Prevention of Future Deaths reports · 2019

Natasha Chin

Regulation 28 report to prevent future deaths, reference 2019-0011, written 10 Jan 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Jan 2019
Reference2019-0011
DeceasedNatasha Chin
CoronerCaroline Topping
Coroner areaSurrey
CategoryState Custody related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

IN THE SURREY CORONER’S COURT 
IN THE MATTER OF: 

__________________________________________________________ 

The Inquest Touching the Death of 
Natasha Learline CHIN 
A Regulation 28 Report – Action to Prevent Future Deaths 
__________________________________________________________ 

THIS REPORT IS BEING SENT TO: 

  Denis Machuel, Chief Executive, Sodexo Justice Services.  
  Ian Trenholm Chief Executive Care Quality Commission 
  Elizabeth Moody, Police and Prisons Ombudsman  
  Peter Clarke, Her Majesty’s Chief Inspector of Prisons.  
  Right Honourable David Gauke MP, Minister for Justice  

1  CORONER 

Caroline Topping HM Assistant Coroner, for the County of Surrey 

2  CORONER’S LEGAL POWERS 

I 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. 

3 

INVESTIGATION and INQUEST 

An inquest into the death of Miss Natasha Chin was opened on 29th July 
2016 and resumed with a jury on 5th November 2018. The jury returned 
their conclusion on the 28th November 2018 having been in retirement for 
4 hours and 26 minutes. They concluded that Miss Chin  died on the 19th 
July 2016 at HMP Bronzefield and that the medical cause of her death 
was ; 

1a. Cardiac arrest due to ventricular arrhythmias  
1b Hypomagnesemia , hypokalemia and myocardial scarring  
1c Chronic cocaine use. 
ll  Chronic alcohol abuse and/or dependence 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 They concluded with a narrative conclusion and found that: 
On the 19th July 2016 Natasha Learline Chin died at HMP Bronzefield, 
Woodthorpe Road, Ashford Middlesex, TW15 3JZ.  
Miss Chin was recalled to prison following a breach of licence. She had a 
history of serious drug and alcohol abuse.  
Between the hours of 9.14 and 18.36 on the 19th July 2016: 

a.)  The healthcare staff failed: 

i.) 

ii.) 

iii.) 

iv.) 

v.) 

vi.) 

to ensure that Miss Chin had her prescribed medication 
when due. 

to escalate Miss Chin’s failure to have her medication in 
accordance with policies. 

to undertake the opiate and alcohol withdrawal scales. 

to carry out any adequate assessments or observations and 
record them. Such assessments and observations would 
have enabled Miss Chin to receive and have adjusted her 
medication. 

to monitor her vomiting adequately or at all. 

to respond to the prison officer’s request for help timeously. 

vii.) 

to put in place any adequate handover at lunchtime. 

viii.) 

to monitor the level of Miss Chin’s hydration.  

b.) The operational staff failed: 

i.) 

ii.) 

to follow the escalation protocol for welfare concerns. 

to diligently record welfare concerns according to policy.  

They concluded that: 
Miss Chin’s death was caused or more than minimally contributed to by 
a systemic failure through poor governance which led to a lack of basic 
care.  
The death was contributed to by neglect. 
The death was caused or more than minimally contributed to by the 
failure on the part of Sodexo Justice Services to  

i.)  ensure the prompt administration of prescribed medication 

ii.) ensure that medical records were checked before clinical 

observations were undertaken or medication administered.  

2 

 
 
 4 

CIRCUMSTANCES OF THE DEATH  

The Jury heard evidence that Miss Chin had been recalled on licence 
and admitted to HMP Bronzefield on the afternoon of the 18th July 
2016. The prison is run by Sodexo Justice Services. Miss Chin was seen 
by a doctor on admission and prescribed medication to treat the 
effects of alcohol and opiate withdrawal. The prescribed medications 
were administered on the 18th July 2016. On the 19th July 2016 
methadone was prescribed to be administered at 8.00 am and 
chlordiazepoxide was prescribed to be administered at 8.00 am and 12 
noon. Neither medication was administered to Miss Chin until 18.34 
that evening. She vomited profusely as a consequence of undertreated 
opiate and alcohol withdrawal during the course of the 19th July 2016. 
The prison officer responsible for the wing that Miss Chin was 
resident on was not aware of what Miss Chin had been prescribed nor 
when medication was due to be administered. She raised concerns 
about Miss Chin’s condition to a nurse in the late morning and again 
at about 16.00. Miss Chin was not seen by a member of the clinical 
staff until 18.07. The prison officer did not escalate her concerns about 
Miss Chin’s condition to a more senior officer when the clinical staff 
did not respond timeously. No clinical observations were undertaken 
of Miss Chin’s condition between 9.14 and 18.34 and no records were 
kept of her fluid loss or intake on the 19th July 2016. Observations 
which were undertaken at 9.14 and 18.34 on the 19th July 2016 were 
not in accordance with National or Sodexo Justice Service’s protocols 
for those withdrawing from opiates and alcohol.  The protocol which 
required both notification to a doctor to be made, and a datix report to 
be created, in the event of a failure to administer prescribed 
medication at the correct time was not adhered to in either respect.  

