Prevention of Future Deaths reports · 2017

Patricia Donovan

Regulation 28 report to prevent future deaths, reference 2017-0087, written 22 Mar 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report22 Mar 2017
Reference2017-0087
DeceasedPatricia Donovan
CoronerPhilip Spinney
Coroner areaSouth Wales Central
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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

| REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT DATED 23 WIARCH 2017 IS BEING SENT TO:

Judith Paget, Chief Executive,

Aneurin Bevan University Health Board
Headquarters

St Cadoc's Hospital

Lodge Road

Caerleon

Newport

NP18 3XQ

| am Philip Charles SPINNEY, Area Coroner, for the coroner area of South Wales

1 | CORONER |
|
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, |

3. | INVESTIGATION and INQUEST

On 25 January 2017 | agreed to conduct an investigation into the death of Patricia
Yvonne Donovan. The investigation concluded at the end of the inquest on the 22
March 2017. The conclusion of the inquest was a narrative conclusion as follows:

Patricia Yvonne Donovan was given a general anaesthetic in preparation for total hip
replacement surgery. She suffered an unforeseen adverse drug reaction that led to
acute cardiac failure.

4 | CIRCUMSTANCES OF THE DEATH

Patricia Yvonne Donovan was admitted to the Royal Gwent Hospital on 12 January
2016 following a fall in which she sustained a fractured neck of femur. It was decided to
treat her by total hip replacement. On 19 January 2016 Mrs Donovan was given a
general anaesthetic in preparation for surgery. Shortly after anaesthesia was induced
she suffered an adverse reaction to the anaesthetic agent that caused cardiac failure
and her death.

5 | CORONER’S CONCERNS

The MATTERS OF CONGERN are as follows.

A decision was made for Mrs Donovan to receive total hip replacement as she was able |
io walk independently of aids prior to her fall. This decision was in accordance with
National Institute for Health and Care Excellence (NICE) guidelines.

Mrs Donovan was listed for surgery on 14 January 2017; due to insufficient theatre staff
the operation was cancelled and it was rescheduled for the following day. The following
day the operation was cancelled due to resource availability. The next available
opportunity for surgery with a specialist surgeon was 19 January 2017 (7 days after the
fail).

NICE guidelines state that treatment of neck of femur fractures should be within 48
hours but recognise that in certain circumstances, it may be appropriate to delay for the
correct operation by the correct specialist. Evidence was given at the inquest that
ideally surgery should be completed in 3 to 4 days.

It is acknowledged that in this case, there were competing priorities on resources and
surgery was arranged for the first available list with an appropriate specialist.

It is also acknowledged that the delay in surgery did not have an impact on Mrs
Donovan's cause of death; however, it is recognised that serious complications leading
to potentially life threatening conditions can arise where prompt surgery is not
undertaken,

ACTION SHOULD BE TAKEN

A review of the procedures in respect of the provision of emergency surgery for
trauma patients where specialist skills are needed. The review should consider
rescheduling elective cases and redeploying specialist staff if necessary.

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 18 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 copy of my report to the Chief Coroner

| 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.

vy)

Mir Philip Spinney
HM Area Coroner

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