Prevention of Future Deaths reports · 2017

Valdas Jasiunas

Regulation 28 report to prevent future deaths, reference 2017-0062, written 8 Mar 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Mar 2017
Reference2017-0062
DeceasedValdas Jasiunas
CoronerNadia Persaud
Coroner areaEast London
CategoryPolice related deaths · State Custody 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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

HE vies ois

Holborn Police Station
10" Floor

10 Lamb’s Conduit Street
London

WC1N 3NR

1 | CORONER

| am Nadia Persaud, Senior Coroner for the Coroner area of East London

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.
http://www. legislation.gov.uk/uksi/2013/1629/part/7/made

3 | INVESTIGATION and INQUEST

On the 2" September 2010 an investigation was commenced into the death of Mr
Valdas Jasiunas. The investigation concluded at the end of the Inquest on the and
March 2017. The conclusion of the jury at the Inquest was a narrative conclusion:

Mr Jasiunas was an alcohol dependent vagrant with serious underlying health problems.
Following seizure in his cell he was taken to hospital where he later died.

4 | CIRCUMSTANCES OF THE DEATH

Mr Jasiunas was a 36 year old gentleman who was arrested for begging and taken into
police custody at around 13:00 on the 1 September 2010. Mr Jasiunas had a very
complex past medical history, to include chronic alcoholic liver disease, severe head
injury, seizures associated with both conditions and cerebral salt wasting syndrome.
This medical history was not available to custody staff. Mr Jasiunas was assessed as
being at risk and was placed on a management plan to be seen by a healthcare
practitioner; to be checked and roused every 30 minutes and to be placed in a cell with
CCTV. Mr Jasiunas underwent a brief medical review at around 17:00 hours and was
deemed to be fit to be detained. At around 21:30 hours an FME inserted information
into Mr Jasiunas’s custody record indicating that medication had been administered to
him. This was an erroneous entry and should have been recorded in the records of
another detainee. Custody staff reviewing the custody record were however given the
impression of 2 FME assessments and the administration of medication. At around
07:50 hours on the 2° September 2010 Mr Jasiunas collapsed in his cell. He was found
by staff at around 08:00 hours. Attempts were made to resuscitate him and the London
Ambulance Service were called. The paramedics arrived and took over resuscitation.
Mr Jasiunas was then taken to Newham University Hospital. Despite ongoing
resuscitation and care in the Intensive Treatment Unit, Mr Jasiunas passed away at

Newham General Hospital on the 2” September 2010. The post-mortem examination
gave a cause of death of 1a: Chronic Alcoholic Liver Disease. On the basis of medical
evidence heard, the jury also added under II — History of traumatic brain injury and acute
hypoxia following seizure activity.

CORONER’S CONCERNS
During the course of the Inquest the evidence revealed matters giving rise to concern.
The MATTERS OF CONCERN are as follows. —

1. It was noted that staff in custody suites have to deal with a large number of
detained persons who suffer from alcohol dependency. The risks of withdrawal
to those who are alcohol dependent are wide ranging from shakes and tremors
to death. In light of the frequency of dealing with detained persons who suffer
from alcohol dependency and in light of the severity of the potential risk, it was
considered that a specific question in the risk assessment document as to
dependency on alcohol should be included. The current risk assessment simply
states “are you dependent on drugs or any other substance”. A directly pointed
question relating to alcohol is likely to be of greater assistance in ensuring that
the risk is clearly identified, assessed and managed.

2. An erroneous entry was inserted into Mr Jasiunas’ record by an FME. The entry
had the effect of providing false assurance to custody staff. The evidence
revealed that errors on the custody records are commonplace and that the
current design of the system renders errors easily made. Suggestions for
improvements of the system included photographs of the detainee on the
computer system; more prominent indication of the detainees surname at the
top of the medical form; pop-up prompts to remind the healthcare practitioner to
ensure that they have identified the correct detainee before prescribing
medication; changes to prevent medication from being entered onto a person's
custody record in the absence of an accompanying medical form being
completed at the same time.

3. There were some question marks around the full understanding of Mr Jasiunas
as English was not his first language. The Medical Director of the Forensic
Healthcare services has confirmed that a very helpful leaflet is now provided to
detained persons in custody setting out the signs and symptoms of alcohol
withdrawal. The leaflet is not yet available in different languages. The FME
stated that in East London, a number of detained persons are of Eastern
European origin. The leaflet may well assist in ensuring that relevant signs and
symptoms are bought to the attention of custody staff. Availability of the leaflet
in the most common presenting languages is likely to ensure that more detained
persons are able to understand and communicate significant concerns.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you 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 4 May 2017. |, 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

| have sent a = of my report to the Chief Coroner and to the Director of Public Health

| 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.

[pate] 8-3. Qo!) [SIGNED BY CORONER] Sj wt

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