Prevention of Future Deaths reports · 2018

Riaz Begum

Regulation 28 report to prevent future deaths, reference 2018-0041, written 26 Jan 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Jan 2018
Reference2018-0041
DeceasedRiaz Begum
CoronerAnna Morris
Coroner areaManchester South
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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: The Chief Executive of Tameside General Hospital NHS
Trust
CORONER

fam Anna Morris Assistant Coroner for Manchester South
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://www. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

http://www. legislation.gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 25/07/2017 | commenced an investigation into the death of Mrs. Riaz Begum. The
investigation concluded at the end of the inquest 26th January 2018. The conclusion of the
inquest was that Mrs Begum underwent a routine laparoscopic cholecystectomy procedure
at Tameside General Hospital on 21st June 2017, as a complication of which she developed a
bile leak. She was readmitted to Tameside General Hospital on 26th June 2027 on referral
from her GP and diagnosed with sepsis. A bile leak was diagnosed after drainage under CT
guidance on Sth July 2017 produced bile-stained fluid. Mrs Begum underwent an ERCP to
repair the bile leak on 13th July 2017 and developed acute pancreatitis as a complication of
that procedure. The severity of that pancreatitis was exacerbated by the pre-existing sepsis
and by a delay in diagnosing and repairing the bile leak. Mrs Begum’s condition deteriorated
and despite treatment for sepsis and multi organ failure she died on 16th July 2017.

The medical cause of death was;

1a) Multi-organ failure

1b) Acute pancreatitis

1c} Biliary peritonitis

1d) Recent cholecystectomy and ERCP
CIRCUMSTANCES OF THE DEATH

See above

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) | am concerned that on the 3" July 2017, a CT Scan indicated the need for fluid
drainage to take place under CT guidance. Despite this procedure being deemed
necessary, it was not done until the 5" July 2017. The evidence t have heard causes
me concern that there were insufficient radiologists/ radiological nurses available to
carry out the procedure.

|am also concerned that after the 3 July the need for the drainage to take place
was not adequately escalated to Radiology management when WE icsten
he could not undertake the procedure within the timescale requested. When the
matter was escalated on the 5" uy had to be essentially told to do the
procedure and offered an additional professional fee. | consider that the lack of
availability of suitable capacity for undertaking a drainage procedure in the case of
someone being treated for sepsis and possible bile leak puts patients at risk.

(am further concerned by the evidence that after took annual
leave on the 3™ July, there were no further lists for ERCP procedures until his return
on the 11° July. Whilst there may have been other surgical consultants available to
review Mrs. Begum whilst he was on leave, his evidence was that once a bile leak
was confirmed the ERCP should have taken place and this on his account would not
have been possible for 6 days after the leak was diagnosed. | found that this delay
played a part in the development of acute pancreatitis in Mrs. Begum and | am
concerned that any other delays caused by annual leave being taken may cause
further delays for ERCP’s for a patient which creates a risk of future deaths.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you The Chief
Executive of Tameside General Hospital NHS Trust 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 6" April 2018. |, 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 to the following Interested Persons

HE, S00 of Riaz Begum.

| 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.

26/01/2018

Signature. fe 4 Mews

Anna Morris Assistant Coroner Manchester South

2

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