Prevention of Future Deaths reports · 2015

Fiona Lewis

Regulation 28 report to prevent future deaths, reference 2015-0441, written 17 Sep 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report17 Sep 2015
Reference2015-0441
DeceasedFiona Lewis
CoronerDr Peter Dean
Coroner areaSuffolk
CategoryHospital Death (Clinical Procedures and medical management) related deaths
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 TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. 

 Medical Director, Ipswich Hospital. 

1 

CORONER 

I am Dr Peter Dean, senior coroner for the coroner area of Suffolk 

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 the 8th of April 2015, I resumed the inquest into the death of FIONA MARGARET 
PATRICIA LEWIS. The conclusion at the end of inquest was that the death was due to 
Natural Causes, however there were circumstances in respect of this very sad death 
that gave rise to concern. 

4 

CIRCUMSTANCES OF THE DEATH 

Fiona Luis was admitted to Ipswich Hospital on the 5th of September 2014 following a 
three week period of symptoms which had initially suggested a possible orthopaedic 
problem, although there was then concern that there was an underlying neurological 
component to her condition.  There were clearly difficulties in obtaining a clinical 
diagnosis for the condition in life, which were looked into at the inquest given her son’s 
concerns here, but her condition sadly deteriorated and she passed away at Ipswich 
Hospital on the 13th of September 2014.  By that time an underlying malignancy was 
suspected but not proven, and the cause of death was found by an independent 
pathologist to be from Disseminated Carcinoma.  No primary mass could be identified at 
post mortem examination.  Medical management and diagnostic issues were explored at 
the inquest, as stated above.  There were, however, concerns raised after the death by 
one of the nursing staff that health care professionals working on the ward had failed to 
initiate prompt resuscitation following the collapse, despite Fiona Luis still being for 
resuscitation in the event of a collapse occurring, and that, once the problem was 
recognised, appropriate knowledge or ability in respect of resuscitation was not 
displayed by those health care professionals.  These matters were explored at the 
inquest, but there was evidence that it was unlikely that failure of prompt resuscitation 
would have altered the outcome here in view of CSF involvement by tumour.   

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.  –  

Although, in the very sad circumstances of the death of Fiona Luis, any problems in 
respect of resuscitation at the time of the collapse are unlikely to have affected the 
outcome for the reasons given above, it is clearly important that there is confidence that 
health care professionals involved with patient care are adequately trained in 
resuscitation and able to respond appropriately in the event of a collapse occurring. 

6 

ACTION SHOULD BE TAKEN 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 In  my  opinion  action  should  be  taken  to  prevent  future  deaths  and  I  believe  those 
responsible for the health care professionals at the hospital have the power to take such 
action.    While  there was clearly  evidence  that  there  was  resuscitation  training  in  place 
within the hospital, what was more difficult was assessing how effective that training had 
been.  In order to minimise the risk of resuscitation associated problems compromising 
the  chances of  a successful  outcome  following a collapse,  I  would  ask  that  the  way  in 
which resuscitation training is provided within the hospital be reviewed and consideration 
be given as to how the effectiveness of that training can be assessed and audited.  
YOUR RESPONSE 

7 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by the 12th of November 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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Persons: 

The family of Fiona Luis 

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 

Dr Peter Dean              17-9-15 

2

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