Prevention of Future Deaths reports · 2015

Katherine Bonaventura

Regulation 28 report to prevent future deaths, reference 2015-0031, written 28 Jan 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 Jan 2015
Reference2015-0031
DeceasedKatherine Bonaventura
CoronerAlison Hewitt
Coroner areaSurrey
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedSurrey and Borders Partnership NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS   

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Surrey and Borders Partnership NHS Foundation Trust – For the attention 

of the Chief Executive, the Medical Director and the Nurse Director. 

1 

CORONER 

I am Alison Hewitt, Assistant Coroner for the coroner area of Surrey. 

2 

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. 

3 

INVESTIGATION and INQUEST 

I commenced an investigation into the death of Katherine Liana Bonaventura aged 28 
years. The investigation concluded at the end of the inquest on 14th January 2015. The 
conclusion of the inquest jury was that  

(i) the medical cause of death was I (a) Haemorrhage I (b) Stab Wound to the Chest,  

(ii) the Deceased died as a result of her own deliberate act, whilst suffering mental ill 
health, but the evidence does not establish, beyond reasonable doubt, whether she 
intended that act to cause her death, and  

(iii)  her death was more than minimally contributed to by failures by the Trust (a) upon 
her return to the Abraham Cowley Unit on 7th December 2012 to elicit information about 
issues arising during her overnight leave and (b) to assess sufficiently and immediately 
her mental state upon her return to the Unit following her overnight leave. 

4 

CIRCUMSTANCES OF THE DEATH 

Katherine Liana Bonaventura was a patient detained under the Mental Health Act in the 
Abraham Cowley Unit of St Peter’s Hospital, Chertsey. Katherine Bonaventura was 
diagnosed as suffering paranoid schizophrenia and had a significant and recent history 
of violent self-harm.  

Her detention had commenced in October 2012 and she had undertaken her first 
overnight leave from the Unit from the 6th December to the 7th December 2012. During 
that overnight leave, which the deceased spent with her family, she consumed alcohol 
and, on the morning of the 7th December, was seen to be in a psychotic state and 
staring at a kitchen knife block.  

These facts were of relevance to the deceased’s risk of self-harm but they were not 
elicited from the family member who returned the deceased to the Unit. Further, the 
deceased’s mental state was not immediately or sufficiently assessed upon her return to 
the Unit.   

In fact, Katherine Bonaventura returned to the Unit with a concealed knife, taken from 
the kitchen knife block at home, with which she fatally stabbed herself a few hours later. 
The evidence suggested that if the full picture had been elicited when Katherine 
Bonaventura returned to the Unit, her mental state may have been more thoroughly 

RT4497 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 examined, she may have been searched and she may have been kept under greater 
and/or more regular observation.  

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.  –  

It was clear from the evidence that the Trust had and has in place Guidelines entitled 
“Working Age Adults Inpatient Leave of Absence Guidelines for Detained Patients” 
dated November 2011 and reviewed in July 2012. Those guidelines state, “Upon return 
from leave, an assessment of the patient should occur and the family member, carer 
should be consulted to ensure any issues arising during leave are noted. The outcome 
of this discussion should be documented in the patient’s clinical record.”  

It was apparent from the evidence that (i) the consultation with the family member / carer 
may consist of no more than an exchange of a few words in the presence of the patient, 
(ii) it is sometimes difficult for a family member / carer to provide all relevant information 
to staff in those circumstances and (iii) if staff are not immediately aware of any issues 
arising, their “assessment of the patient” may consist of no more than an exchange of a 
few words in the reception area.   

It is, therefore, of great importance that staff elicit as much information as possible about 
the leave and any concerns arising, at the point of the patient’s return.   

It is of concern that there is no system in place to ensure that a sufficiently thorough 
consultation takes place with the family member / carer, which is designed to elicit as 
much information as possible as soon as possible.  One nurse stated in evidence that it 
is now his personal habit to escort the family member / carer off the Unit so that he can 
conduct a further, private, consultation, but that not all nurses do so.  It is also of 
concern that there is no system in place to ensure that a sufficient mental state 
assessment of the patient is conducted, and its outcome is recorded, at the time of 
arrival back on the Unit. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths by addressing the 
concerns set out above and I believe 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 25th March 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 Chief Coroner and to the following Interested 
Person : 

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 

RT4497 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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. 

9 

28th January 2015                                              Alison Hewitt 

RT4497

Related reports

Other reports by Alison Hewitt

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Surrey and Borders Partnership NHS Foundation Trust

See every Prevention of Future Deaths report matching Surrey and Borders Partnership NHS Foundation Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.