Prevention of Future Deaths reports · 2018

Martin Baker

Regulation 28 report to prevent future deaths, reference 2018-0130, written 3 May 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report3 May 2018
Reference2018-0130
DeceasedMartin Baker
CoronerAndrew Cox
Coroner areaPlymouth, Torbay and South Devon
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedAvon and Wiltshire Mental Health Partnership NHS Trust
Sourcejudiciary.uk record · original PDF
Responses published1

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.

for Plymouth Torbay and South Devon

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: Dr A Morris, Chief Executive Officer, Livewell South-
west, Windsor House, Tavistock Road, Plymouth, PL6 5UF

CORONER

| am Andrew James Cox, Assistant Coroner for Plymouth Torbay and South Devon.

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 9 September 2016, | commenced an investigation into the death of Martin Glyn Baker, then
aged 48. The investigation concluded at the end of the inquest on 19 April 2018. The conclusion
of the inquest was prescription drug-related death. It is likely Mr Baker suffered from a slow
metabolism which caused potentially toxic levels of venlafaxine, prescribed to him, to build up.
Together with a deteriorating physical condition and mild myocardial scarring found at post-
mortem, it is likely this induced a fatal cardiac arrhythmia.

The medical cause of death was given as
1a) drug toxicity

CIRCUMSTANCES OF THE DEATH
Mr Baker suffered with mental health issues for over 20 years. He had previously attempted
suicide on a number of occasions. After a failed attempt to take his own life following a jump from
height he fractured his spine and was left confined to a wheelchair. Psychiatric support for Mr
Baker was provided through Livewell South-west and I heard at inquest |
— both of whom saw the deceased. Prior to the deterioration in Mr Baker's

condition that led to his demise, had decided to stop a prescription of lithium.
This was as a consequence of excessive thirst complained about by Mr Baker which, in turn, led

to the consurgatiggsof a large number of fizzy drinks and resulted in problems with urinary
nconnencofhliam unaware, at the time of his decision, that there had been
earlier failed attempts to stop the lithium prescribed to Mr Baker i 2s also
unaware that Mr Baker had signed a form of consent authorising Livewell South-west to discuss
care arrangements made for him with his family.
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. —

[BRIEF SUMMARY OF MATTERS OF CONCERN]
(1) It was accepted in evidence that there had been a lack of communication with the family.
They had not been involved in any psychiatric reviews instead, on one occassion, a consultant
was left to rely upon information provided by a junior healthcare assistant. At inquest | expressed
my view that where a patient has signed a consent form authorising discussion of relevant

1 Derriford Park, Derriford Business Park, Plymouth, PL6 5QZ
Tel 01752 204636 | Fax

events with the family, the default position should be that there will be involvement of the family
in the absence of any good reason not to do so, for example, a patient's subsequent express
instruction not to share something with the family. In this case the family were unaware that Mr
Baker had been discharged from psychiatric support and were unaware of what to do in the
event of deterioration in Mr Baker's condition.

(2) It was also accepted in evidence that at the time of these events there was a shortage of care
coordinators something described as “very far from ideal.” | was advised that this situation has
now been corrected. Nevertheless, it was the clear view of the family, which | accepted, that in
the absence both of a care coordinator and the involvement of the family there had been no one
to act as an advocate on Mr Baker's behalf, something that had been to his detriment.

(3) It was accepted in evidence b’ that his risk assessment failed to address periodic
impulsivity that Mr Baker demonstrated. | found this was not causative of the death.
Nevertheless, | felt this was a point of learning that may well have a bearing in the care of future
patients and | felt it appropriate to bring it to your attention.

ACTION SHOULD BE TAKEN
wer

In my opinion action should be taken to prevent future deaths and | believe you have the po'
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
1 July 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.

COPIES and PUBLICATION

of my report to the Chief Coroner and to the following Interested Persons lll

| have sent a co)
| 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.

Signature
for Plymouth To’ and South Devon

Lt

1 Derriford Park, Derriford Business Park, Plymouth, PL6 5QZ
Tel 01752 204636 | Fax

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Bath North East Somerset NHS Trust (PDF)
© :;+

Bath & North East
Somerset Council Bath and North East Somerset
Clinical Commissioning Group

Working together for health & wellbeing

Adult Care & Health Commissioning
Kempthorne House

Mr lan M Arrow St Martin's Hospital
Senior Coroner for County of Devon Clara Cross Lane
1 Derriford Park Combe Down, Bath

BA2 5RP

Derriford Business Park

Plymouth .
PL6 5QZ co aia
epsite: www.batnnes.gov.u

Date: 23 June 2018

Dear Mr Arrow

Re: Martin Glyn Baker, DOB 30.03.68
Regulation 28: Report to Prevent Further Deaths

In response to the outcome of this case and your Regulation 28 Report to Prevent
Further Deaths a meeting was held between senior managers from Bath and North
East Somerset Council (the B&NES Council) and Avon and Wiltshire Mental Health
Partnership NHS Trust (the AWP Trust) to agree a joint approach to address the
learning from Mr Baker's death. Within the Bath and North East Somerset local
authority area mental health provision is delivered through integrated teams where
AWP Trust and B&NES Council staff work alongside each other under a heads of
agreement arrangement. However, B&NES Council acknowledges the request within
the Regulation 28 Report for the Council to accept responsibility for responding to the
recommendations made.

An action plan to deal with each of the points in the Regulation 28 Report has been
prepared by Karyn Yee-King, Principal Mental Health Social Worker for BRNES
Council. This details how B&NES Council and AWP Trust will approach each of the
points you identified. AWP Trust colleagues have contributed to the drafting of this plan
and have agreed the final version. It specifies the actions that we will take in the
B&NES local authority area, which agency will take the lead and provides a timeframe
for completion of actions.

Bath and North East Somerset - The place to live work and visit

() +

+

Bath & North East
Somerset Council Bath and North East Somerset
Clinical Commissioning Group
The action plan also incorporates additional learning not documented in the Regulation
28 Report. Finally, the plan also indicates how we will monitor the effectiveness of the
changes made.

Please find a copy of the action plan attached. | hope that the actions identified respond
sufficiently robustly to the concerns identified in your report. Please do not hesitate to
contact me regarding any further information you require or if you want a progress
update report at a later stage.

Yours sincerely

Mike Bowden
Corporate Director
B&NES Council

Bath and North East Somerset -7he place to live work and visit

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