Prevention of Future Deaths reports · 2019

Gareth Bickerstaff

Regulation 28 report to prevent future deaths, reference 2019-0029, written 25 Jan 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report25 Jan 2019
Reference2019-0029
DeceasedGareth Bickerstaff
CoronerLisa Hashmi
Coroner areaManchester North
CategoryEmergency Services related deaths · Mental Health related deaths
Organisation namedPennine Care NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1) 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Chief Executive, Joint Royal Colleges Ambulance Liaison Committee (JRCALC) 

1 

CORONER 

I am Ms L Hashmi, Area Coroner for the Coroner area of Manchester North. 

2 

CORONER’S LEGAL POWERS 

I make this report under paragraph 7, Schedule 5, of the Coroner’s and Justice Act 2009 and Regulations 28 
and 29 of the Coroners (Investigations) Regulations 2013. 

3 

INVESTIGATION and INQUEST 

On the 8th January 2019 I commenced an inquest into the death of Gareth Cecil Bickerstaff.  

4 

CIRCUMSTANCES OF DEATH 

Against  a  backdrop  of  long  term  illicit  substance  and  alcohol  misuse,  depression,  and  personal 
tragedy at a young age, in the months leading up to his death the deceased had started to exhibit 
increasingly  frequent  episodes  of  paranoia  and  associated  erratic  and  sometimes  dangerous 
behaviour.    This  brought  him  into  contact  with  mental  health  RAID  teams  on  three  separate 
occasions between January and May 2018.  Assessments were conducted and support offered but 
declined. 

On the 20th  May 2018, the deceased entered a local Tesco Express supermarket.  At the material 
time  he  was  experiencing  paranoia  whilst  under  the  influence  of  drugs  and  alcohol.    He  became 
increasingly agitated and scared.  Having climbed across and then on to the check-out counter he 
began  to  damage  the  suspended  ceiling,  thereafter  entering  the  roof  space.    The  shop  was 
evacuated and the doors locked pending police arrival.  Police attended on a category 1 response, 
with the first officer on scene at around 22:24.  Further officers arrived shortly thereafter.  At the point 
the  deceased  was  seen  to  place  a  wire  ligature  around  his  neck,  the  first  police  officer  and  the 
deceased’s  brother  entered  the  store  and  tried  to  engage  with  him,  to  no  avail.    He  subsequently 
removed the ligature and continued to move around the roof space. 

At around 22:40 the deceased went quiet and on closer inspection was noted to have self-ligatured 
on a main roof suspension cable.  Police attempted to gain access to the roof space but their efforts 
proved futile. 

Contact  with the  ambulance  service was  initially  made  at  around  22:33  however  a  further call  was 
logged at 22:39.  At was at this point the call to the ambulance service was regraded to a category 1 
response as the deceased had self-ligatured.  Paramedics were in attendance by 22:43.   

The Fire and Rescue Service was not called to attend until 22:44, despite their rescue capabilities.  
They arrived on scene at 22:47. Extrication of the deceased was achieved shortly after 23:00.  The 
fact  of  the  deceased’s  death  was  confirmed  by  paramedics  at  23:06  at  the  Tesco  Express  Store, 
Ashton Road, Oldham. 

Cause of Death: 

1a) Hanging 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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  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:- 

1. During the course of the evidence heard at inquest, it became apparent that there was a critical 
difference  between  the  language  used  within  the  JRCALC  Guidance  and  the  local  ambulance 
Trust’s guidance to Paramedics in relation to the diagnosis of death/decision to resuscitate criteria.  

I  was  told  that  whilst  Trusts  base  the  drafting  of  local  Guidance/Policy  on  the  JCALC  Guidance, 
they are permitted to use their own language/interpretations.   

The JCALC Guidance indicates that resuscitation should not be attempted [inter alia] where more 
than  15  minutes  have  passed  since  the  onset  of  cardiac  arrest  (presumably  diagnosed  clinically 
and/or by way of ECG), whereas the local ambulance Trust’s guidance indicates that the 15 minute 
timeframe  should  be  calculated  from  the  onset  of  ‘collapse’  (this  is  not  defined  further  but  prima 
facie  is  reliant  upon  bystander  observation).    I  am  concerned  that  in  allowing  for  ‘local 
interpretation’  and  different  meanings  as  to  when  the  15  minutes  is  calculated  from,  there  is  the 
to  emergency 
potential 
resuscitation, creating a risk of future deaths. 

for  misinterpretation,  ambiguity  and  misunderstanding 

in  relation 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe each of you respectively 
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 the 22nd 
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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested Persons namely:- 

-  The deceased’s family 
-  NWAS 
-  GMP 
-  Pennine Care NHS Foundation Trust 
-  DoH 
-  College of Paramedics 
-  Health and Care Professions Council 

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 from. 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 

Date:     25th January 2019                                       Signed:

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