Prevention of Future Deaths reports · 2017

Christopher Roberts

Regulation 28 report to prevent future deaths, reference 2017-0283, written 5 Oct 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report5 Oct 2017
Reference2017-0283
DeceasedChristopher Roberts
CoronerAled Gruffydd
Coroner areaSwansea and Neath Port Talbot
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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

CHIEF EXECUTIVE ABMU HEALTH BOARD
1 TALBOT GATEWAY

BAGLAN ENERGY PARK

BAGLAN

PORT TALBOT

SA12 7BR

1 | CORONER

lam Aled Gruffydd, Assistant Coroner, for the coroner area of SWANSEA NEATH &
PORT TALBOT

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.

3 | INVESTIGATION and INQUEST

On 8" January 2016 | commenced an investigation into the death of Christopher John
Llewellyn Roberts. The investigation concluded at the end of the inquest on 4 October
2017.

The medical cause of death is
1a opiate toxicity

The conclusion of the inquest as how Mr Roberts came to his death is a narrative one
and is as follows:-

The deceased died of overdose of prescription medication. The intent to take his own life
could not be proven to the required standard.

4 | CIRCUMSTANCES OF THE DEATH

The deceased was Christopher Roberts and he was pronounced dead on the 19" of
October 2015 at his home address of 57 St Nicholas Square, Swansea Marina,
Swansea. The cause of death was a deliberate overdose of his pain relieving opiate
prescription medicine, MST Continus, with 498mcg/L of morphine being found in his
blood by way of a toxicology report.

Christopher was receiving treatment for mental illness by the Community Mental Health
Team (CMHT). Christopher was diagnosed as having a depression and anxiety coupled
with borderline personality traits. Christopher's care plan was written in February 2014
and_a review was planned for February 2015. The evidence of the Community

Psychiatric Nurse (CPN) was that the review had been carried out with no changes to
the care plan, however this was never recorded. Shortly before the care plan was due to
be reviewed, Christopher made an attempt on his life by way of overdose. There was no
evidence or decision making trail to confirm whether this issue was considered when
deciding if the care plan should remain the same.

The care plan stipulated that the deceased was responsible for his medication and that
this would be administered by way of a dossiette (or nomad tray) and would be prepped
on a weekly basis. The evidence was that the deceased’s medication regime was
chaotic with tablets being taken in the wrong order or not being taken at all. This was
known to CMHT by way of reports from the deceased's support worker, and from
admissions by the deceased himself.

CORONER’S CONCERNS

During the course of the inquest it was apparent that the decision to maintain the current
care plan was not recorded and no clear decision making trail was demonstrated,
particularly in view of the fact that the deceased had made an attempt on his life a few
weeks before the care plan was due to be reviewed.

Furthermore it was established in evidence that the deceased was not coping with taking
his medication in the manner prescribed. The nomad trays were in disarray with the
deceased sometimes forgetting to take some medication, and sometimes he would take
medication not on the day prescribed. As such the deceased may not have received the
full benefit of the medication prescribed to control his mental illness. 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. The care plan review was not recorded which would not allow another person
reviewing the file to ascertain that a care plan review had taken place and what
the outcome of that review was. It was also the case that a lack of
documentation would not demonstrate whether CMHT had considered the
matter of the attempt on his own life by the deceased in the weeks leading up to
that review, when considering whether to amend or retain the care plan in place
at the time.

2. Nomad trays may be unsuitable in dispensing medication to some patients,
which may deprive them of the benefits in taking that medication.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you AND/OR
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 30 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.

COPIES and PUBLICATION

| have seni of my report to the Chief Coroner and to the following Interested
Persons

| 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.

5 October 2017 Lb LE. vee [SIGNED BY CORONER]

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