Prevention of Future Deaths reports · 2019

Madeline Staples

Regulation 28 report to prevent future deaths, reference 2019-0041, written 11 Feb 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Feb 2019
Reference2019-0041
DeceasedMadeline Staples
CoronerJohn Gittins
Coroner areaNorth Wales (East and Central)
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Emergency services related deaths (2019 onwards) · Wales prevention of future deaths reports (2019 onwards)
Organisation namedWelsh Ambulance Services NHS Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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John Adrian Gittins
Senior Coroner for North Wales (East and Central)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: BCUHB, Ysbyty Gwynedd, Penrhosgarnedd, Bangor,
Gwynedd LL57 2PW and Welsh Ambulance Services NHS Trust, HM Stanley Site, St Asaph,
Denbighshire LL17 ORS

CORONER

lam John Adrian Gittins, Senior Coroner for North Wales (East and Central)

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 11" of April 2018 | commenced an investigation into the death of Madeline Constance
Staples (DOB 19.7.31 DOD 9.4.2018) The investigation concluded at the end of the inquest on
7‘ of February 2019, The conclusion of the inquest was one of an accidental death the Cause of
Death being recorded as 1(a) Bronchopneumonia (b) Immobilisation due to Femoral and Tibial
Fractures 2. Lung Cancer

CIRCUMSTANCES OF THE DEATH

On the 6" of April 2018 the Deceased (an 86 year old lady) had an unwitnessed fall in her care
home. She had sustained long bone fractures of both legs as a result of the fall and the position
in which she was lying prohibited her from receiving oral pain relief. An ambulance was called to
her assistance at 22.11 hours however due to the absence of available resources (primarily due
to lost ambulance hours awaiting discharge of patients at hospital) it was not possible to get
assistance to her (and hence some pain relief) until 03.40 hours during which time she remained
according to the attending paramedic, “crying out in pain which could be heard from the entrance
of the care home despite her room being on the second floor’. A second ambulance was
required to assist in her removal to hospital and again there was a delay in this being allocated
due to an absence of available resources and she did not reach hospital until 05.23 around
seven and a quarter hours after the first call for help. Despite treatment for her injuries her
condition deteriorated and she died on the 9" of April 2019 at 23.20.

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. —

Following an inquest which concluded in January 2014 | issued a regulation 28 report in which |
expressed concerns regarding the handover of patients at an emergency department which
resulted in “unacceptable delays with patients being kept waiting for long periods in ambulances
and ambulance resources consequently being unavailable for allocation to other calls”.

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LLIS 1YN
Tel 01824 708047 | Fax 01824 708048

In the intervening period from then until the present either | or my Assistant Coroners have
issued at least a further twelve similar regulation 28 reports expressing concerns associated with
unacceptable delays and yet despite being given assurances in the responses to the same by
BCUHB and WAST (and other organisations) that action is being taken to reduce such delays,
the situation continues to prevail.

As has been stated previously in my other reports, | recognise that the issues which cause these
difficulties is multifactorial, however unless services and resources are made available or
working practices altered to facilitate change then it is inevitable that future deaths will occur
which might have otherwise been preventable. Patients’ lives are being placed at risk and this is
wholly unacceptable.

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
8'" April 2079. 1, 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 Family of the Deceased

1am 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
telease or the publication of your response by the Chief Coroner.

Dated 11" February 2019

Signature. FAH

Senior Coronet for North Wales (East and Central)

Coroner's Office, County Hall, Wynnstay Road, Ruthin, LL15 1YN
Tel 01824 708047 | Fax 01824 708048

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