland

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/paragraph/7
http://www. legislation. gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 26/03/2014 an investigation into the death of Leonard Henry Hudson, aged 74 was
commenced. The investigation concluded at the end of the inquest on 23th September
2014. The conclusion of the inquest was “Accident contributed to by complications
arising from diabetes”.

CIRCUMSTANCES OF THE DEATH

Mr Hudson fell at his home address on the 12th May 2013 and was admitted to
Sunderland Royal Hospital on 13th May 2013 for surgery to repair a fracture of the right
neck of femur which appeared to meet it's objectives. Given Mr Hudson's other medical
conditions particularly his diabetes he was susceptible to pressure sores the management
of which was challenging. On the 16th October 2013 Mr Hudson underwent a below the
knee amputation of his right leg. As a consequence of his immobility he developed

bronchopneumonia from which he died on the 19th March 2014 at his home address
a Fell Chester le Street.

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.

Civic Centre, Burdon Road, Sunderland, SR2 7DN
Tel 0191 5617843 | Fax 01915537803 | DX 60729 Sunderiand
www,sunderland.gov.uk/coroner

The MATTERS OF CONCERN are, as follows. —

During the course of Mr Hudson’s in-patient admission from the 13” of May 2013 to the
13" of August 2013, staff did not follow the requirements of the Trust’ Prevention and
Management of Pressure Ulcers Policy in that incident reports were not submitted.

Due to the co-morbidities of Mr Hudson, he ought to have been identified as having a
higher risk factor.

Mr Hudson ought to have been referred to the foot protection team in a more timely
manner,

The nursing documentation was not as comprehensive as it ought to have been.
The classification of Mr Hudson’s heel injuries was “variable”.

From the evidence given by FCO the Tissue Viability Specialist Practitioner,
that these matters have been or will be addressed and I was encouraged to learn about
that, and the Awareness and Training Programme together with the work of the Foot
Protection Team.

During the course of the evidence some other matters of concern were raised,
particularly those relating to the mobilisation of Mr Hudson. I would like to draw them
to your attention, as follows: -

1) there were episodes of inadequate record keeping; for example, although the family
had met with medical staff to discuss concerns, there appeared to be no available
record or the action taken thereafter; also Mr Hudson was to have the benefit of an
Exogen machine for 20 minutes each day to stimulate the healing of the bone, but
there appeared to be no records about this;

2) there was confusion about Mr Hudson being moved from the bed to his chair by
hoist;

3) there was some degree of confusion about any fluid restrictions for Mr Hudson: the
family were under the impression that there would be fluid restriction, but in
evidence this appeared to be related to six occasions following Mr Hudson’s dialysis;

4) although physiotherapists attended the ward on two occasions per day, Mr Hudson
was absent from the ward for three days having dialysis and there was no
contingency provision for physiotherapy;

5) there appeared to be some conflict with regard to the arrangements made for Mr
Hudson to go to the toilet and whether his hygiene needs were met;

6) it was accepted that Mr Hudson had Type 2 Diabetes but there was an impression that
this was Type 1.

All of these matters dented the trust and confidence that the family had in the provision
of healthcare and although they submitted to me that Mr Hudson had died of Natural
Causes contributed to by neglect, I did not make that finding.

However, some aspects of Mr Hudson’s care could impact on the care of others and you
will appreciate my duty to draw these matters to your attention.

I know that some of them have —_ been particularly in respect of the

matters received in evidence by but I shall be glad of your response to
this Report To Prevent Future Deaths.

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.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 21 November 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 sent a copy of my report to the Chief Coroner and to the following Interested
Persons: -

- Family

- City Hospitals Sunderland NHS Foundation Trust

- Care Quality Commission

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.

Dated this 24" day of September 2014

Signature ) A | ae

Senior Coroner for the City of Sunderland

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