Prevention of Future Deaths reports · 2014

Yaser Saleh

Regulation 28 report to prevent future deaths, reference 2014-0453, written 17 Oct 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 Oct 2014
Reference2014-0453
DeceasedYaser Saleh
CoronerAndrew Harris
Coroner areaLondon Inner (South)
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
Re Yaser Saleh, case ref 02233-2012

THIS REPORT iS BEING SENT TO:

1. Mr Christopher Spencer, Chief Executive Officer, EMIS, Rawdon House,
Yeadon, Leeds LS19 7BY

2. The Secretary of State for Health, Rt. Hon Jeremy Hunt,
Richmond House, 79 Whitehall, London SW1 2NS

ii lveagh Surgery Akerman Health Centre, 60
Patmos Road, London SW9 6AF

1 | CORONER

lam Dr Andrew Harris, Senior Coroner, London Inner South

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 | INQUEST

On17" September, 2012, | opened an inquest into the death of:
Yaser Saleh, aged 15 years, died 13.09.12

| concluded the inquest at a full hearing on 145h October 2014.
The medical cause of death was Acute Asthma. The boy collapsed with an arrest. The
conclusion as to the death was natural causes.

4 | CIRCUMSTANCES OF THE DEATH

Master Saleh was registered with a general medical practice in London. Evidence from a
consultant physician and ambulance service senior paramedic was that cardio-
respiratory arrest from acute asthma may occur very suddenly and is, as here, is
refractory to resuscitation. To prevent such deaths appropriate treatment must be given
and medical advice sought earlier in an exacerbation. A respiratory nurse gave evidence
that the National Report on Asthma Deaths identified under use of steroids as a key
cause of avoidable deaths and identified that electronic surveillance was needed of
those not getting steroids, who need them.

This boy received regular steroid inhalers in 2004 and presented to accident and
emergency department in 2006 requiring restarting steroids. Between 2003 and 2009 he
attended A&E 6 times with asthma and had 3 non attendances at respiratory clinics. We
know that the family regularly visit Saudi Arabia and so that there availability for
monitoring and prescribing was not continuous. His general practice last prescribed for
him in September 2008, and the attendance at A&E with uncontrolled asthma in 2009
did not trigger a GP review, as it would under today’s arrangements.

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 MATTER OF CONCERN is as follows. —

The GP reported that she believes that her EMIS computer system only called up people
for review who were receiving regular prescriptions and thus a patient who had been on
regular treatment but no longer was asking for inhalers was not identified as requiring
call up for review. Whilst the court heard it was possible to customize the QOF system to
call up patients, there was, according to the GP, no computerised system of calling up
asthmatics who needed review unless they were currently on regular medication. She
and the consultant in emergency medicine considered this created a risk of preventable
deaths, that merited my making this report. The consultant in emergency medicine also
said that this risk applied to other chronic diseases, such as epilepsy.

This risk of not identifying those at risk of death because they no longer comply or have
not rebegun necessary treatment taken in the past is brought to the attention of EMIS
and the Secretary of State, to consider whether EMIS has the potential or another
electronic system should be commissioned to ensure that those with chronic disease
requiring review and monitoring, are triggered for the attention of the GP i

criteria than current prescribing, or if such a system is available |
considers using it and other GPs are made aware of its use.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe that EMIS,
and/or Secretary of State may have or know who has the power to take

such decisions.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by Friday 12" December 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.

If you require_any further information
case Officer,

ut the case, please contact the

COPIES and PUBLICATION

| have sent.a copy of my report to th i id to the f i

Persons: (father (brother),

London Ambulance: i ings College Hospital. | am also
sending this report onsultant in Emergency Medicine KCH and
Senior Paediatric Respiratory Specialist Nurse KCH (witnesses) and to
the Royal College of General Practitioners and the British Thoracic Society.

| 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] [SIGNED BY CORONER
17 Soc One “

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