Prevention of Future Deaths reports · 2015

Jeanne Summers

Regulation 28 report to prevent future deaths, reference 2015-0139, written 16 Apr 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Apr 2015
Reference2015-0139
DeceasedJeanne Summers
CoronerMary Burke
Coroner areaWest Yorkshire (West)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedCalderdale and Huddersfield 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.

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: 

1.  Owen Williams, Chief Executive, Calderdale and Huddersfield NHS 

Foundation Trust 

2. 
3. 
CORONER 

1 

I am MARY BURKE, Assistant Coroner for the coroner area of WestYorkshire (Western) 

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 

On 30 July 2013 I commenced an investigation into the death of Jeanne Elsie Summers, 
aged  78  years.  The  investigation  concluded  at  the  end  of  the  inquest  on  3rd  and  4th 
March  2015.  At  the  conclusion  of  the  inquest  the  medical  cause  of  death  was 
established as 1(a) Bronchopneumonia and 11. Immobility due to fracture of right ankle 
(operated)  and  Chronic  Obstructive  Pulmonary  Disease  and  the  narrative  conclusion 
was:    “On  14  July  2013, whilst  a  patient  at  Huddersfield  Royal  Infirmary,  Jeanne  Elsie 
Summers suffered an unwitnessed fall which it is likely could have been prevented.  As 
a result she suffered a fracture to her right ankle which required surgery, following which 
she  had  a  period  of  worsening  immobility  which  is  likely  to  have  contributed  to  the 
development of bronchopneumonia which led to her death on 24 July 2013.” 

4 

CIRCUMSTANCES OF THE DEATH 

On the 29th June 2013 Mrs. Summers was admitted to Huddersfield Royal Infirmary with 
an exacerbation of her Chronic Obstructive Pulmonary Disease, together with infection.  
Mrs Summers was commenced on intravenous antibiotic medication and began to show 
signs of improvement.  By the 6th July 2013 she was thought well enough to be 
discharged home, although there appears to have been no assessment of Mrs. 
Summers’ mobility levels at the time of discharge.  

The following day, the 7th July  2013, Mrs. Summers was readmitted as she was unable 
to mobilise at home and was unable to get out of bed.  Following further admission on 
the 7th July she was queried to be suffering from pneumonia and/or a urinary tract 
infection and she once again commenced intravenous antibiotics. She subsequently 
showed signs of slow but gradual improvement.  

Shortly after midnight on the 14th July 2013 she was using a zimmer frame to mobilise to 
the toilet, supervised by members of staff.  Following arrival at the toilet she suffered an 
unwitnessed fall in the toilet cubicle.  As result she suffered an open fracture to her right 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ankle, which required surgical intervention. 

Mrs. Summers subsequently developed pneumonia, which was treated with antibiotic 
medication. Unfortunately Mrs. Summers did not respond.  Her condition continued to 
deteriorate and her death was confirmed at 0250 hours on the 24th July 2013 on Ward 5 
at Huddersfield Royal Infirmary. 

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)   The assessment review of Mrs. Summers’ ability prior to her discharge on the  
6th July 2013.  There is no clear indication that an assessment had been undertaken 
prior to Mrs. Summers’ discharge on the 6th July 2013.  Her condition was such that she 
required further readmission on the 7th July 2013. 

(2)  During the further readmission on the 7th July 2013 Mrs. Summers was reviewed on 
 Clinical 
a number of occasions by a physiotherapist.  At the inquest 
Lead Physiotherapist, provided evidence and indicated that the physiotherapy written 
records did not provide a full record of all relevant details.  These notes are reviewed by 
nursing staff in order to ensure the patient’s safe mobilisation and the preparation of 
appropriate care plans.  I would ask you to consider that additional training and/or 
direction should be given to the Physiotherapy Department in order to ensure that a full 
record of all relevant details are made within patients’ records. 

(3) From the evidence presented at the inquest it appears that at the time when Mrs. 
Summers was mobilising in the early hours of the 14th July 2013 she was wearing her 
own “fluffy socks”.  These were not slipper socks.  She was clearly not wearing slippers 
at the time.  In addition the health care assistant who was supervising Mrs Summers did 
not ensure that Mrs. Summers was seated on the toilet within the toilet cubicle before he 
left her. 

I would request you to consider training and guidance to nursing staff to ensure that, 
firstly,  patients are wearing appropriate footwear prior to mobilisation and, secondly, to 
provide training guidance to staff of safe systems of transfer to ensure that patients are 
not left whilst in the process of transfer. 

(4)  At the inquest Matron 
she undertook in respect of the circumstances surrounding Mrs. Summers’ fall.  Matron 
indicated in her evidence that she had not received full training with regard 

gave evidence in respect of an investigation which 

to undertaking an investigation and preparing an investigative report.   

Although in her report she stated that one of the objectives was to consider if the fall 
could have been prevented,  that question was not addressed in her report.   When 
questioned by me she confirmed in evidence that the socks which Mrs. Summers was 
wearing at the time of her fall and the fact that she was left before she had effectively 
safely transferred on to the toilet are likely to have been factors which would have 
caused, or significantly contributed to Mrs. Summers’ fall.  Neither of these points were 
identified in the report.  I would request that in future all investigators receive the 
appropriate training to enable them to undertake a full and appropriate investigation. 

 6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths 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.  
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  
Persons:  

who may find it useful or of interest. 

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 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 

16th April 2015                                               

                                                                                 M. T. Burke, Assistant Coroner

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