Prevention of Future Deaths reports · 2017

Reginald Lewis

Regulation 28 report to prevent future deaths, reference 2017-0149, written 4 May 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 May 2017
Reference2017-0149
DeceasedReginald Lewis
CoronerZafar Siddique
Coroner areaBlack Country
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text extracted from the PDF text layer. 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.  Black Country Partnership, NHS Foundation Trust 

Chief Executive, New Cross Hospital. 

1 

CORONER 

I am Zafar Siddique, Senior Coroner, for the coroner area of the Black Country. 

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 29 of the Coroners (Investigations) Regulations 2013. 

3 

INVESTIGATION and INQUEST 

On  the  17  January  2017,  I  commenced  an  investigation  into  the  death  of  the  late  Mr 
Reginald Frank Lewis. The investigation concluded at the end of the inquest on 27 April 
2017. The conclusion of the inquest was a short narrative conclusion of accident. 

The cause of death was:   

1a Intracerebral Haemorrhage 
  b  Fall 
  c 
II Bronchopneumonia, Chronic Kidney Disease, Ischaemic Heart Disease, Hypertension 

4 

CIRCUMSTANCES OF THE DEATH 

i)  Mr Lewis was admitted to New Cross hospital after a fall at home on the 13 

January 2017.  

ii)  He had a medical history including chronic kidney disease, previous 

myocardial infarction, poor memory, peripheral vascular disease, COPD and 
worsening confusion.  A chest x-ray showed consolidation of the right upper 
lobe suggestive of pneumonia and he was started on antibiotics.  

iii)  A CT head scan on admission did not show any intracranial haemorrhage, 
subdural collection or fractures. He was then transferred from the Acute 
Medical Unit (AMU) ward to ward C19 which deals with respiratory illness 
when a bed became available.  

iv)  He was transferred on the basis that he had mild confusion but it wasn't 

made clear to staff on ward C19 the extent of his confusion and risk of falls 
and that he was also registered blind. 

v)  On the afternoon of the 14 January 2017, Mr Lewis became increasingly 

agitated and after family had left visiting him he had a fall and sustained a 
significant head injury. The family maintain they had notified staff they were 

1 

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 leaving at the time.    

vi)  A repeat CT head scan demonstrated a left parietal intraparenchymal bleed. 
This was discussed with neurosurgeons who deemed he wasn't suitable for 
surgical intervention. He was also reviewed by the stroke team.  

vii)  He gradually deteriorated following this with GCS dropping to 3 and sadly 
passed away on the 17 January 2017 due to the head injury and bleed on 
the brain. 

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.  –  

1.  Evidence  emerged  during 

left  alone 
unsupervised  when  family  visitors  left  the  ward.    It  transpired  that  staff  didn’t 
know relatives had left the ward. 

the  patient  was 

inquest 

that 

the 

2.  On  ward  c19,  there  were  already  six  patients  on  the  ward  required  to  be 
observed  24  hours  a  day  in  two  bays.  Two  bays  were  subsequently  closed  to 
diarrhoea and vomiting. 

3.  Evidence  emerged  from  nursing  staff  on  Ward  C19  that  they  were  unable  to 
take  any  more  patients  that  are  confused,  wandering  or  aggressive.    This  was 
based  on  the  enhanced  scoring  tool  and  the  number  of  patients  that  required 
one to one observation.   

4.  Despite  initial  reservations,  junior  nursing  staff  did  eventually  accept  Mr  Lewis 
into Ward C19 on the basis he had mild confusion and claimed they felt “under 
some pressure” from senior nursing staff to accept him.  This was in contrast to 
the opinion of the senior Charge Nurse on ward C19 who gave evidence that he 
still would not have accepted the patient in the circumstances.  

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you have the 
power to take such action.  

1.  You  may  wish  to  consider  setting  up  a  review  of  the  management  policy  of 
transfers  of  patients  between  wards  and  the  sharing  of  information  including 
medical history so that a clear picture of the risk assessment is considered. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 29 June 2017. I, 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. 

8 

COPIES and PUBLICATION 

I  have  sent  a  copy  of  my  report  to  the  Chief  Coroner  and  to  the  following  Interested 
Persons; Family. 

2 

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 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. 

9 

 4 May 2017                                                   

Mr Zafar Siddique
Senior Coroner 
Black Country Area 

3 

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