Prevention of Future Deaths reports · 2017

Henry Honour

Regulation 28 report to prevent future deaths, reference 2017-0413, written 20 Nov 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report20 Nov 2017
Reference2017-0413
DeceasedHenry Honour
CoronerPatricia Harding
Coroner areaKent (Central & South East)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedEast Kent Hospitals University NHS Foundation 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 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO:  East Kent Hospitals University NHS Foundation Trust 
CORONER 

1 

I am Patricia Harding Senior Coroner for Central and South East Kent 

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. 
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 

3 

INVESTIGATION and INQUEST 

4 

On 09/03/2017 I commenced an investigation into the death of Henry George  HONOUR. The 
investigation concluded at the end of the inquest 18th September 2017. The conclusion of the 
inquest  was  Henry  Honour  died  on  21st  February  2017  at  William  Harvey  Hospital  from  a 
bronchopneumonia  occasioned  as  a  result  of  immobility  and  insult  from  a  non-displaced 
transcervical fracture to the left neck of femur sustained as a result of a fall on Cambridge L 
ward on 4th February 2017  
 Bronchopneumonia 
1a    
 Fractured Neck of Femur (operated) 
 b 
 Fall 
c   
 Biological Frailty 
II   

CIRCUMSTANCES OF THE DEATH 
Mr Honour presented to the Accident and Emergency department at William Harvey Hospital 
on 1st February 2017 after two falls. He was very frail with general debilitation and had recently 
suffered  a  pneumonia  and  acute  kidney  injury  for  which  he  was  still  on  antibiotics.  After  a 
period on the clinical decision unit he was admitted to Cambridge L ward on 2nd February 2017 
for further investigations. 
On 3rd February 2017 Mr. Honour was seen by a consultant on a ward round who found him to 
be  very  frail  and  cachetic  with  tachycardia.  His  pneumonia  and  acute  kidney  injury  were 
resolving. The consultant ordered a CT chest, abdomen and pelvis to investigate his weight loss 
and  reduced  functionality  and  a  blood  test  but  was  of  the  opinion  that  Mr.  Honour  was  not 
particularly medically unwell and if his blood tests were normal he could be discharged from 
hospital. 
At approximately 22.45 on 4th  February 2017 Mr. Honour suffered an unwitnessed fall on the 
ward in circumstances where he had needed to use the toilet and had either tried to climb over 
or around the rails on his bed which were raised. He was found by a nurse lying on the floor by 
his bed. Mr Honour reported no pain, he had no apparent injury and could move all his limbs. 
He was transferred back to his bed and his observations were taken all of which were within 
normal limits. Mr Honour was assessed by a doctor at 01.50 on 5th February 2017 who found no 
obvious injury. 
That  Mr.  Honour  had  suffered  an  undisplaced  transcervical  fracture  to  his  left  hip  was  not 
discovered until 8th February 2017. He underwent a cemented hemiarthoroplasty the following 
day but did not make a good recovery following the procedure and sadly died on 21st February 
2017 after contracting a bronchopneumonia on 10th  February 2017 which did not respond to 
treatment. 

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)  Between  January  2017  and  April  2017    five  deaths  occurred  on  Cambridge  Wards  at 
William  Harvey  Hospital.  Common  to  each  was  the  fact  that  the  death  was  caused  as  a 
result  of  a  fall  on  the  ward  in  circumstances  where  falls  risk  assessments  were  either 
inadequate,  incomplete,  not  reviewed  or  not  enforced.  Inquests  in  respect  of  each  the 
deaths  have  been  held,  the  last  in  November  2017.  The  Trust  was  given  an  opportunity 
following  the  earlier  inquests  to  provide  evidence  of  changes  to  practice  following  the 
deaths.  It  is  recognised  that  at  the  time  of  hearing  the  inquests  much  work  has  already 
been done to address these issues  but that work is ongoing and parts of that work have 
not yet been implemented/were in the process of being implemented. It is for this reason 
that Regulation 28 reports arise from three of the deaths. 

(2)  In  respect  of  Mr  Honour  the  falls  risk  assessment  completed  on  admission  was  at  best 
perfunctory, as were subsequent reviews which did not rectify earlier errors or recognise 
the  need  for  precautionary  measures  to  be  taken  when  Mr.  Honour  should  have  been 
nursed in an observable bed with a falls alert and hip protectors in light of the risks posed. 

(3)  The bedrail risk assessment was difficult to interpret in light of the falls risk assessment, 

bed rails were utilised when they should not have been. 

(4)  The falls risk assessment was not updated post fall and no protective measures were put in 

place. 

 
 
 
 
 
 
 6 

ACTION SHOULD BE TAKEN 

In  my  opinion  action  should  be  taken  to  prevent  future  deaths  and  I  believe  you  East  Kent 
Hospitals University NHS Foundation Trust 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 16th 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 Chief Coroner and to the following Interested Persons 
Next of KinI have also sent it to Care Quality Comission who may find it useful or of interest. 

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

9 

20/11/2017 

Signature:  

Patricia Harding Senior Coroner Central and South East Kent

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