Prevention of Future Deaths reports · 2018

Joyce Long

Regulation 28 report to prevent future deaths, reference 2018-0406, written 24 Dec 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report24 Dec 2018
Reference2018-0406
DeceasedJoyce Long
CoronerCrispin Butler
Coroner areaBuckinghamshire
CategoryCommunity health care and emergency services related deaths · Hospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBuckinghamshire Healthcare NHS Trust
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.

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C.G.BUTLER
SENIOR CORONER + BUCKINGHAMSHIRE

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Buckinghamshire Healthcare NHS Trust
2. South Central Ambulance Service

1 | CORONER

| am CRISPIN GILES BUTLER, Senior Coroner, for the coroner area of Buckinghamshire

2 | 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:/Awww. legislation.gov.uk/uksi/2013/1629/pdfs/uksi/2013/1629/part/7/made

3 | INVESTIGATION and INQUEST

On 12" July 2018 | commenced an investigation into the death of Joyce Phoebe Mary LONG.
The investigation concluded at the end of the inquest on 19" December 2018.

The conclusion was that Mrs Long died as a result of an accident.

The medical cause of death was: 1a Acute subdural haematoma; 2. Atrial Fibrillation (treated
with Warfarin)

4 | CIRCUMSTANCES OF THE DEATH

Mrs Long died at John Radcliffe Hospital, Oxford at 0034 hours on 11" July 2018 from injury
sustained when she struck her head in her bedroom at her home address on the morning of
10" July 2018, leading to her collapsing later that afternoon.

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 could 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) Shortly after Mrs Long had been mobilised into an ambulance outside her home
address in Hazlemere, near High Wycombe, Buckinghamshire, her condition
deteriorated very quickly and her Glasgow Coma Score dropped from 15/15 to 3/15.
Her breathing became abnormal and irregular and she became unresponsive.
Although the overall intention was to transport to John Radcliffe Hospital as a result

Coroner’s Office, 29 Windsor End, Beaconsfield, Buckinghamshire. HP9 2JJ
Tel: (01494) 475505
Fax: (01494) 673760
E Mail: coroners@buckscc.gov.uk

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C.G.BUTLER
SENIOR CORONER + BUCKINGHAMSHIRE

of the traumatic head injury, the ambulance crew contacted and requested
assistance from the nearest hospital, Wycombe Hospital, due to the concern over
Mrs Long’s compromised airway.

Admission was refused with an instruction to attend the nearest Accident &
Emergency Unit so, instead, roadside assistance was provided to the crew near
Stokenchurch at the M40 junction from an Enhanced Care Response Unit car whilst
en route to John Radcliffe Hospital.

Due to the severity of the injury Mrs Long had sustained, exacerbated over the day
prior to collapse by her warfarin prescription, the refusal of assistance by Wycombe
Hospital (part of Buckinghamshire Healthcare NHS Trust) did not impact upon the
outcome in this case.

There was, however, a clear difference of opinion between South Central Ambulance
Service and Buckinghamshire Healthcare NHS Trust as to the interpretation of the
reception policy appropriate to the Cardiac and Stroke Unit at Wycombe.

It is understood that informal discussions have been had between both trusts about
whether South Central Ambulance Service should or should not be seeking
assistance from Wycombe Hospital (where it is the nearest facility) in cases where a
compromised airway may lead to cardiac arrest.

There is a continuing concern that, in the absence of a clear, formalised
understanding, circumstances may arise where either help to stabilise a patient's
airway is refused, or a delay occurs as a result of confusion, and a patient dies as a
consequence.

6 | ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe you have 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 25" February 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.

8 | COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and to the family of Joyce Long

lam 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.

Coroner's Office, 29 Windsor End, Beaconsfield, Buckinghamshire. HP9 2JJ
Tel: (01494) 475505
Fax: (01494) 673760
E Mail: coroners@buckscc.gov.uk

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C.G.BUTLER
SENIOR CORONER +» BUCKINGHAMSHIRE

9 | Date: 24™ December 2018

Signed: Craton brtehe

Crispin Giles Butler, Senior Coroner for Buckinghamshire

Coroner’s Office, 29 Windsor End, Beaconsfield, Buckinghamshire. HP9 2JJ
Tel: (01494) 475505
Fax: (01494) 673760
E Mail: coroners@buckscc.gov.uk

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