Prevention of Future Deaths reports · 2018

Savannah-Rose Owen

Regulation 28 report to prevent future deaths, reference 2018-0367, written 22 Nov 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report22 Nov 2018
Reference2018-0367
DeceasedSavannah-Rose Owen
CoronerAlison Mutch
Coroner areaManchester South
CategoryChild Death (from 2015) · Product related deaths
Sourcejudiciary.uk record · original PDF
Responses published2

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: Secretary of State for
Health, Secretary of State for Business
CORONER

| am Alison Mutch, Senior Coroner, for the Coroner area of
South Manchester

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 23rd April 2018 | commenced an investigation into the
death of Savannah-Rose Michelle Owen. The investigation
concluded on 7th November 2018 and the conclusion was one
of Natural Causes.

The medical cause of death was 1a) Unascertained

(4 | Savannah-Rose Michelle Owen was a healthy baby born on
16th February 2018. On 22nd April 2018 she fell asleep on a
nursing pillow on the sofa at her home address. Her parents
realised she had become unresponsive and an ambulance was
called. Attempts to resuscitate her were unsuccessful. A post-
mortem did not find a cause of death but did exclude any third
party involvement or suspicious circumstances and on the
balance of probabilities would have been due to natural
causes.

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. —

The inquest heard that:

Savannah-Rose’s mother had purchased the multi-purpose
nursing pillow from a well-known supermarket chain. There
were warnings about its use on a card that came with the
pillow but was not attached to it. On the warning/information
leaflet were 5 pictures of a baby positioned on the pillow. In
only 2 images was the baby with an adult. On the other 3 the
baby was alone.

The inquest heard that sleeping unsupervised on such pillows
was not consistent with the safe sleeping advice given to new
parents. However:

1. Unlike many items associated with babies/young children
such as high chairs/cots there was no specific safety
regulation for such items. Instead manufacturers had to
interpret the all-embracing safety policy. This risked
inconsistent safety warnings/labelling;

2. It was unclear if Health Visitors/ Midwives in the
community seeing multi-use pillows being used were
flagging up the risks of allowing babies to be propped on
them for naps and that their use in such a way was
wholly inconsistent with safe sleeping advice;

3. On the warning/information leaflet were 5 pictures of a
baby positioned on the pillow. In only 2 images was the
baby with an adult. On the other 3 the baby was alone.
The inquest was told that this could be misleading as to
the importance of never leaving a baby unattended on

the pillow; and

4. The warning label was not attached to the item therefore;
once the package had been opened, there was a high
risk that the warning label would be lost. On resale/
recycling of baby items this meant that second hand
users/purchasers were unlikely to see the warning.

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 17" January 2019. |, 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 namely i a0

aa: deceased’s parents, who may find it useful
or of Interest.

| 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.

Alison Mutch OBE

HM Senior Coroner
22.11.2018 iD

Responses

2 responses 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 Department for Business Energy Industrial Strategy (PDF)
pas Kelly Tolhurst MP
Department for Business, Energy &

Department for ‘'vectora Steet
Business, Energy Sane

& Industrial Strategy

T +44 (0) 20 7215 5000
E  enquiries@beis.gov.uk

Alison Mutch OBE a

HM Senior Coroner Our ref: aepeosernees-
Coroner’s Court

1 Mount Tabor Street [4 December 2018
Stockport

SK1 3AG

RECEIVED
24 DEC 2018

Thank you for your letter and Regulation 28 Report to Prevent Future Deaths, dated 22
November 2018, following your investigation and inquest into the death of baby Savannah-
Rose Michelle Owen on 22 April 2018, who died after falling asleep on a nursing pillow on the
sofa and becoming unresponsive. | am responding as the Minister responsible for product
safety policy in the Department for Business, Energy and Industrial Strategy (BEIS).

1 would first like to say how sorry | was to hear about this terrible incident. If you have the
opportunity, please convey my deepest sympathies to Savannah-Rose’s family.

The death of baby Savannah-Rose was unexplained and ruled on the balance of probabilities
to be death by natural causes. However, we must do everything we can to ensure that our
product safety system continues to function effectively for the safety of products used by
babies and new parents, so as Minister for product safety policy |! am addressing the points
you have raised regarding the nursing pillow on which Savannah-Grace fell asleep.

You raise the concern that there are no specific safety regulations for nursing pillows. The
safety of nursing pillows, along with many other products, is regulated by the General Product
Safety Regulations 2005 (GPSR). Under the GPSR, products are required to be safe in normal
or reasonably foreseeable use when placed on the market.

Before the product is placed on the market, manufacturers must ensure products are safe.
Distributors and retailers must act with due care and must not supply a product which they
know or ought to know is unsafe.

In this case, you have raised concerns that the product was sold with safety use warnings on a
leaflet that was not attached to the product. Furthermore, three out of five images on the
warning leaflet showed a baby using the product without an adult figure, which is not
consistent with safe sleeping advice given to new parents. In determining whether a product is
safe under GPSR, one of the factors is the presentation of the product, including any labelling,
warnings and instructions for use.

