Prevention of Future Deaths reports · 2014

Stephen Mayoll

Regulation 28 report to prevent future deaths, reference 2014-0515, written 25 Nov 2014. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report25 Nov 2014
Reference2014-0515
DeceasedStephen Mayoll
CoronerDavid Horsley
Coroner areaPortsmouth & South East Hampshire
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedPortsmouth Hospitals University NHS Trust
Sourcejudiciary.uk record · original PDF
Responses published1

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:

The Chief Executive, Portsmouth Hospitals NHS Trust

1 | CORONER

| am David Clark Horsley, senior coroner, for the coroner area of Portsmouth and South
East Hampshire.

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 28" June 2013 | commenced an investigation into the death of Stephen Anthony
Mayoll, aged 44. The investigation concluded at the end of the inquest on 19°
November 2014. The conclusion of the inquest was:

Narrative Conclusion:

1- On10" June 2013 Stephen Anthony Mayoll fell from a ladder at work and
sustained a right Achilles tendon injury for which he received treatment as an
out-patient at Queen Alexandra Hospital, Portsmouth, between 11" and 20"
June 2013.

2 On21* June 2013 he became very unwell at home and was taken by
ambulance to Queen Alexandra Hospital where he died at 03.20 hours on 22™
June 2013.

3- He died as a result of complications of his injury and its treatment at the hospital
between 11" and 20" June 2013, namely a pulmonary thromboembolism arising
from a deep vein thrombosis in his right lower leg. Mr Mayoll did not fulfil the
criteria then in force at the hospital for the use of anti-coagulation therapy in
respect of Achilles tendon injury patients and in consequence did not receive
such therapy which, on the balance of probabilities, would have reduced the risk
of those complications arising.

4 | CIRCUMSTANCES OF THE DEATH

The circumstances of Mr Mayoll's death are set out in Paragraph 3 above.

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 MATTERS OF CONCERN are as follows. —

1- Out-patients with similar injuries to Mr Mayoll's returning to the fracture clinic at

Queen Alexandra Hospital experiencing problems with their treatment or for
periodic review are not subject to re-assessment under the hospital's DVT
assessment policy. If they were, there would be less risk of their developing
DVT's during the course of their treatment.

2- Evidence was given at the Inquest highlighting the delay in typing fracture clinic
doctors' notes meaning that they would not always be available if an out-patient
returned to the clinic and improved methods of making the notes available
sooner to the clinic (e.g. by use of voice recognition IT) would obviate this
problem.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisation 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 20" January 2015. |, 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 to the following Interested
Persons:
4-

a
2- RCN Legal Services [A

| 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.

25" November 2014 [SIGNED BY,CORONER]

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 Portsmouth Hospitals NHS Trust (PDF)
Portsmouth Hospitals

NHS Trust

Trust Headquarters

F Level, Queen Alexandra Hospital

Ursula Ward MSc MA Southwick a Road

ti osham

li PORTSMOUTH, PO6 3LY
Tel;

PRIVATE & CONFIDENTIAL

Mr D C Horsley LLB, Solicitor

Her Majesty's Coroner for Portsmouth and South East Hampshire
Coroner's Officer

The Guildhall

Guildhall Square

Portsmouth

PO1 2AB

19 January 2014

Our ref:

(Please quote our ref in all correspondence)

Dear Mr Horsley

| refer to your Regulation 28 Report of 25 November 2014 which the Trust has considered carefully. |
am pleased to be able to set out below the actions which we are Intending to take to ensure that
everything possible is done to prevent future cases such as Mr Mayoll's.

1. Patients who retum to the fracture clinic with lower limb injuries as “in trouble” or for routine
review, will have a reassessment of thelr risk factors for VTE each time they attend, the
result of which will be considered by the doctor reviewing them. This will be documented via
the normal route on a plaster room “in trouble” form which is currently being updated and
will include the recommendations which arose from the Inquest relating to VTE assessment.

2a. We will ensure that the review by the plaster technicians will be recorded, signed and
correctly dated and then scanned and saved by “Windip" (an electronic storage system) so
that if the patient returns again, the information is available for the health care professional
to view and follow the decision making and treatment plan from the previous visit, The
scanner required for this to take place is currently on order.

2b. An_“in trouble” patient reviewed by the Consultant will have the notes dictated that day and
then typed up by the Orthopaedic secretaries and the alm is for them to be typed within 24-
hours. We are exploring IT solutions as well but thls Is the interim solution. The current
EPRO system (a digital dictation system) involves the notes being typed up by agency staff
and, possibly, in the future, outside agencies and It is anticipated that the normal typing
turnaround will be at 48-hours by the end of March which is still not quick enough to ensure
that information Is available for a Consultant reviewing a returning patient. However, there
Is the abllity through EPRO to gain access to the tapes but the Consultants can listen to the
recording If the typed notes are not available. This is being fed back at the next consultants’
meeting, by way of reminder.

| hope that the above plan addresses your concerns but of course please contact me again if you
require any further clarification or information.

Yours sincerely

Ursula Ward MSc MA
Chief Executive

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