Prevention of Future Deaths reports · 2016

Khazna Khalaf

Regulation 28 report to prevent future deaths, reference 2016-0489, written 18 Jul 2016. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Jul 2016
Reference2016-0489
DeceasedKhazna Khalaf
CoronerMartin Fleming
Coroner areaWest Yorkshire (West)
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.

IN THE WEST YORKSHIRE WESTERN CORONER'S COURT
IN THE MATTER OF:

The Inquest Touching the Death of Khazna Jane Sara Khalaf
A Regulation Report - Action to Prevent Future Deaths

THIS REPORT IS BEING SENT TO:

St Marien Hospital Trust,
St. Marien-Hospital,
Kunibertskloster 11-13,
50668 KoIn,

GERMANY.

1 | CORONER
Martin Fleming HM Senior Coroner for West Yorkshire Western

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 20 of the Coroners
(Investigations) Regulations 2013

INVESTIGATION and INQUEST

On 3 December 2014 I opened an inquest into the death of J Khazna Jane
Sara Khalaf who, at the date of her death, was aged 19 years old. The
inquest was resumed and concluded on 6" July 2016.

I found that the cause of death to be: -

ja. Hypoxic-ischaemic encephalopathy

1b Cerebral oedema

Ic Ecstasy/MDMA toxicity

I concluded by way of a narrative as follows:

On 12 November 2014 Khazna Jane Sara Khalaf was taken by ambulance
to St Marien’s Hospital in Cologne, Germany, after ingesting ecstasy
under circumstances which remain unclear. Upon arrival she was
monitored until she suddenly collapsed. When she was transferred to
Merheim Hospital, Cologne, Germany, she was found to have suffered a

RT3589 1

cerebral oedema caused by hyponatraemia, a rare complication of ecstasy
use, to which she succumbed and died on 20 November 2014. It is found

more likely than not that there were several lost opportunities to monitor
and treat her low sodium blood levels whilst at St Marien’s Hospital and

that, had she been treated, it would have prevented her death.

4 | CIRCUMSTANCES OF THE DEATH

Khazna Jane Sara Khalaf, a UK citizen was studying at Koln University as
part of a student exchange. On the evening of 11 November 2014 she
attended at the Odonien Nightclub during the carnival celebrations. The
circumstances as to how she came to ingest ecstasy remain unclear, but
after becoming unwell an ambulance was called at approximately 4.50am
12 November 2014 and when taken to St Marien Hospital in Cologne she
was first examined at 5.03am, when records say she admitted to taking a
pill of ecstasy. Subsequently she was monitored hourly until 9.20am
when she collapsed unresponsive. At 10.30am she was transferred to
Merkheim Hospital, where CT head scans revealed that she had suffered
a cerebral oedema such that it brought about hypoxic ischaemic
encephalopathy as a result of ecstasy toxicity.

Thereafter she very sadly succumbed and died on 20 November 2014.

5 | CORONER'S CONCERNS

During the ¢ inguest I noted the full contents of the report
provided = could not attend to give oral evidence,
and it was his view that upon Jane's initial arrival at the hospital she did
not present with sufficient clinical signs to justify a blood sample to
determine serum sodium levels, and that there was no evidence to
suggest that an early blood sample would have led to a much longer
survival. This was at variance to the oral evidence I heard from

HE an independent expert in Anaesthesia and Intensive Care
Medicine, and I accepted his view that had an early blood sample been
taken prior to her collapse, it would have identified her low sodium
levels such that she would have received effective treatment that would
on the balance of probabilities have prevented her death.

The MATTER OF CONCERN is as follows. —

e The effectiveness of local protocols and the sufficiency of existing
hospital guidelines alerting clinicians to the risks of ecstasy
toxicity, the symptoms and signs it might present.

e To consider the appropriateness of a clinical protocol which

RT3589 2

provides structure to the initial decision to intervene or simply
monitor, and guidance on what that monitoring should consist of
(and when to be concerned and reassess the initial decision).

6 | ACTION SHOULD BE TAKEN
In my opinion action should be taken to prevent future deaths and I

believe that St Marien’s Hospital Trust, Cologne, Germany has the power
to take such action. ©

7 | YOUR RESPONSE |
You are under.a duty to respond to this report within 56 days of its date; I
may extend that period on request.

Your response must contain details of action taken or proposed to be
taken, setting out the timetable for such action. Otherwise you must
explain why no action is proposed.

8 | COPIES
Ihave sent a copy of this report to:

° (father)

@ er Coroner

9 | DATED this 18™ July 2016

I R Feu

M.D. Fleming
Senior Coroner

RT3589 3

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