Prevention of Future Deaths reports · 2016

David Cooper

Regulation 28 report to prevent future deaths, reference 2016-0459, written 21 Dec 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report21 Dec 2016
Reference2016-0459
DeceasedDavid Cooper
CoronerAndrew Barkley
Coroner areaSouth Wales Central
CategoryHospital Death (Clinical Procedures and medical management) 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.

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:

1. Chief Executive of ABMU Health Board
2. Minister for Health, Welsh Assembly Government

CORONER

| am Andrew Roger BARKLEY, Senior Coroner for the coroner area of South Wales
Central.

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.

EWE cc PTY GPE O07 <1 <7 <1 c |
INVESTIGATION and INQUEST

On 6" April 2016 | commenced an investigation into the death of David Bassett
COOPER aged 81. The investigation concluded at the end of the inquest, with a jury, on
15"" December 2016. The conclusion of the inquest jury was that of a narrative
conclusion and the medical cause of death was recorded as 1a. Acute on chronic
subdural haematoma (traumatic) 1b Recurrent Falls 2. Hospital Acquired Pneumonia.

The narrative conclusion was “following a fail as an inpatient, Mr Cooper died of a
traumatic brain injury, to which failure(s) in medical / nursing care contributed”

4 | CIRCUMSTANCES OF THE DEATH

Mr COOPER suffered a traumatic head injury as a result of a road traffic collision in
1992, from which he recovered, and suffered a stroke in January 2009. He fell in the
community and sustained a serious head injury on 12" October 2015 and was admitted
to the Princes of Wales Hospital in Bridgend. Whilst in hospital, he was transferred

between several wards and up to the time of his death, he suffered 9 separate falls. The
final fall on 5" March 2016 caused a subdural haematoma from which he died.

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. —

[BRIEF SUMMARY OF MATTERS OF CONCERN]

i. When transfers between wards took place, the evidence revealed that there was

a lack of comprehensive hand-over by the transferring ward to the receiving
ward especially in terms of identifying the patient's risk of falls. For example, on
ward 18 Mr Cooper was in receipt of “1:1” nursing care, but on transfer to ward
21, not only was that never given, but the evidence suggested it was not
considered.

2. The accuracy and completeness of nursing notes and records left much to be
desired. For example, on Ward 21 when he fell three times, there was no entry
made in the Falls Diary - a document which was supposed to act as a tool for
nursing staff to assess whether there was a pattern to the numerous falls being
sustained — save for the last fall on 5" March . This deprived staff of the
opportunity to see the “whole picture” and to take into consideration the eight
falls which he had sustained up to that point.

3. The evidence revealed that there was a distinct lack of “joined up” thinking and a
failure to see the “whole picture”. Mr Cooper's risk of falling was as high when
he was admitted in October 2015 as it was when he died in March 2016, but still
he sustained 9 falls.

4. As with many other cases involving patients at high risk of falls, the evidence
revealed shortcomings in the system used for booking additional staff to provide
“4:1” care, revealing a system which left front line nursing staff unable to cope
with the challenges in looking after the most vulnerable.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you and your
organisation 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 15"" February 2017. 1, 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

| have sent a copy of my report to the Chief Coroner and who may find it
| useful or of interest.

! 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.

SIGNED:

Dated:

2

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 University Health Board (PDF)
. GIG | Bwrdd techyd Prifysgol
<1. .e. | Abertawe Bro Morgannwg
NHS University Health Board

Dyddiad/Date: 14! February 2017 @ 01639 683302
Alexandra Howells

PRIVATE & CONFIDENTIAL Acting Chief Executive
Mr A Barkley ABMU Health Board
Coroner's Office

1° Floor

Rock Ground

Aberdare

CF44 7AE

Dear Mr Barkley,

Re: David Bassett Cooper

Inpatient at Princess of Wales Hospital, Bridgend, CF31 1RQ

| write further to the Regulation 28 Report to Prevent Future Deaths in relation to Mr.
David Bassett Cooper, received by Abertawe Bro Morgannwg Health Board from your
department in December 2016.

| have enclosed an Action Plan completed by Princess of Wales Directly Managed Unit
and Mental Health Learning Disability Unit in retation to the four points highlighted in
your report.

| hope the enclosed Action Plan demonstrates the actions that have, and will continue to
be taken, in relation to these issues and provides you the level of assurance that is
required.

The Health Board established a Falls Management Group in September 2015. This
was a task and finish group that reviewed policies and training requirements in relation
to falls management. The Health Board introduced the National Patient Safety
Agency's Risk Assessments and | enclose the Health Board’s Falls Policy and other
supporting information for your review. The Falls Management Group last met in
December 2016 and devolved falls management to the Directly Managed Units to
ensure clinical orientation and responsibility.

The Falls Management Group will continue to meet as a scrutiny panel to ensure that

appropriate training and individual falls scrutiny is being undertaken along with
continued review of performance data. Te Physician and
Geriatrician, will be leading the Falls Management Group.

See

Bwrdd lechyd ABM yw enw gweithredu Bwrdd lechyd Lleol Prifysgol Abertawe Bro Morgannwg
ABM University Health Board is the operational name of Abertawe Bro Morgannwg University Local Health Board
Pencadlys ABM / ABM Headquarters, 1 Talbot Gateway, Port Talbot, SA12 7BR. Ffon / Tel: (01639) 683344

www.abm.university-trust.wales.nhs.uk

If you require any further information in relation to the information contained in the
Action Plan, please do not hesitate to contact me.

Yours sincerely,

Alexa Howells
\ Acting Executive
Abertawe Bro Morgannwg Health Board

ey

Bwrdd lechyd ABM yw enw gweithredu Bwrdd lechyd Lleol Prifysgol Abertawe Bro Morgannwg
ABM University Health Board is the operational name of Abertawe Bro Morgannwg University Local Health Board
Pencadlys ABM / ABM Headquarters, 1 Talbot Gateway, Port Taibot, SA12 7BR. Ffon / Tel: (01639) 683344

www.abm.university-trust.wales.nhs.uk

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