Prevention of Future Deaths reports · 2017

Mark Berry

Regulation 28 report to prevent future deaths, reference 2017-0232, written 11 Jul 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Jul 2017
Reference2017-0232
DeceasedMark Berry
CoronerKaren Harold
Coroner areaHampshire (Central)
CategoryCommunity health care and emergency services related deaths · Hospital Death (Clinical Procedures and medical management) related deaths
Organisation namedSouth Central Ambulance Service NHS Foundation Trust
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.

1 | CORONER

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

ee

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Alex Whitfield, Chief Executive, Royal Hampshire County Hospital
Romsey Road, Winchester, Hampshire SO22 5DG

2. Will Hancock, Chief Executive, South Central Ambulance Service NHS Foundation

Trust, North Wing, Southern House, Sparrowgrove, Otterbourne, Hampshire SO21
2RU

| am Karen Harrold, Assistant Coroner for the coroner area of Central Hampshire.

4 | CIRCUMSTANCES OF THE DEATH 7a

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:/Awww.legislation.gov.uk/ukpga/2009/25/schedule/5

http://www. legislation.gov.uk/uksi/2013/1629/made

INVESTIGATION and INQUEST

On 27" March 2017 the Senior Coroner, Grahame Short, commenced an investigation
into the death of Mark William Berry, aged 47 years old.

The investigation concluded at the end of the inquest on 29 June 2017. | recorded a
| conclusion of Drug Related Death and the medical cause of death as:

1a) Morphine toxicity.

An ambulance was called at 23:39 on 29" April 2017 to Flat 3 at 68 Stockbridge Road,
Winchester due to Mark Berry being in cardiac arrest. It arrived at 23:48 and Mr Berry
was taken to the Royal Hampshire County Hospital (RHCH) after paramedics managed
to get a pulse arriving there at 00:53. Despite treatment, Mr Berry was declared dead at
01:32.

After police enquiries, they eventually obtained the address where the ambulance staff
had treated Mr Berry. Further officers attended Flat 3 at 68 Stockbridge Road at 06:45
and managed to rouse the male occupant and his girlfriend who lived there. It was
ascertained that with friends, Mr Berry, appeared to have taken a mixture of prescription
and illegal drugs thought to be pregabalin and heroin the prevous evening following
which they all went to Flat 3. The occupants of the flat fell asleep and later found Mr
Berry in the room and became concerned as he was unresponsive and thought he was
not breathing. The male occupant started CPR until ambulance staff arrived at
approximately 23:00.

Toxicology analysis reported that 0.16mg/L of morphine was detected in Mr Berry’s
blood. As the therapeutic concentrations in plasma is usually in the range of 0.01-0.07
mg/L, the level found in Mr Berry fell within the levels associated with therapy and
fatalities. Pregabalin was also found in blood but this was within therapeutic range.

However, the pathologist concluded that both of these drugs are respiratory depressants.
and the combination of toxic levels of morphine with the pregabalin may have led to

respiratory depression, coma and death. In addition, the presence of vegetable matter
in the airways possibly represented aspiration of food or vomit which could also further
compress depressed respiratory functions. In conclusion, the pathologist gave cause of
death as Morphine Toxicity.

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. —

| heard evidence at inquest from a... also had sight of a statement rom
of Hampshire police that he attended RHCH at 05:55 after hospital staff contacted
police to report the sudden death of Mr Berry. The officer queried with the sister in
charge SEE why there had been such a delay (over 4 hours since death) in
notifying police about the death. The officer was told that there had been some
| confusion about the correct procedure to contact police. It was known that Mr Berry was
| a heroin user and it had been suspected that he had consumed heroin prior to his death.
It was noted that there were two small puncture wounds on Mr Berry's right forearm only
one of which was caused by ambulance staff during treatment.

HS confirmed that hospital staff did not have the details of the address where
Mr Berry was found so this necessitated IEEE in having to make further enquiries to
try and locate the ambulance staff. IEEEEEEBmanaged to locate an ambulance
technician NEE, who was part of the second ambulance crew to arrive at |

_ but the first attender EJ had by then gone off duty. | was also
told that when SCAS control room was contacted for the exact details, police were told
that a private ambulance attended.

PC Headen attended FC at 06:45 but it again took some time to
discover the exact address as the building is multi-occupancy. It was therefore some 6
hours+ after death was confirmed that the officers were able to locate and speak to the
occupants of the flat who found Mr Berry. On the evidence | heard, it seemed clear that
the occupants were themselves under the influence of drugs.

My concerns are:

1. Hospital staff did not contact police in what appeared to be a suspicious and
unnatural death for several hours. Further, | was told there appeared to be
confusion about the correct procedure with regards to notifying police. This
suggests a possible need to revisit who, when and how hospital staff contact the
police both before and after death in appropriate cases.

2. Although | was not shown the handover paperwork from the ambulance technicians
to hospital staff, the lack of basic detail such as the address where Mr Berry was |
found may mean that handover procedures should be revisited especially if there is
a private ambulance service involved.

3. Finally, the lack of an address may require further consideration of how basic but
potentially important data is conveyed to SCAS control room from a private
ambulance service especially before staff go off duty and thereby avoiding delay.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you have the
ower 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 5" September 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and | am also under a duty to send
the Chief Coroner a copy of your responses.

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 usefull
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.

Date: 11° July 2017

Karen Harrold =
Assistant Corertér—

Central Hampshire

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