Prevention of Future Deaths reports · 2017

William Bergman

Regulation 28 report to prevent future deaths, reference 2017-0343, written 31 Oct 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Oct 2017
Reference2017-0343
DeceasedWilliam Bergman
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBarts Health NHS Trust
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:  Prevention of Future Deaths report 

William Henry BERGMAN (died 20.12.16) 

THIS REPORT IS BEING SENT TO: 

1.  Dr Alistair Chesser 

Chief Medical Officer 
Barts Health 
Royal London Hospital 
Whitechapel Road 
London  E1 1BB 

1 

CORONER 

I am:   Coroner ME Hassell 
           Senior Coroner  
           Inner North London 
           St Pancras Coroner’s Court 
           Camley Street 
           London  N1C 4PP 

2 

CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009,  
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  29  December  2016,  one  of  my  assistant  coroners,  Sarah  Bourke, 
commenced an investigation into the death of William Bergman, aged 88 
years. The investigation concluded at the end of the inquest earlier today. 
The jury made a narrative determination, which I attach. 

4 

CIRCUMSTANCES OF THE DEATH 

Mr Bergman, who suffered with vascular dementia, was admitted to the 
Royal  London  Hospital  and  diagnosed  with  pneumonia.    He  died 
following an impact to his forehead sustained while healthcare assistants 
were changing him on 19 December 2016, variously described as hitting 
it on the cot side or on the side of the nearby television.   

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 His deterioration was noted several hours after the incident, and when 
he  was  then  scanned,  he  was  found  to  have  sustained  a  subdural 
haematoma and a massive intracranial bleed. 

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.  

The staff nurse who was called to see Mr Bergman after the accident, 
quickly formed the opinion that he was fine.   

Although  the  medical  records  were  not  available  for  consideration 
because Barts Health has been unable to locate them, she said that she 
would not go into detail such as whether he felt sick.   

She did not ask for immediate general observations, then to be repeated.  
She  did  not  ask  for  immediate  neurological  observations,  then  to  be 
repeated.  She did not ask for a medical review.   

She said very candidly that she did not consider the possibility of a minor 
head injury in an elderly person with vascular dementia and liver cirrhosis 
having the potential for a major consequence.   

When she noted a bruise (which a family member attending Mr Bergman 
that day described as being accompanied by a lump) some hours later, 
she did not change her management plan.   

She completed a Datix report only the following day, after Mr Bergman’s 
death. 

The staff nurse said in court how sorry she was that she had not acted 
differently,  and  described  her  contact  with  Mr  Bergman  as  career 
changing. 

The reason I write to you now is because if one staff nurse responded in 
this way to a head injury, immediately assuming that it was minor and 
therefore with minor consequences, then others may behave in the same 
way. 

6 

ACTION SHOULD BE TAKEN 

2 

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

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date 
of this report, namely by 2 January 2018.  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 following. 

  HHJ Mark Lucraft QC, the Chief Coroner of England & Wales 
  Care Quality Commission for England  
 

, daughter of William Bergman 

I  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 Senior Coroner, at the time of your response, 
about  the  release  or  the  publication  of  your  response  by  the  Chief 
Coroner. 

9 

DATE                                                  SIGNED BY SENIOR CORONER 

31.10.17 

3
Also filed under 2017-0343: 2017-0343-Barts-NHS-Trust.pdf
ell

INHS

Barts Health

NHS Trust

Senior Coroner for Inner North London Barts Health NHS Trust
St Pancras Coroner’s Court Trust Executive Offices
Camley Street Ground floor, Pathology Block
London The Royal London Hospital
N1C 4PP London, E1 2ES

Telephone: 020 32460632
21°' December 2017 www. bartshealth.nhs.uk

By special delivery

Dear Ms Hassell

| write in response to your Regulation 28: Report to Prevent Future Deaths, dated 31 October 2017.
Your concerns are related to the standard of nursing care provided to William Henry BERGMAN
(died 20.12.16). This by an individual staff nurse and following a minor accident and head injury he
sustained while an inpatient at the Royal London Hospital. These are concerns about lack of
observation and escalation by the staff nurse and failure to recognise or act on potential risk factors
which developed later.

Certain preventative measures have already been taken. Since October 2017 new post
management of head injury guidance and a training package has been rolled out within the Royal
London Hospital Older Peoples Service wards with other inpatient areas to follow. The guidance
‘Observation of patients’ with head injury in hospital’ was developed as an interim measure prior to
the role out of a more formal and trust wide policy for the management of head injury (patients and
staff) next year when this is completed (March 2018).

A trust safety notice was also distributed site wide warning other wards in our hospital group of the
risks associated with post head injury management.

Finally | can advise that The Royal London Senior Management Team are commissioning an internal
concise serious incident investigation to review the trusts handling of this case post death and are in
the process of compiling an investigation case file to facilitate this (to be finalized by February 28"
2018).

Thank you for bringing your concerns to my attention. | trust that you are assured | have taken them
seriously and investigated them appropriately.

Yours faithfully

Dr Simon Harrod
Medical Director
Royal London Hospital

cc
Legal Services

a Director of Nursing & Governance Royal London Hospital

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