Prevention of Future Deaths reports · 2017

Harold Mullins

Regulation 28 report to prevent future deaths, reference 2017-0127, written 20 Apr 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Apr 2017
Reference2017-0127
DeceasedHarold Mullins
CoronerAndrew Barkley
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.

ANNEX A

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is fo be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1.

The Chief Executive of Cwm Taf Health Board

CORONER

| am Andrew Barkley, Senior Coroner, for the coroner area of South Wales Central.

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.

INVESTIGATION and INQUEST

On the 18" January | commenced an investigation into the death of Harold Mullins aged
92. The investigation concluded at the end of an inquest on the 18" April 2017. The
conclusion of the inquest was that of “natural causes”.

CIRCUMSTANCES OF THE DEATH

The deceased was admitted to the Royal Glamorgan Hospital on the 3 January having
sustained a fall or collapse at his home address. No detail was known as to what may
have caused that. On admission to hospital he was found to have a fracture to the left
neck of femur. He had a raised INR level and an Acute Kidney Injury and therefore
surgery was delayed until the 5" January. On the afternoon of that day he underwent
surgical repair of the fracture to his hip. After surgery his standard observations (NEWS
Scores) were noted to be raised. in the early parts of the evening they continued to rise
and assistance was sought by the nursing staff from one of the clinical team treating Mr
Mullins. The Doctor indicated that “they were not concerned” as Mr Mullins had
undergone surgery and did not examine him. The matter was then further escalated
when his blood pressure fell further and no clinician was available to examine him. The
initial contact with the treating clinician appears to have been at 2010 hours and the
matter escalated again at 2145. On that occasion advice was given for fluids to be
administered but again the treating clinician did not see Mr Mullins. By the time the
clinician did see Mr Mullins he had suffered a cardiac arrest and despite efforts could not
be resuscitated.

CORONER'S CONCERNS

During the course of the inquest, and the investigation leading up to it, the evidence
revealed matters giving rise to concern. In my opinion there is a risk that future deaths
could occur unless action is taken. in the circumstances it is my Statutory duty to report
to you.

The MATTERS OF CONCERN are as follows. —

[BRIEF SUMMARY OF MATTERS OF CONCERN]

(1) A review of the care that was received by Mr Mullins revealed that the surgical
team were unaware of his history of deep vein thrombosis when undertaking the
surgery and caring for him in general.

(2) Despite a deteriorating position in relation to his observations (NEWS scores) he
was not seen by a clinician in a timely fashion.

There appears to be a difficulty in patients being seen in these circumstances

appropriately by clinical staff which is a concern given that the purpose of the

NEWS score system is to escalate care in cases of deterioration. It is a concern

that the clinician contacted initially when the NEWS scores were deteriorating

indicated that this was to be expected given that he had undergone surgery.
ACTION SHOULD BE TAKEN

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 13" June 2016. |, 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, the Welsh Assembly Government
and the family who may find it useful or of interest.

1am 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.

20th April 2017

Mr Andre (Barkley
HM Senior Coroner

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