An anti- emetic, metochlopramide, was administered after 18.07 to 
Miss Chin by a nurse. It was administered in contravention of the 
Patient Guidance Direction. The nurse administered it without 
reference to Miss Chin’s System 1 medical records. Miss Chin’s 
previous medical history precluded a nurse from administering 
metoclopramide. The medication should have been prescribed by a 
doctor.  

No record was made of the observations said to have been undertaken 
at 6.34 on the 19th July 2016. No record was made of the 

3 

 
 
 
 
 
 
 
 
 administration of metochloramide on the evening of the 19th July 2016. 

Miss Chin died sometime before 10.41 on the 19th July 2016 in her cell. 
The death was caused or contributed to by metabolic derangement 
caused by profuse vomiting on the 19th July 2016 which was a 
consequence of undertreated withdrawal from opiates and alcohol.  

Her Majesty’s Chief Inspector of Prisons published a report dated the 
13th April 2016 in respect of HMP Bronzefield. The inspection which 
informed the report was undertaken between the 9th and 20th 
November 2015. Inspection of health care services was jointly 
undertaken by the Care Quality Commission and HM Inspectorate of 
Prisons.  The report raised concerns about the non-administration of 
medication, failure to follow up non attendances by prisoners for 
medication and failures to keep accurate and complete medical 
records.  
The Deputy Head of Healthcare at HMP Bronzefield gave evidence on 
the 30th November 2018 that the prison still has no formal process in 
place by which to know if critical medicine is being given on time. 
There is also no evidence to suggest that any formal auditing of 
clinical records in the prison has taken place since 2015.  

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.  The prison officer with responsibility for the wing on which Miss 
Chin was resident was not privy to what medication she was 
prescribed nor when it should be administered. There is no system 
in place for consent to be obtained from prisoners for this 
information to be shared with discipline staff.  

2.  The Sodexo Justice Service Protocols in respect of opiate and 
alcohol withdrawal did not adequately mirror the National 
Protocols and were, in parts, unclear and difficult to comprehend. 

3.  Nurses failed to make any datix referrals in respect of missed 

medications.  

4.  The following matters have to date not been formally audited by 

Sodexo Justice Services: 

4 

 
 
 
 
 
 
 
 i.)  Whether prisoners who do not attend for prescribed 
medications are followed up and the reason for non-
attendance is properly recorded.  

ii.)  Whether critical medication is administered on time. 
iii.)  Whether proper observations are undertaken in line with 
national or local protocols in respect of opiate and alcohol 
withdrawal.  

iv.)  Whether medical records on System 1 are accurately 

recorded.  

v.)  Whether the Patient Guidance Directions in respect of 

prescribing by nurses are adhered to, and whether medical 
records are checked before any prescriptions are made by 
nurses pursuant to the directive. 

5.  As a consequence it is not possible for Sodexo Justice Services to 

know whether the matters raised in 4.(i) to (v) have been 
adequately addressed.  

6.  The response by Sodexo Justice Services to the issues identified in 

the report dated the 13th April 2016 of Her Majesty’s Chief 
Inspector of Prisons in respect of non-administration of prescribed 
medication was inadequate. It does not appear that there was a 
clear line of governance in respect of this matter.  

7.  Whether there is adequate training: 

i.) 

ii.) 

of discipline and clinical staff, including agency staff, to 
make them aware of the signs and dangers of opiate and 
alcohol withdrawal.  
of clinical staff in respect of the completion of opiate and 
alcohol withdrawal scales. 

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I 
believe your organisation has 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 7th March 2019. 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. 

5 

 
 
 
 
 
 
 8  COPIES and PUBLICATION 

I have sent a copy of my report to the following: 

1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 
10. The Chief Coroner  

I 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. 

9  Signed: 

Caroline Topping 

Dated this 10th January 2019.            

6

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 Hm Inspector of Prisons (PDF)
HM INSPECTORATE OF PRISONS 
3rd Floor 
10 South Colonnade  
Canary Wharf 
London  
E14 4PU  
     Tel:  020 7340 0500 

     22 January 2019 

HM Chief Inspector of Prisons 
PETER CLARKE CVO OBE QPM 

Caroline Topping 
HM Assistant Coroner for the County of Surrey 
HM Coroner’s Court 
Station Approach 
Woking 
Surrey 
GU22 7AP 

Dear Ms Topping 

Thank you for sending Her Majesty’s Inspectorate of Prisons (HMI Prisons) a copy of your 
Regulation 28 report following the death of Natasha Chin. Your correspondence was 
received by our office on 10 January 2019.  

As I am entirely independent of Her Majesty’s Prison and Probation Service, I am 
therefore unable to direct the Service to take any specific action in this case. HMI Prisons 
regularly inspect all prisons in England and Wales and measure the successful 
implementation of both our recommendations and those made by the Prisons and 
Probation Ombudsman.  

Your Regulation 28 report contains concerning information regarding the lack of action 
taken by the prison to prevent the death of Natasha Chin. I will therefore place a copy of 
your report in our intelligence file to inform future inspections of HMP Bronzefield.  

I very recently inspected HMP Bronzefield and I expect the report to be published in April 
2019. The report will be available on our website at: 
https://www.justiceinspectorates.gov.uk/hmiprisons/inspections/  

Yours sincerely   

PETER CLARKE  

Our ref: Topping D4-19 Bronzefield 

www.justiceinspectorates.gov.uk/hmiprisons

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