Prevention of Future Deaths reports · 2016

Helen Millard

Regulation 28 report to prevent future deaths, reference 2016-0482, written 6 Oct 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report6 Oct 2016
Reference2016-0482
DeceasedHelen Millard
CoronerPaul Marks
Coroner areaEast Riding and Kingston-upon-Hull
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

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.

HER MAJESTY’S SENIOR CORONER
For the Counties of Kingston upon Hull and the East Riding of Yorkshire
Professor Paul Marks BA LLM MD FRCS

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: NHS Improvement

ni:

CORONER

fam Professor Paul Marks BA LLM MD FRCS Senior Coroner for East Riding and
Kingston-upon-Hull

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

INVESTIGATION and INQUEST

On 14/05/2015 I commenced an investigation into the death of Helen Louise
MILLARD. The investigation concluded at the end of the inquest 26th September 2016.
The conclusion of the inquest was Accidental Death.

CIRCUMSTANCES OF THE DEATH

At between 18.32 & 18.59 on the 12th May 2015, the deceased hanged herself using the
taps in a bathroom at the Westlands Mental Health Unit, Hull. She died at the Hull
Royal Infirmary at 01.28 on the 13th May 2015.

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. —

Evidence was heard that NHS England is undertaking an ongoing programme of work to
eliminate ligature points in in-patient and other psychiatric facilities. It was established
that a ‘traffic light” system is in operation which prioritises the work once a ligature
point has been identified in any particular facility. The Court heard that if a point is
scored ‘red’ this equates with an extreme risk and mandates urgent elimination of the
point. If, however, a risk is categorised as ‘amber’ this nevertheless represents a high
tisk. The classification according to this traffic light system is based upon the height of
the ligature point from the ground. If a ligature point is one metre or less it is
categorised as being ‘amber’, whereas if it is over one metre above the ground it is
categorised as ‘red’.

Expert evidence was adduced from a number of expert witnesses and Consultant
Psychiatrists that at least 50% of deaths due to hanging in inpatient psychiatric facilities
occur from ligature points which are one metre or less in height above the ground.
Patients merely need to learn forward and tighten the ligature around their neck under
their body weight and they collapse into unconsciousness within ten to twenty seconds
and death can occur in as little as two to three minutes. This evidence was backed up by
peer reviewed literature which was also read out during the course of the Inquest.

My principal concern is that there is an obvious incongruity in the classification system
as effectively all ligature points, no matter what their height, should be regarded as
representing extreme risks. Evidence was heard that the risk is independent of height
and consideration needs to be given to classifying all ligature points once identified as
‘red’ and their elimination tackled on an urgent basis.

16

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe you I 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 1 December 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.

COPIES and PUBLICATION

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

i. P| Howells Solicitors;
2. PF DAC Beacheroft LLP

Tam 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.

06/10/2016

Professor Paul Marks BA LLM MD FRCS Senior Coroner East Riding and
Kingston-Upon-Hall

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