Prevention of Future Deaths reports · 2018

Jonathan Earp

Regulation 28 report to prevent future deaths, reference 2018-0135, written 8 May 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 May 2018
Reference2018-0135
DeceasedJonathan Earp
CoronerCaroline Saunders
Coroner areaGloucestershire
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedGloucestershire Hospitals NHS Foundation 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.

H M Assistant Coroner for Gloucestershire
Ms Caroline Saunders

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

Gloucestershire Hospitals NHS Foundation Trust

CORONER

| am Caroline Saunders, H M Assistant Coroner for Gloucestershire.

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.

INVESTIGATION and INQUEST

On the 21/7/2017 | commenced an investigation into the death of Jonathan EARP.
The investigation concluded at the end of the inquest on 25/4/18.

The conclusion of the inquest was a Drug Related Death.

The medical cause of death was determined to be:

1a The combined toxic effects of Alcohol, Diazepam, Pregabalin, Fentanyl, cocaine, Zopiclone,
Mirtazepine and Morphine

CIRCUMSTANCES OF THE DEATH

Jonathan Earp died at 08:15 on 10/7/17 at Gloucester Royal Hospital from the effects of
prescribed and non-prescribed drugs

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. —

| heard during the inquest that Mr Earp had been prescribed Fentanyl which was administered by
way of transdermal patches. Mr Earp repeatedly requested additional patches however there
was no evidence that all of the “unspent” patches had been returned to the nursing staff or
appropriately discarded. The clinical staff believed that Mr Earp was accessing illicit drugs when
he left the ward, however there was no evidence that staff considered that he may have been
taking additional Fentanyl and illicit medication, and the effect this could have.

| would ask that consideration is given to providing staff with guidance on how to manage the
administration and provision of prescribed drugs when the patient is also accessing non-
prescribed potentially illicit drugs

Gloucestershire Coroner's Court, Corinium Avenue, Barnwood, Gloucester, GL4 3DJ
Tel 01452 305661 | Fax 01452 412618

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you 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
4pm on 10/7/18. |, 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
(1) —_— and brother of the deceased)
(2)
(3)

| 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.

Dated 8/5/18
Signature Carole i)

Caroline Saunders
H M Assistant Coroner for Gloucestershire

Gloucestershire Coroner's Court, Corinium Avenue, Barnwood, Gloucester, GL4 3DJ
Tel 01452 305661 | Fax 01452 412618

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 Gloucestershire Hospitals NHS Trust (PDF)
INHS

Gloucestershire Hospitals
NHS Foundation Trust

Alexandra House
Cheltenham General Hospital
Cheltenham

Gloucestershire

GL53 7AN

Tel: 0300 422 4721
e-mail: deborah.lee2@nhs.net

g July 2018

Ms Caroline Saunders

HM Assistant Coroner for Gloucestershire
Gloucestershire Coroner's Court
Corinium Avenue, Barnwood

Gloucester, GL4 3DJ

Dear Ms Saunders

The Late Mr Jonathan Earp

| am writing in response to the letter dated 8 May 2018 from your Officer I enclosing the
Regulation 28 Report to prevent future deaths.

The Trust has noted your outstanding concerns as described in paragraph 5 of your Report.

Following the inquest, the Trust has further reviewed the circumstances of the administration of
fentanyl to Mr Earp.

Under the direction of Mr Steve Hams, Director of Quality and Chief Nurse, this case has been
discussed with the ward staff who looked after Mr Earp, and has been presented to the Senior
Nurse and Midwifery Committee.

The enclosed Action Plan confirms the work which the Trust has undertaken, and continues to work
on, as a result of Mr Earp’s death. The Trust Quality Delivery Group will maintain oversight of these
actions and ensure they are being delivered.

| hope this is helpful.

Please do not hesitate to contact me if you require further information

Yours sincerely

Wooom. Lv

Deborah Lee
Chief Executive

Chair: Peter Lachecki
Chief Executive: Deborah Lee

BEST CARE FOR EVERYONE

www gloshospitals,nhs,uk

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