Prevention of Future Deaths reports · 2017

Khuong Lam

Regulation 28 report to prevent future deaths, reference 2017-0455, written 24 Jul 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report24 Jul 2017
Reference2017-0455
DeceasedKhuong Lam
CoronerChristopher Woolley
Coroner areaSouth Wales Central
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.

REPORT TO PREVENT FUTURE DEATHS 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  The Chief Medical Officer for Wales 

1 

CORONER 

I am Christopher John Woolley, Assistant Coroner, for the Coroner area of South Wales 
Central 

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 

In  June  2015  I  commenced  an  investigation  into  the  death  of  Khuong  Lam.  The 
investigation  concluded  at  the  end  of  the  inquest  where  I  sat  with  a  jury  on  14th  July 
2017.The medical cause of death was: 1.a A sudden collapse in a 42 year old man with 
schizophrenia and recent behavioural abnormality taking Quetiapine, after a  prolonged 
struggle and pressure to the neck. The jury returned a narrative conclusion as follows:  

4 

CIRCUMSTANCES OF THE DEATH 

Khuong Lam had had a long history of schizophrenia, having first undergone treatment 
in January 2004. He had periods of stability but also periods of relapse, and in 2007 he 
was  admitted  for  8  weeks  as  an  inpatient  at  Whitchurch  hospital.  In  June  2015  his 
condition worsened and he was admitted to the Crisis Assessment Ward at Whitchurch 
Hospital  on  15th  June  2015  under  Section  2  of  the  Mental  Health  Act  and  then 
transferred  to  the  Psychiatric  Intensive  Care  Ward  (PICU)  on  23rd  June  2015.  The 
Responsible  Clinician  (RC)  was  not  informed  of  the  transfer  and  the  Section  17  leave 
form was not revoked or reviewed on transfer to the PICU by the RC. He was granted 
Section  17  leave  on  the  19th  June  and  enjoyed  such  leave  on  at  least  two  occasions 
prior to the 25th June outside the hospital grounds. On 25th June 2015 he was taken on a 
further  period  of  Section  17  leave  and  absconded.  The  hospital  were  informed  by  the 
carer  of  the  absconsion  and  the  police  were  involved  to  assist  in  the  search.  Khuong 
Lam  was  traced  to  Asda  café  in  Coryton.  Police  officers  attended  at  the  café  and 
allowed him to finish his meal before escorting him out of the café via the fire door. He 
then absconded from the police officers. A search was undertaken but he was not found. 
 on the path and he began to say threats 
At around 2.30pm Khuong Lam saw a 
. There was a struggle in which 
to him and took off his belt with which he hit 
Khuong Lam put the belt around 
 managed to get it 
off his own neck and put it around the neck of Khuong Lam, intending by that action to 
counter an imminent threat of harm to himself. Khuong Lam then died. The pathologist 
gave as his opinion at Khuong Lam died from a combination of factors, any one of which 
might have been fatal. He also said that the lack of petechiae showed that the belt had 
only been around his neck for under 15 seconds and in most people this would have just 
resulted  in  a  sore  throat.  The  police  later  arrested 
  but  no  further  action  was 
taken against him. .  

 neck, and then 

1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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.  –  

For the Chief Medical Officer, Wales  

(1)  The issue of Section 17 leave is covered in the Guidance issued in 2016. There 
is  no  section  in  this  guidance  covering  the  issue  of  review  or  revocation  of 
Section 17 leave on transfer to another ward or to the PICU. It is the concern of 
the coroner that such guidance should be given across Wales in the next edition 
of the guidance.  

(2)  The  inquest  heard  evidence  that  two  escorts  can  provide  a  deterrent  effect 
against absconsion, and are better able to deal with absconsions.  Cardiff and 
Vale  Health  Board  have  now  concluded  a  two  month  study  of  the  efficacy  of 
having two escorts to a patient on Section 17 leave and the lessons of this study 
should be applied across Wales. 

(3) 

 the RC told the inquest that if he had been made aware of Khuong 
Lam’s  transfer  to  PICU  he  could  have  reviewed  him  and  decided  whether 
Section 17 leave was still appropriate. The Coroner is concerned that the good 
practice  now  adopted    by  Cardiff  Health  Board  should  be  replicated  across 
Wales i.e. that the RC be informed of any transfer between wards; that Section 
17  leave  is  reviewed  on  a  transfer  (and  especially  to  PICU);  and  to  consider 
further the number of escorts required for any Section 17 leave.   

(4)  The review of this incident is being presented to an All Wales forum on mental 
health  (Service  Collaboration  Group)  on  11th  October  2017  and  it  may  be  that 
the Chief Medical Officer can further any resolutions that may come out of this 
meeting.  The  Chief  Medical  Officer  may  wish  to  ensure  that  any  lessons  are 
discussed  or  disseminated  in  any  other  appropriate  Mental  Health  forum.  The 
Coroner accepts that it is for the Chief Medical officer to decide the best way to 
do this.  

ACTION SHOULD BE TAKEN 

In  my  opinion  action  should  be  taken  to  prevent  future  deaths  and  I  believe  that  the 
Chief Medical Officer for Wales has 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 18th 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. 

8 

COPIES and PUBLICATION 

 (for Khoung Lam’s family) 

I  have  sent  a  copy  of  my  report  to  the  Chief  Coroner  and  to  the  following  Interested 
Persons:  
1. 
2.The Chief Executive, Cardiff and Vale Health Board 
3. The Chief Constable, South Wales Police.  
4. The Health and Safety Inspectorate of Wales 
5. The Minister of Health, Welsh Assembly Government 

I am also under a duty to send the Chief Coroner a copy of your response.  

2

 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 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 

24th July 2017                                                  
C J Woolley                            Assistant Coroner, South Wales Central 

3

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