Both the Office for Product Safety (OPSS) and Local authority Trading Standards have powers
to act where unsafe products are identified including, requiring changes to safety information
and instructions for use and, where appropriate, issuing a recall of the product.

| have passed your concerns regarding the nursing pillow on to OPSS’s Product Safety
Enforcement Team but in order to investigate further they have asked that any details you
have of the specific product involved, including information about the distributor be shared with
them. If you have any further information that would assist their assessment, | would be
grateful if you could pass it directly to Graham Russell, Chief Executive, OPSS, Victoria
Square House, Birmingham B2 4AJ. This would allow OPSS to work with Local Authority
Trading Standards to determine whether further action is needed, based on all the evidence
available.

Thank you for bringing this issue to my attention. | hope | have reassured you that the
Government takes product safety issues seriously and is working with its partners to
continually improve the level of safety for children and babies.

KELLY
Minister for Small Business, Consumers & Corp§rate Responsibility
Response from Department of Health Social Care (PDF)
Me From Jackie Doyle-Price MP

D epartm ent Parliamentary Under Secretary of State for Mental Health,

inequalities and Suicide Prevention
of Health &

i 39 Victoria Street
Social Care a Street
SW1H OEU

RECE IVED | 020 7210 4850
16 JAN 20:3

Your Ref: 10179/CH

Our Ref: PFD-1158107

Ms Alison Mutch OBE

HM Senior Coroner, Manchester South
HM Coroner's Court

1 Mount Tabor Street

Stockport wonTy 26
SK1 3AG iphh yonwmry 1

Deo, Ly Match

Thank you for your correspondence of 22 November to Matt Hancock about the
death of Savannah-Rose Michelle Owen. I am replying as Minister with
responsibility for child health.

I have noted carefully the concerns in your report.

Firstly, I should clarify that nursing pillows are not classified as medical devices and
are therefore outside the remit of the Medicines and Healthcare Products Regulatory
Agency (MHRA). Safety regulation in this case is a matter for the Department for
Business, Energy and Industrial Strategy and I note you have issued your report to the
Secretary of State.

With regard to guidance given by health visitors and midwives on safe sleeping and
nursing pillows, discussions with parents about safe sleeping are a part of maternity
care, both antenatal and post-natal, as is the support offered by health visitors.

We know that health visitors and midwives are a trusted resource for parents. Health
visitors and midwives are crucial in supporting a healthy pregnancy, safe birth and
support for health and wellbeing for both the parents and child. This includes support
for a healthy weight during pregnancy, breast feeding and safer sleeping advice, all of
which can reduce the risk of Sudden Infant Death Syndrome (SIDS).

Health visitors and midwives receive in-depth training in pre- and post-registration
development programmes, about SIDS and the evidence describing what works to
reduce the incidence and minimise the risk of SIDS occurring. SIDS is multi-
factorial. However, ensuring parents have the most recent evidence available can
help to maintain the momentum in decreasing the number of babies dying. Health
visitors and midwives advise and guide parents about safe sleep environments and
work with parents regarding unsafe practices and how to reduce a risk to their baby,
including the use of nursing pillows, supporting parents to make the safest choice for
their baby.

We acknowledge it can be very difficult for parents to know which products are safe
for their baby. Confusion around product safety was highlighted by a recent survey
of new and expectant parents commissioned by The Lullaby Trust. 91 per cent of
parents who responded stated compliance with safer sleep advice was a very
important consideration when buying a product.

In March 2018, Public Health England (PHE) and The Lullaby Trust jointly
published guidance to help new and expectant parents make safer choices when
deciding on sleeping products for their baby'. It aims to provide parents with some
key pieces of advice when choosing sleeping products.

Safer Sleep Week is The Lullaby Trust’s annual national awareness-raising
campaign. It aims to make sure parents, carers and health professionals know the
importance of safer sleep and are aware of how to reduce the risk of SIDS. The
campaign this year runs 11-17 March 2019. PHE is working with The Lullaby Trust
to develop new resources that will be showcased during Safer Sleep Week. PHE and
The Lullaby Trust are collaborating and co-producing information sheets for parents
and detailed fact sheets for professionals to further describe the evidence base for
safer sleep spaces and drive down the incidence of SIDS.

Finally, other sources of advice for parents are the NHS’ Start4Life Information
Service for Parents”, which provides information via email on keeping babies safe.
This includes guidance on preventing SIDS, with links to further information online,
including to the Lullaby Trust’s website. In addition, the NHS Choices website
contains factsheets on minimising the risk of SIDS*, that include the importance of

? https://www.nhs.uk/start4life

2 http://www.nhs.uk/conditions/sudden-infant-death-syndrome/pages/introduction.aspx
4 http://www.nhs.uk/conditions/pregnancy-and-baby/pages/reducing-risk-cot-death,aspx,

using a baby mattress that is firm, flat, well-fitting, clean and waterproof on the
outside, and that the mattress is covered with a single sheet. Parents are advised not
to use duvets, quilts, baby nests, wedges, bedding rolls or pillows.

I hope this information is helpful.

E DOYLE-PRICE

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