Prevention of Future Deaths reports · 2015

James Savo

Regulation 28 report to prevent future deaths, reference 2015-0209, written 1 Jun 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Jun 2015
Reference2015-0209
DeceasedJames Savo
CoronerNicola Mundy
Coroner areaSouth Yorkshire (East)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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.

Nicola Jane Mundy
Senior Coroner for South Yorkshire (East District)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: The Chief Executive
Rotherham Doncaster And South Humber Woodfield House Trust Headquarters, Tickhill
Road Hospital Doncaster DN4 8QN

CORONER

| am Nicola Jane Mundy, Senior Coroner for South Yorkshire (East District)

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.

http:/Avww legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www legislation.gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 06/12/2013 | commenced an investigation into the death of James Savo, aged 27. The
investigation concluded at the end of the inquest on 01 June 2015. The conclusion of the inquest
was a Narrative Conclusion Mr Savo's cause of death was 1a Hanging and the Narrative
Conclusion is as follows "James Savo had a long standing history of depression. Following his
first period of inpatient treatment he was discharged home on 29 November 2013. At the time of
his discharge insufficient weight was attached to both the timing and nature of the home
treatment team's input and also to family concerns and issues. On balance this led to earlier
discharge that should have been the case. Mr Savo hanged himself in woodland off Scholes
Lane on 3rd December 2013. Had Mr Savo not been discharged on 29 November 2013 it is
unlikely that he would have died at the time he did.

CIRCUMSTANCES OF THE DEATH

Mr Savo had a long standing history of depression. In October 2013 he had his first period of
inpatient treatment. During that time there was a change in his anti-depressant, assessment on
the ward and four periods of home leave, three of which were with his family the fourth period
and, longest, was with a friend. There was insufficient communication with the family regarding
Mr Savo’s presentation and their views on home leave. The last direct Home Treatment Team
involvement was some 9 days prior to discharge when there was still issues with Mr Savo’s
home environment, family tensions. There was a need for on-going assessment of his response
to medication. He had continuing suicidal thoughts. There was noted to be improvement in the
ward setting although he was not as well whilst at home. After a seven day period of leave with
a friend Mr Savo returned to the ward where he was then discharged back to his home
environment; a Home Treatment Team representative - was not present at this meeting. Their
last involvement would have been documented in the computerised records, with the last
assessment being some 9 days prior to discharge. There was no evidence of communication
with the family/carers at this time. Following Mr Savo's discharge there was a crisis situation 2
days later where the decision was made to continue James’ treatment i in the community setting
(whilst he remained at home). 4 days after discharge on the 3% December Mr Savo hanged
himself.

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. —

Coroner's Court and Office, Doncaster Crown Court, College Road, Doncaster, DN1 3HS
Tel 01302 320844 | Fax 01302 364833

(1) The systems described as being in place which should be followed to ensure effective
communication between families/carers appear not to be routinely followed. As this
communication is an integral part of a patient's management and future treatment plans it is
essential that all staff are aware of the need for this communication, the nature of it and who has
primary responsibility. for ensuring that it takes place. Furthermore, there is no evidence of any
effective auditing process to ensure such systems are being followed.

(2) The early discharge plan was described as a mechanism to try and ensure a seamless
transition from inpatient care to community based care in appropriate cases. Whilst this is
clearly a system adopted locally and currently being re-evaluated, given it’s significance in
facilitating smooth transitions at a time which was recognised as being difficult for many patients
returning to the community, consideration should be given as to whether the current guidance
etc adequately incorporates the ethos and workings of the early discharge plan. Witnesses
knowledge and understanding of this pathway was variable.

Coroner's Court and Office, Doncaster Crown Court, College Road, Doncaster, DN1 3HS
Tel 01302 320844 | Fax 01302 364833

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you The Chief
Executive and Medical Director 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
27 July 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the following Interested Persons |
HB | have also sent it to who may find it useful or of interest.

| 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 fo 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 th cai by the Chief Coroner.

Signature__|
Senior Coron}

Coroner's Court and Office, Doncaster Crown Court, College Road, Doncaster, DN1 3HS
Tel 01302 320844 | Fax 01302 364833

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