Prevention of Future Deaths reports · 2017

Anne-Marie James

Regulation 28 report to prevent future deaths, reference 2017-0210, written 8 Sep 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Sep 2017
Reference2017-0210
DeceasedAnne-Marie James
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.  Chief Executive, NHS Lothian, Scotland. 
2.  Chief Coroner 

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  21  March  2017,  I  commenced  an  investigation  into  the  death  of  the  late  Mr 
Melvin James and his sister, Ms Anne-Marie James. The investigation concluded at the 
end of the jury inquest on 24 August 2017. The conclusion of the inquest was a narrative 
conclusion: 

“On the 07th March 2017, Melvin spent the evening smoking and drinking with his sister 
and  mother.  On  the  morning  of  the  08th  March  2017  Melvin  was  displaying  unusual 
behaviour. This resulted in the fatal stabbing of his sister Anne-Marie James. 
This  was  followed  by  multiple  stabbings  of  his  mother  who  managed  to  lock  herself  in 
the bathroom and call the police 
There were 2 confrontations with unarmed and firearm police who used the appropriate 
level of force in attempting to detain Melvin. At some point that morning Melvin inflicted 
multiple  stab  wounds  to  himself,  which  ultimately  lead  to  his  death  at  approximately 
11.00. 
Regrettably  there  was  a  missed  opportunity  for  the  handover  to  discuss  discharge  by 
both  the  hospital  staff  and  Melvin’s  family.  Consequently  there  was  no  follow  up  care. 
There was a further missed opportunity on the inadequate documenting and recording of 
the conversations between the hospital staff and Melvin’s family.” 

The cause of death was:   

1a     Multiple Stab Wounds 

4 

CIRCUMSTANCES OF THE DEATH 

i)  Approximately six years prior to this incident, Mr James moved from 
Wolverhampton to Edinburgh. On 4 February 2017 Police officers in 
Edinburgh responded to reports of a male walking on a carriageway in the 
early hours of the morning.  Both officers recalled that Mr James was 
displaying obvious mental health issues, believing that he, his family 
members and various public figures were Transformer characters trying to 
defend the world. 

ii)  Due to these concerns, Mr James was taken to Royal Edinburgh Hospital. 

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 He was not detained at any point by police and agreed to attend Hospital on 
a voluntary basis. 

iii)  Upon arrival at the Royal Edinburgh Hospital on 4 February 2017, Mr James 

presented as having altered perception and described significant psychotic 
symptoms. He reported having taken ‘red pills’, ‘alien eggs’ and  reference 
was made to that he was ‘Megatron’ (Transformers character) and referred 
to other family members and public figures as other Transformers 
characters. He also stated that a ‘dangerous clown’ could brainwash him to 
‘kill or be killed’.  

iv)  He was formally detained initially for a 72 hour period.  He was seen by 

various clinicians and Consultant Psychiatrist.   They concluded that he had 
likely had some form of drug induced episode initially.  During the initial 
admission, he went to the door of the ward where he spoke about the need 
to travel to see his mother in Wolverhampton.  He could not really explain 
what his concerns about his mother were but he appeared to be worried 
about her safety.  He did not accept reassurance or persuasion to stay in 
hospital and at this point he began to kick the door of the ward.  He became 
aggressive towards the Nursing Staff and this led to him being detained 
under an Emergency Detention Order (a 72 hour detention order used in 
Scotland which authorises detention in hospital but not treatment).  

v)  He was restrained and given intramuscular medication. At this time Mr 

James was actually given 2mg of intramuscular Lorazepam, a 
Benzodiazepine medication which is commonly used to treat symptoms of 
anxiety. There was evidence of acute kidney injury from the blood test 
results and he was encouraged to drink larger volumes of fluid. There was 
no previous history of any mental health conditions.  

vi)  During his admission, his brother, 

 remained in contact with 

him and nursing staff.  Blood tests revealed presence of opioids.  His 
brother was told that he had a paranoid psychotic episode.   

vii)  Between the period, Monday 6th February and Friday 10th February Mr 

James’ mental state showed a gradual and consistent improvement.  His 
beliefs about being a transformer, his beliefs about world figures and his 
general level of disorganisation all improved significantly. 

viii) On 10 February 2017 Mr James was discharged having been diagnosed 
with a drug induced psychosis and overall  was considered a low level of 
risk on discharge and no further psychiatric follow up was planned.   

ix)  His brother 

 travelled to Edinburgh on 10 February 2017 to 

collect him. There was no one to meet or greet him from Hospital staff and 
there was no explanation or handover done and nobody explained what 
signs to look for in case of a relapse.  

x)  He was then taken to Wolverhampton to live with his mother, 

.  During the journey Mr James was still exhibiting delusional beliefs 

when talking to his brother. 

xi) 

 recalled he was in contact with Mr James whilst he was 

living in Wolverhampton. He recalled there were a few occasions where Mr 

2 

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 James said some things that were ‘clearly not reality’ and suggested he was 
still suffering with some mental health problems. 
telling Mr James to visit his doctor, as he was not taking any medication to 
help him, but Mr James maintained that he did not need to. 

 recalled 

xii) 

 stated that when Mr James arrived at her address in 
February he ‘seemed ok, he looked fine and was his normal happy self’. 
She recalled that in the days leading up to this incident on the 8 March, 
Melvin kept talking about going on holiday to Jamaica and said he had put a 
deposit down on a holiday, though she thought he was joking as he did not 
have the money to afford such an expensive holiday. She explained that 
during the evening before and morning of this incident Melvin was in a 
strange mood and was very quiet. He was smoking and drinking a lot and 
there appeared to be something wrong with him.  

xiii) On the morning of 8 March 2017 officers from West Midlands Police 

attended 
stabbed his mother and sister.  

’ address following reports that Mr James had 

xiv) Initially unarmed officers attended and Mr James was tasered. This had little 
impact  and  the  unarmed  officers  retreated  fearing  for  their  own  safety.  He 
then went back into his flat and firearms officers then intervened and he was 
further tasered and restrained.   

xv)  It  was only  after being  detained,  did  it  become  apparent  the  extent of stab 
wound  injuries  he  sustained.  Sadly,  Mr  James  and  his  sister,  Ms  Anne-
Marie  James  were  both  pronounced  deceased  a  short  time  later.    Their 
mother  sustained  extensive  injuries  and  after  extensive  treatment  in 
Hospital she recovered. 

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 the inquest that by the time of his discharge on Friday 
10th February 2017 and as far as the Hospital were concerned, they recorded 
he showed no evidence of mental illness.  However, the Clinician who dealt with 
the discharge confirmed that he wasn’t aware of the conversation he had with 
his brother on the way to Wolverhampton where Mr James was still talking 
about his delusions including creatures transforming.  Significantly, during the 
inquest he accepted, had he known this he would have formed the view that he 
was still unwell.  

2.  He also accepted that there was a missed opportunity in communication and 
information sharing and it was regrettable they didn’t speak to the family and 
explain what symptoms to look out for in case of relapse.   

3.  Evidence also emerged during the inquest that after discharge, there was no 
formal referral or contact made with Mental Health services or his General 
Practitioner based in the Wolverhampton area.  There was no evidence of any 
aftercare being delivered after discharge back into the community. 

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 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.  Given  the  inadequate  discharge  process,  you  may  wish  to  consider  re-visiting 
your procedures and systems arising from this incident to ensure that this is not 
replicated and appropriate lessons are learned. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 6 November 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. 

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 

8 September 2017                                                   

Mr Zafar Siddique
Senior Coroner 
Black Country Area 

4 

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