Prevention of Future Deaths reports · 2014

William Davies

Regulation 28 report to prevent future deaths, reference 2014-0475, written 5 Nov 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Nov 2014
Reference2014-0475
DeceasedWilliam Davies
CoronerMary Hassell
Coroner areaInner North London
CategoryState Custody 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:  Prevention of Future Deaths report 

William DAVIES (died 16.06.14) 

THIS REPORT IS BEING SENT TO: 

1.  Mr Kevin Reilly 

Governor 
HMP Pentonville 
Caledonian Road 
London  N7 8TT 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On 23 June 2014, I commenced an investigation into the death of William 
Davies, aged 67. The investigation concluded at the end of the inquest on 
3  November  2014.  I  made  a  determination  that  death  came  about  from 
natural causes, being: 1a) coronary artery atherosclerosis. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Davies was found unresponsive in his cell at HMP Pentonville. 

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 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 report to you. 

The MATTERS OF CONCERN are as follows.  

There seems to be confusion in the prison regarding the requesting of an 
ambulance  after  a  level  one  (i.e.  regarding  a  potentially  life  threatening 
situation) call has been made by a prison officer.   

1.  I  have  been  told  in  other  inquests  (and  delay  in  HMP  Pentonville 
ensuring ambulance attendance has been a feature since the first 
prison  death  inquest  I  heard  in  Inner  North  London,  on  30 
September 2013) that prison comms should call an ambulance as 
soon as they have been notified of a level one. 

However, the prison duty governor on the day of Mr Davies’ death, 
  said  that  when  he  arrived  two  or  three  minutes 
after  the  prison  officer  who  found  Mr  Davies  had  contacted 
comms,  no  ambulance  had  been  called.   
told  me  that 
he  did  not  know  why  this  was,  though  he  was  duty  governor  that 
day and the most senior person from the prison in court.   

2.  The  whole  process  of  attending  a  prisoner  with  a  life  threatening 
condition  seemed  unclear  to  the  prison  general  practitioner  (now 
GP lead) giving evidence.  She assumed that a prison officer had 
responsibility for calling an ambulance, but she was not sure.   

The GP also did not know that she was allowed to verify the fact of 
death,  and  told  me  that,  as  a  consequence,  she  carried  on  with 
CPR after she knew that Mr Davies had died. 

And  if  the  GP  lead  has  not  got  a  good  understanding  of  the 
procedures  in  place,  then  other  GPs  in  the  prison  may  not  have 
either. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you 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 12 January 2015.  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. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 8 

COPIES and PUBLICATION 

I have sent a copy of my report to the following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  HM Inspectorate of Prisons 
  National Offender Management Service 

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 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

05.11.14 

3
Also filed under 2014-0475: Davies-2014-0475.pdf
Regulation 28:  Prevention of Future Deaths report 

William DAVIES (died 16.06.14) 

THIS REPORT IS BEING SENT TO: 

1.  Mr Mike Parish 
Chief Executive 
Care UK Limited 
29 Great Guildford Street 
London  SE1 0ES 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On 23 June 2014, I commenced an investigation into the death of William 
Davies, aged 67. The investigation concluded at the end of the inquest on 
3  November  2014.  I  made  a  determination  that  death  came  about  from 
natural causes, being: 1a) coronary artery atherosclerosis. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Davies was found unresponsive in his cell at HMP Pentonville. 

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 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 unless  action  is  taken.  In  the  circumstances,  it  is  my  statutory  duty  to 
report to you. 

The MATTERS OF CONCERN are as follows.  

There seems to be confusion in the prison regarding the requesting of an 
ambulance  after  a  level  one  (i.e.  regarding  a  potentially  life  threatening 
situation) call has been made by a prison officer.   

The whole process of attending a prisoner with a life threatening condition 
seemed  unclear  to  the  prison  general  practitioner  (now  GP  lead)  giving 
evidence.  She assumed that a prison officer had responsibility for calling 
an ambulance, but she was not sure.   

The GP also did not know that she was allowed to verify the fact of death, 
and told me that,  as  a  consequence,  she  carried  on  with  CPR  after she 
knew that Mr Davies had died. 

And if the GP lead has not got a good understanding of the procedures in 
place, then other GPs in the prison may not have either.  This could prove 
fatal, depending upon the circumstances. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you 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 12 January 2015.  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 following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
  HM Inspectorate of Prisons 
  National Offender Management Service 

I  am  also  under  a  duty  to  send  the  Chief  Coroner  a  copy  of  your 
response.  

