Prevention of Future Deaths reports · 2015

Michael Logue

Regulation 28 report to prevent future deaths, reference 2015-0426, written 4 Nov 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Nov 2015
Reference2015-0426
DeceasedMichael Logue
CoronerLouise Hunt
Coroner areaBirmingham and Solihull
CategoryCommunity health care and emergency services related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

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.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1.

2. The Practice manager at Central Surgery

CORONER

| am Louise Hunt Senior Coroner for Birmingham and Solihull

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.

INVESTIGATION and INQUEST

On 25/06/2015 | commenced an investigation into the death of Michael Patrick Joseph LOGUE. The
investigation concluded at the end of the inquest 2nd November 2015. The conclusion of the inquest was
that the deceased died from recognised complications following a liver transplant.

CIRCUMSTANCES OF THE DEATH

The deceased had a liver transplant on 03/07/12. He developed a biliary stricture after the operation. He
was admitted for biliary reconstruction surgery on 29/05/15. He went home on 01/06/15. He requested
a home visit from his GP as he was complaining of pain on 03/06/15. The GP did not carry out a physical
examination. He requested a further home visit by another GP on 09/06/15 who carried out a physical
examination and diagnosed a wound infection. He was admitted to University Hospital Coventry and
Warwickshire on 11/06/15 where he died a few hours later.

A post mortem examination confirmed that he died from sepsis from a liver abscess following the biliary
tree reconstruction.

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 GP failed to carry out any physical examination of the patient during a home visit on 03/06/15.

Mr Logue was complaining of not feeling at all well and of pain and was 5 days post biliary reconstruction
surgery.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you BB 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 30"
December 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 and to the following Interested Persons The family
and NHS England.

1am 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.

04/11/2015

Louise Hunt Senior Coroner Birmingham & Solihull District

##DW<<corAddress>>
‘Tel ##DW<<corTel>> | Fax ##DW<<corFax>>

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Central Surgery (PDF)
J.Cotterill
E.Eedle
D.Black
Central Surgery yaa
J.Barhey
L.Armstrong
CORPORATION STREET, RUGBY, CV21 3SP_ Tel 01788 524366 AWinter
ALSO AT BILTON GREEN, RUGBY, CV22 7LY Tel: 01788 818939 B.Sriram
Fax01788 547693 T.Rayment
Z Hughes
L Marshall
T Atwal
R Kalyani

Dear Mrs Hunt,

As requested | have reflected on the content of your report aimed at preventing future
deaths. Central Surgery has discussed the case as a significant event as well.

| appreciate that you are concerned to prevent future deaths. On reflection | believe in
the case of Mr Logue the standard of my medical care, both in history taking and
examination fell short of my usual practice. | have learned to be extra vigilant for post-
operative complications and not to rely solely on the history given by the patient. or just
on their general appearance.

| would like to reassure you that in the past year | have successfully managed two cases -
of biliary sepsis. | am pleased to say that | received positive comments from both
relatives and colleagues in relation to my care for these patients. | am, if required, able
to provide you with documentary evidence to support this statement.

The care of Mr Logue was discussed at a significant event analysis meeting at Central
Surgery. My GP colleagues did not think that a routine examination of every post-
operative patient was indicated and that use of a sepsis check list was not routine
practice. However, it was agreed that in future it would be prudent to undertake a more
detailed examination and to accurately and fully record the findings in any consultation.
Some of the GPs in the practice have surgical training and considered that the hospital
could be more proactive in contacting patients at home after major surgery. | have
spoken to the hepatobiliary co-ordinator at University Hospitals, Birmingham and was
advised that following a liver transplant, patients are contacted at home within one week
of surgery, but that this is not the case following bile duct surgery. | am aware that
following cardiac surgery in University Hospital, Coventry every patient is contacted by
the liaison nurse within a few days following discharge.

Following the significant event meeting | am now, on behalf of the practice, in the
process of contacting Professor Muiesan to discuss with him how communication in
relation to postoperative care can be improved.
Yours sincerely,

ae

Dr Emma Eedle

J.Cotterill
E.Eedle
D.Black
Central Surgery Diack
J.Barhey
L.Armstrong
CORPORATION STREET, RUGBY, CV21 3SP_ Tel: 01788 524366 AWinter
ALSO AT BILTON GREEN. RUGBY. CV22 7LY Tel: 01788 818939 B.Sriram
T.Rayment
Z. Hughes
L. Marshall
Dr T Atwal

23" December 2015.

Mrs L Hunt,

Senior Coroner for Birmingham and Solihull Areas, r

50 Newton Street, | RECEIW
Birmingham,

B4 6NE. f JAN

Our ref: RB/2015/12-1 Your Ref: 002189/2015 ( T ORGAN/AS) —
Dear Mrs Hunt,
Re: Report on Preventing Future Deaths (Mr Michael Patrick Joseph Logue) .

Your report and the concerns that you raised have been reviewed under our clinical review
Process. As is our normal Procedure your concerns were raised as a Significant Event.

The Practice has carried out a significant event review. The review noted that during the home
visit Dr Eedle did not carry out a physical examination of the patient. During the review process
it was noted that a physical examination of post-operative patients was not always indicated and
that the use of a sepsis check list was not routine practice. The review benefited from input from
GP Colleagues who are qualified Surgeons and or have surgical experience. As such it was also
observed that the hospital did not appear to have been proactive in its follow-up care.

Following the Significant event review the following actions were agreed for immediate
implementation:

1.0 That the event be shared with all clinicians to improve their work practices.

2.0 That in future more detailed examination of the patient in such cases should be carried out
and the results of which should be fully recorded in the patient notes.

3.0 Dr Eedle to contact the Hospital to see how communication can be improved to support the
care of Post-Operative patients.

If you require any additional information please do not hesitate to contact me.

tooo

R St Claire-Barrass.
Practice Manager.

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