Prevention of Future Deaths reports · 2016

Isla Lord

Regulation 28 report to prevent future deaths, reference 2016-0035, written 5 Feb 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Feb 2016
Reference2016-0035
DeceasedIsla Lord
CoronerThomas Osborne
Coroner areaBedfordshire and Luton
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

Thomas R. Osborne 
Senior Coroner for Bedfordshire and Luton 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:   
Mr Philip Morley 
Chief Executive 
The Princess Alexandra Hospital NHS Trust 
Hamstel Road 
Harlow 
Essex CM20 1QX 

1 

CORONER 

I am Thomas R Osborne, Senior Coroner for Bedfordshire and Luton                             

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. 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 

3 

INVESTIGATION and INQUEST 

On  19  November  2012  I  commenced  an  Investigation  into  the  death  of    Isla  Peyton  
LORD,  aged  4  days  .  The  Investigation  concluded  at  the  end  of  the  inquest  on  28 
January 2016. The Conclusion of the Inquest was a ‘Narrative Conclusion’ that “… 
Isla Peyton LORD was born on 4 November 2012 at the Princess Alexandra Hospital in 
Harlow.  Following delivery she suffered an inexplicable immediate post-natal collapse; 
initial attempts at resuscitation were unsuccessful and she suffered a hypoxic ischaemic 
brain injury. She was transferred to the Luton and Dunstable Hospital where she died on 
8 November 2012. 

4 

CIRCUMSTANCES OF THE DEATH 

Isla  was  born  at  Harlow  Hospital  on  the  4th  November  2012.  During  pregnancy,  an 
antenatal scan detected the right leg bent above the knee. There were also concerns over 
an  enlarged  heart  chamber.  She  was  born  by  Emergency  C  Section;  she  cried  upon 
delivery, however, then collapsed. There was a prolonged period of resuscitation and she 
was found to have a hypoxic brain injury. She was subsequently transferred to the Luton  

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX 
Tel 0300-300-6559    |    Fax 0300-300-8267 

 
 
 
 
 
 
 
 
 
        
      
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 and  Dunstable  Hospital  at  06.00  hours  on  the  5th  November  2012,  where  she  was 
ventilated. Discussions then took place with Isla's parents when a decision was made to 
withdraw treatment. She sadly died on the 8th November 2012.  

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.  During the course of the evidence it became apparent that once the possibility of 
heart  anomalies  was  identified  at  University  College  Hospital  in  London 
(UCLH),  there  was  no  liaison  between  Princess  Alexandra  Hospital  in  Harlow 
and UCLH as to the plan for the delivery of the baby. It was simply agreed that 
UCLH  were  content  for  her  to  be  delivered  at  the  local  hospital  with  a  referral 
being  made  to  Great  Ormond  Street  Hospital after delivery. In order to prevent 
deaths in the future there needs to be a review of the system that exists between 
the tertiary hospitals and Princess Alexandra Hospital as to how to formulate an 
Agreed Delivery Plan for both mother and baby. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you as Chief 
Executive of the Princess Alexandra Hospital 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, 
namely by 2nd April 2016. 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 : 

Parents; 
Chief Executive,  University College London Hospitals (UCLH) NHS Foundation Trust, 
235 Euston Rd, Fitzrovia, London NW1 2BU; 

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX 
Tel 0300-300-6559    |    Fax 0300-300-8267 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Hertfordshire Safeguarding Children Board Team, Room 147, Postal Point 
CHO143, County Hall, Hertford.  SG13 8DF admin.hscb@hertfordshire.gov.uk     

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 

Dated 5th  February  2016 

…………………………………. 
TOM OSBORNE 
Senior Coroner 
Bedfordshire and Luton 

Senior Coroner, The Court House, Woburn Street, AMPTHILL, Bedfordshire, MK45 2HX 
Tel 0300-300-6559    |    Fax 0300-300-8267

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 Respondent Not Named (PDF)
The Princess Alexandra Hospital

NES Trust
Family and Women’s Services Health Group
DE/MTW Princess Alexandra Hospilal
Hamstel Road
8" March 2016 Harlow
Essex
CM20 1QX

Confidential

Mr Tom Osborne
Senior Coroner for Bedfordshire & Luto'
The Court House
Woburn Street
AMPTHILL
Bedfordshire
MK45 2HX

7 eo lalla

Dear Mr Osborne
RE: REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

| write further to your report following the investigation into the death of Isia Peyton Lord
which requested a review of the system that exists between the tertiary centres and the
Princess Alexandra Hospital on how to formulate an Agreed Delivery Plan for both
mother and baby. | would like to assure you of the following:

1. The Standard Operating Policy for obstetric ultrasound scanning has been
amended to include that consultants in charge of patients referred for second
opinion in tertiary centres should request a detailed pian for delivery of the
mother and care of the baby. The policy also requests the consultants to
document the plan clearly in the patient’s hand held notes and hospital notes.

2. The new policy has been added to the Trust guidelines folder accessible by ail
clinicians.

3. Obstetric doctors have been notified of the policy.

4. Referrals to tertiary centres will be notified to and monitored by the weekly
Multidisciplinary Paediatric Plans of Care Meeting.

| am confident that the above actions will ensure the prevention of avoidable neonatal
deaths.

Kind regards,

Yours sincerely

_ cr

WN

ry on

\ .
boven Bo ceeccteee Vd eee
DEYA ELSANDABESEE PHIL MORLEY ANDY MORRIS
Associate Medical Director / Chief Executive Chief Medical Officer
Consultant Obstetrician SU
& Gynaecologist

Chair: Douglas Smallwood Chief Executive: Phil Morley

www.pah.nhs.uk

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