Prevention of Future Deaths reports · 2015

Alec Mathias

Regulation 28 report to prevent future deaths, reference 2015-0247, written 26 Jun 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jun 2015
Reference2015-0247
DeceasedAlec Mathias
CoronerElizabeth Earland
Coroner areaExeter and Greater Devon
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.

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:
4. Chief Executive of the Royal Devon and Exeter Hospital

2. -
3. -

4 | CORONER

1 am Dr Elizabeth Earland Senior Coroner for the coroner area of Exeter and Greater
Devon.

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 7" October 2014 | commenced an investigation into the death of Alec James
MATHIAS, 78 years old. The investigation concluded at the end of the inquest on 24"
June 2015. The conclusion of the inquest was Misadventure with the Cause of Death of
being —

1a — Liver Failure

4b —Flucloxacillin Induced Cholestatic Liver Injury

4c — Treatment for Cellulitis of the Left Index Finger

Il — Radiation Proctitis following Radiotherapy for Carcinoma of the Prostate

4 | CIRCUMSTANCES OF THE DEATH

Mr Mathias suffered from a whitlow of his Left Index Finger in June/July 2008 during
which time he was treated with Flucloxacillin.

He was admitted to the Royal Devon and Exeter (Wonford) Hospital on the 10"
September 2008 with a presumptive diagnosis of painless obstructive jaundice under I
HE following a GP letter dated 9" September 2008 t

Consultant Gastroenterologist (see p.4 statement off

HE dated 29.01.2015).

It was found that he had suffered drug induced jaundice and the Flucloxacillin was
stopped (further doses having been given while he was an in-patient).

There is no record of a discharge summary being sent to Mr Mathias’s GP or that he had
suffered a reaction to the Flucloxacillin and that this had been the agreed cause of his
liver probiems.

Mr Mathias suffered further infection of the index finger in August 2014 and was again
prescribed Flucloxacillin by the GP practice nurse, which proved fatal — see Record of
Inquest. .

| received evidence fro ZEEE c September 2008 admission and I
and iE regarding the 22" August 2014 admission and it is clear
that not only was no discharge letter sent to the GP in 2008 alerting the practice to Mr
Mathias's idiosyncrasy regarding Flucloxacillin but there was no highlighting of the
hospital notes that he had an allergy or would suffer a reaction if given Flucioxacillin.

The administration of Flucloxacillin has caused Mr Mathias’s death.

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) Discharge letters have not been sent to the patients GP in a case where a dangerous
side effect to treatment has been noted

(2) That the hospital has not highlighted its own records with vital information on drug
sensitivity discovered and diagnosed on an in-patient.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you 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 21° August 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.

lam 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 Coraner.

26" June 2015 [SIGN ONER’ wi

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