Prevention of Future Deaths reports · 2016

Chentoori Chanthirakumar

Regulation 28 report to prevent future deaths, reference 2016-0037, 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
Reference2016-0037
DeceasedChentoori Chanthirakumar
CoronerMary Hassell
Coroner areaInner North London
CategorySuicide (from 2015)
Organisation namedEast London NHS Foundation Trust
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:  Prevention of Future Deaths report 

Chentoori Chanthirakumar (died 30.07.15) 

THIS REPORT IS BEING SENT TO: 

Dean for Education 
Barts and the London School of Medicine and Dentistry 
Queen Mary University of London 
Mile End Road 
London  E1 4NS 

1. 

2. 

Medical Director 
East London NHS Foundation Trust 
Trust Headquarters 
9 Alie Street 
London  E1 8DE 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  31  July  2015  I  commenced  an  investigation  into  the  death  of 
Chentoori Chanthirakumar, aged 24.  The investigation concluded at the 
end of the inquest on 27 January 2016.  I made a determination of death 
by suicide, when this young woman hanged herself at home on the night 
of 29-30 July 2015.   

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 4 

CIRCUMSTANCES OF THE DEATH 

Ms  Chanthirakumar  was  a  fourth  year  medical  student  at  Barts  and  the 
London who became acutely mentally unwell in the early part 2015.  She 
was  admitted  to  Mile  End  Hospital  on  16  June  2015  via  the  emergency 
unit, and then spent three weeks in Crisis House before being discharged 
with follow up. 

Following her attendance at the emergency unit, the medical school also 
became involved in supporting her emotionally. 

They  then  sent  an  email  to  her  on  29  July  2015,  informing  her  that  she 
would not be able to take her examinations in August 2015, but would be 
able to re-take the year. 

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.  

Barts and the London 

1. Whilst  it  was  clear  to  me  from  the  evidence  I  heard  at  inquest  that 
Barts and the London, both in terms of certain individuals within it and 
as  an  organisation,  took  its  pastoral  responsibilities  very  seriously 
indeed and made great efforts to support this student, there was one 
aspect of their processes that I think would benefit from review. 

The decision that Ms Chanthirakumar could re-take the fourth year of 
her  medical  degree  was  seen  by  the  medical  school  as  a  helpful 
decision.   The  re-take  was  allowed  on  the  basis of  her ill health and 
was not a criticism of her academic achievement.   

That  she  would  not  be  able  to  take  her  fourth  year  examinations  in 
August  2015  came  to  be  regarded  as  almost  self  evident,  because 
she  had  not  been  able  to  attend  the  majority  of  her  recent  clinical 
placement and had been so recently so unwell.   

However,  unbeknown  to  the  university  staff,  Ms  Chanthirakumar 
appears  to  have  lacked  some  insight  at  this  point,  and  was  actually 
hoping not to have to re-take the year, but instead to take her fourth 
year exams in August 2015. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Given  the  very  particular  course  of  very  recent  events  leading  up  to 
the  medical  school’s  decision,  I  wonder  whether  a  personal  meeting 
to  discuss  matters  with  her  could  have  been  arranged,  rather  than 
communicating  this  by  email.    A  face  to  face  meeting  may  not 
necessarily have had any impact on the outcome, but nevertheless I 
think would be a helpful consideration for the process in the future. 

East London Trust 

2. After  the  medical  school  was  alerted  to  Ms  Chanthirakumar’s  illness 
by  two  of  her  friends  on  17  June  2015,  a  senior  lecturer  working  in 
student  support  services  (and,  as  it  happens,  herself  a  general 
practitioner)  rang  Globe  Ward  of  Mile  End  Hospital  and  spoke  to  a 
treating nurse.   

Her  intention  in  making  this  call  was  to  deliver  information,  most 
specifically  to  relay  concerns  that  Ms  Chanthirakumar was  not  being 
wholly open with staff about the extent of her distress.  However, such 
was the ward nurse’s anxiety not to breach patient confidentiality, the 
conversation  was  not  as  meaningful  or  as  productive  as  it  might 
otherwise have been.   

It  seems  to  me  that  nurses  and  doctors  working  in  mental  health 
particularly,  would  benefit  from a  reminder of  the  difference between 
absorbing  (and,  if  appropriate,  acting  upon)  concerns  raised  by  a 
patient’s relatives, friends, tutors etc., and divulging a patient’s private 
details. 

In  addition,  it  may  well  be  that  a  piece  of  self  reflection  has  already 
been  undertaken  by 
for  Ms 
the  mental  health 
Chanthirakumar, taking into account the fact that she took her own life 
so soon after her discharge from a period of inpatient treatment, and 
with  her  university  being  unaware  of  her  own  expectation  that  she 
would be able to take her exams in August 2015.  It seems that such 
reflection might usefully inform future practice.  

team  caring 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe  that  you  and  your  organisations  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, by 11 April 2016.  I, the coroner, may extend the period. 

3 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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 following. 

  HHJ Peter Thornton QC, the Chief Coroner of England & Wales 
 

parents of Chentoori Chanthirakumar 

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 
interest.  You  may  make 
representations to me, the Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

it  useful  or  of 

find 

9 

DATE                                                   SIGNED BY SENIOR CORONER 

05.02.16 

4

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