Prevention of Future Deaths reports · 2015

Isobel Griffin and Jane Clark

Regulation 28 report to prevent future deaths, reference 2015-0049, written 12 Feb 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report12 Feb 2015
Reference2015-0049
DeceasedIsobel Griffin and Jane Clark
CoronerBelinda Cheney
Coroner areaNorthamptonshire
CategorySuicide (from 2015)
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 ON ACTION TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:
1. Chief Executive of the Northamptonshire NHS Partnership Trust
2. Berrywood Hospital
1 CORONER
I am Belinda Cheney, Assistant Coroner for Northampton.
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 conducted three inquests into deaths that occurred in Berrywood Hospital and
in two of them the concerns were similar so I have written this report to cover
both deaths.
On Wednesday 4th September 2013 I commenced an investigation into the
death of Jane Marie Clark whose date of birth was 20th July.1989 The
investigation concluded at the end of the inquest on 20th January 2015. The
conclusion of the inquest was
The medical cause of death was:
1a hanging
The narrative conclusion was:
Jane Marie Clark was an informal patient at Berrywood Hospital Northampton
diagnosed with emotionally unstable personality disorder. On 22nd August 2013
staff became aware that Jane had been involved in discussions about suicide
with other patients. At 07.00 hours she was found in possession of a ligature.
Around 09.30 hours she was granted leave from the ward without an adequate
assessment of the risks. She went to the woods and tied a ligature, intending to
commit suicide. She was found deceased by a passerby at 13.40 hours. Life was
finally pronounced extinct at 14.32 hours.
On Wednesday 28th August 2013 I commenced an investigation into the death
of Isobel Griffin whose date of birth was 6th September 1956. The investigation
concluded on 23rd January 2015. The conclusion of the inquest was:
The medical cause of death
1a hypoxic brain injury
b hanging
2 psychiatric illness
The conclusion was a short form with additional comment as follows
Suicide – contributed to by inconsistent community care and difficulties in
treating her mental disorder in the period from 2011‐ 2013, and lack of
adequate risk assessments and a well formulated management plan on the final
admission between 1 and 17 August 2013.
4 CIRCUMSTANCES OF THE DEATH
Jane Marie Clark
Jane Clark had a very long standing history of personality disorder and multiple
lengthy inpatient admissions. There were no issues with her care in hospital but
rather that a nurse granted leave without apparently reading the notes which
made clear that events in the last 12 hours (including Mrs Griffin’s death some
days earlier on the ward, discussions between patients about suicide, to which
discussions Jane was central, attempts by others to tie ligatures on the ward in
the early hours of 22nd August, Jane being found in possession of a ligature on
the morning of the 22nd) required a full risk assessment and prompt escalation
to the multi disciplinary team before any decision was made about leave. The
risk assessment documents had further not been updated. Further, no
boundaries were placed on the leave.
Isobel Griffin
had been Mrs Griffin’s psychiatrist for many years. When
retired in 2011 Mrs Griffin was seen by a number of different junior doctors in
the community and frequent changes were made to her medication. She had a
number of admissions to the Welland Centre and her diagnosis was changed
from recurrent depressive disorder to personality disorder. On 27 July Mrs
Griffin was discharged from the Welland Centre against the wishes of her
family. On 28 July she attempted to take her life and was readmitted to the
Welland Centre and at the request of her family transferred to Berrywood
Hospital Northampton from 1‐17 August 2013. She was commenced on a
medication free trial. She was documented as being very suicidal in the days
leading to her death and from 7th August started confiding about attempts to tie
ligatures which was a new development. On 17 August around 8.30 am she
hanged herself from her bedroom door on the ward with a ligature made from
a bathrobe cord and a sweater. Despite efforts to resuscitate her, Mrs Griffin
died on 21 August at Northampton General Hospital.
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 could occur unless
action is taken. In the circumstances it is my statutory duty to report to you.
The MATTERS OF CONCERN are as follows. –
Re Jane Marie Clark
1. The very challenging events of the previous evening and that morning
do not appear to have been handed over and the nurse in charge did not
read the notes before granting leave. Her risk assessment then was ill
informed. It was not discussed with anyone nor properly documented.
2. She did not place any boundaries on the leave for example providing a
time by which Jane was to return.
3. Risk assessment documentation generally was poor and appeared
perfunctory.
Re Isobel Griffin
1. Mrs Griffin was admitted on 1 August and was not allocated a key
worker until 8th August. The key worker did not read the notes so was
not aware of the events of the 7th.
2. The risk assessment was not updated with the events of the 7th.
3. Mrs Griffin’s responsible clinician saw her on only one occasion on 14
August 2013 at which time he did not read the notes so he was unaware
of events on the 7th when she handed in a belt and scissors and said she
had 3‐4 times tried to hang herself using a ligature.
4. A planned review of medication, diagnosis and treatment never took
place despite a number of references in the notes to it from 6 August
2013. Mrs Griffin had been substantially unmedicated for most of the
admission despite concerns expressed by her family.
5. On 11 August Mrs Griffin started to express thoughts to harm others.
These thoughts distressed her. She did not intend to act on them but
they were something new and a measure of her distress. These thoughts
and their significance were not included in any risk assessment.
6. A risk assessment concluded on the 18th, the day after she had hanged
herself on the ward, purports to be made with her agreement. It was
evidence that risk assessment documentation is cut and pasted rather
than reflecting the true circumstances.
7. The doors do not appear to be ligature proof and little was made
available by way of evidence as to what measures would now be taken
to minimise this risk.
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 9th April 2015. I, the Assistant 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 Persons, namely the families of both Jane Clark and Isobel Griffin.
Similarly, you are 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.
9 DATE SIGNED BY ASSISTANT CORONER
12.2.15 Belinda Cheney

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