2 

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

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

05.11.14 

3

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 Care UK (PDF)
PRIVATE AND CONFIDENTIAL 
Coroner ME  Hassell 
Inner North London 
St Pancras Coroner's Court 
Carnley Street 
London NC1  4PP 

23 December 2014 

Dear Mr Hassell, 

Healthcare Department 
HMP Pentonville 
Caledonian  Road 
Islington 
London 
N7 8TT 

RE:  Prevention of Future Deaths - Mr William Davies (died 16.06.14) 

On  5 November 2014 Coroner ME Hassell  issued a Regulation  28 :Prevention of Future 
Deaths Report to Care UK. 

This  letter  is  in  response  to  the  aforementioned  PFD  report  (a  copy  of  which  we  have 
enclosed for your reference) and we will deal with each point highlighted in  turn: 

1.  Requesting an  ambulance after a level one emergency has been declared 

We  understand  from  our  prison  colleagues  that  on  3rd  December  2014,  the  Head  of  Safer 
Prisons, Head of Operations 2 (gates and the control room) and the Deputy Governor met with 
the  local  London  Ambulance  Service  (LAS),  Emergency  Planning  &  Resilience  Officer  and 
Station  Officer  to  discuss  how  make  the  process  clearer  regarding  the  calling  of  an 
ambulance. We are told that the following actions are being taken forward: 

•  Control Room  staff have been  re-briefed  about their requirement to  call  an  ambulance 

when a level  1 emergency is called  (See Appendix 1 - Calling of an Ambulance). 

• 

Information specifically required  by the LAS has been  made into a crib sheet so control 
room  staff  are  aware  of what  questions  the  LAS  could  ask  before  attending  to  the 
emergency.  It is  anticipated  that this will  speed  up the phone call  process. The details 
of this can  be found  at Appendix 1, page 2. 

•  A publicity campaign  (based  on  PSI  2013/03 Emergency Response  Codes) has taken 
place  reminding  staff of who  can  call  a medical  emergency, who  calls  the ambulance, 
the use of the correct medical emergency codes, and what information they should be 
communicating  with  the  control  room  (See  Appendix  3  - Emergency  Healthcare 
Response).  This  document was jointly developed  with  prison  service  colleagues  prior 
to  us  taking  over  healthcare  services  in  HMP  Pentonville  and  our  Health  in  Justice 
team  are  reviewing  this  as  part  of  a  wider  piece  of work  around  emergency  care, 
including training of staff and standardisation of the emergency bags. 

The  publicity  campaign  has  reached  out  to  all  staff  working  within  Pentonville; 
operational, non-operational and healthcare. The leaflet has been published to staff via 

 the  intranet,  publicised at the main gate entrance and  a small copy will  be  attached to 
all  operational staffs' payslips for December 2014. 

The  leaflet  and  information  has  been  added  in  induction for new non-operational and 
healthcare staff. 

•  Better  signage  has  been  ordered  to  help  emergency  services  identify  Roman  Way 

Gate (January 2015). 

2.  GPs  understanding  of their responsibilities  and  permission  to verify the  fact  of 

death 

The  Care  UK National  Medical  Director for Health  in  Justice has  spoken  with  the  lead  GP to 
clarify  her  role  regarding  decision  to  cease  CPR  and  declare  life  extinct.  The  Head  of 
Healthcare has additionally briefed all General Practitioners working at HMP Pentonville about 
their  responsibility  and  legal  right  to  declare  life  extinct  following  their  examination  in  an 
emergency situation. All  doctors  are given  orientation  and  induction  prior to  working  at HMP 
Pentonville;  this  has  been  reinforced  with  the  existing  team  and  any locum  providers. This  is 
also included in all  GP inductions. 

Decisions to cease CPR or to  not commence CPR can  be difficult in  emergency situations so 
in  addition  to  the  above  actions,  our  National  Medical  Director and  National  Lead  Nurse  a·re 
currently  working  with  our  networks  of lead  GPs  and  lead  nurses  to  develop  guidance  and 
additional  training  to  help  support good  decision  making  in  cases  of unexpected  collapse  or 
death.  In  the case of expected  deaths and  palliative care  situations we  have well established 
protocols  for  DNAR  (do  not  actively  resuscitate)  forms  to  be  used  in  our  prisons  elsewhere 
and  are  in  the  process of sharing this  practice as part of a  wider project on  improving  end of 
life care across our prisons. 

We  trust  this  answers  all  of  your  concerns  raised  in  the  Prevention  of  Future  Deaths 
Regulation 28 Report. 

Should you  require any further clarification please do not hesitate to get in touch with us. 

Yours Sincerely, 

Company Secretary 
Care UK Limited 

Enc. 

Page 2 of 2

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