Prevention of Future Deaths reports · 2017

Grant Richards

Regulation 28 report to prevent future deaths, reference 2017-0089, written 23 Mar 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report23 Mar 2017
Reference2017-0089
DeceasedGrant Richards
CoronerIan Wade QC
Coroner areaEast London
CategoryCommunity health care and emergency services 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:

1. | Place Surgery, 45 Wanstead Place,
Wanstead, London E11 2SW .

1 CORONER

| am lan Wade QC, Assistant 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 20" October 2016 I commenced an investigation into the death of Grant Lincoln
RICHARDS (born 30" September 1966) who died on 19'" October 2016. The
investigation concluded at the end of the inquest on the 20" March 2017. The
conclusion of the inquest was suicide.

4 | CIRCUMSTANCES OF THE DEATH

Grant Richards had a history of depression for which he was treated. On the 19"
October 2016 he made his own way to the tenth floor of his tower block at 22 Gardner
Close Leytonstone, opened a window, ejected himself and suffered catastrophic injuries
upon striking the ground.

5 | 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. —

Mr Richards previous medical history included diagnoses of depression, and anxiety, for
which he was treated at various times pharmacologically, by inpatient treatment in a
secure hospital, by access to the Home Treatment Team and by community based
mental health care. His history included self-harm and suicide attempt. His anxieties
included financial worry, debt, unemployment and eviction. He attended A&E at Whipps
Cross Hospital on 23 July 2016 for treatment of pain in his right loin. Whilst there he
was x-rayed to the chest, which revealed a “shadow’ on the right side. The hospital
advised Mr Richards and his sister who attended with him that this matter would be
raised with the GP, and he was informed that the hospital recommended follow-up in the
chest clinic. The discharge summary recorded “disch for GP F/Up — to check progress”
and also specifically noted the clinician's comments which included “please arrange F/U
in the chest clinic”. A letter was given to the patient as well as emailed to the GP
surgery. The initial GP evidential witness report to the Coroner, prepared for submission

to the Inquest, made no mention of this event. | heard evidence that the usual surgery
protocol was that a reviewing doctor would assess all emailed reports received into the
surgery, and in a case like this would instruct the surgery receptionist to contact the
patient to arrange an appointment for such follow-up to be actioned. The evidence was
that this did not happen. There was no follow-up. When Mr Richards was next seen in
surgery on 5" October 2016, the x-rays were not discussed and there was no discussion
of the requested follow-up by either the doctor, Mr Richards or his sister. The evidence
was that Mr Richards was thought to be alarmed at the prospect that he might have lung
cancer, from which his mother had died, and it was possible that this anxiety played a
part in the prolongation or exacerbation of his depression leading to his suicide.
Additionally, evidence was given that in the course of a Root Cause Serious Incident
Investigation conducted by an independent panel at the behest of the mental health
authority (North East London Foundation Trust) that documents were sent electronically
by fax from agencies of the Trust, especially the home treatment team and/or the
Redbridge Access and Assessment Brief Intervention Team, which the GP surgery did
not act upon although the Trust had received successful transmission reports generated
by the fax machine. The features of:

a) failure to act upon the request in the A&E discharge summary;

b) failure to have a contingency system or audit in place to ensure that such
failures are not missed;

c) failure to include reference to the ditendence at A&E and the discharge
summary generated as a result of it, in the GP evidential report;

d) and failure to act on fax documents sent to the surgery,

all indicate a want of management control, lack of suitable procedures in place and a
poor attention to documents received.

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 17th 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 and (sister),

CQC and Mr Matthew Cole, 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.

ch Wide

[DATE] 23 March 2017 [SIGNED BY CORONER]

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