Prevention of Future Deaths reports · 2019

Geoffrey Jackson

Regulation 28 report to prevent future deaths, reference 2019-0071, written 26 Feb 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Feb 2019
Reference2019-0071
DeceasedGeoffrey Jackson
CoronerChris Morris
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedManchester University NHS Foundation Trust · Central Manchester University Hospitals NHS Foundation 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.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: Sir Michael Deegan CBE, Chief Executive, Manchester University
NHS Foundation Trust, Cobbett House, Manchester Royal Infirmary, Oxford Road, Manchester M13
OWL

CORONER

lam Chris Morris, Area Coroner for Manchester South.

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://www.legislation.gov.uk/uksi/2013/1629/part/7/made

INVESTIGATION and INQUEST

On 14" November 2018, Rachel Galloway, Assistant Coroner for Manchester South opened an
inquest into the death of Mr Geoffrey Jackson, who died at Trafford General Hospital on 6"
November 2018 aged 87 years. The investigation concluded at the end of the inquest which | heard
on 19" February 2019.

At the end of the inquest, | recorded a narrative conclusion that Mr Jackson died as a consequence
of natural causes contributed to by recognised complications of recent surgery.

CIRCUMSTANCES OF THE DEATH

Mr Jackson’s medical history included ischaemic heart disease and coronary artery disease. He had
previously suffered two myocardial infarctions, but was considered stable by the cardiologists who
kept him under regular review as an outpatient.

Mr Jackson’s mobility had declined in recent years, as a consequence of osteoarthritis of both knees
and the left hip joint.

On 28" September 2018, Mr Jackson was admitted to Manchester Royal Infirmary for an elective
(acknowledged to be high-risk) hip replacement procedure under the care yd The surgery
proceeded without incident, however Mr Jackson became unwell in its aftermath, having
experienced a cardiac event and developed hospital acquired pneumonia.

On 25" October 2018, Mr Jackson was transferred to Trafford General Hospital for rehabilitation, via
the Acute Medical Unit. On 1* November 2018, Mr Jackson was moved to Ward 6.

A Risk of Falls assessment undertaken on the Acute Medical Unit had identified Mr Jackson as being
at risk of falls. Upon transfer to Ward 6, there was a delay in completing a further Risk of Falls
Assessment within the timescales prescribed by Manchester University Hospitals NHS Foundation
Trust.

On 3% November 2018, Mr Jackson removed his NG feeding tube, and according to his daughter was
exhibiting signs of agitation. Despite this and the fact he was moved to a side room, no repeat Risk
of Fails Assessment was undertaken.

Later that day, Mr Jackson was found on the floor near his bed, having sustained an unwitnessed fall.
In view of the fact Mr Jackson appeared to have sustained a head injury, a junior doctor sought to
obtain a CT scan. This was, however, never undertaken.

Mr Jackson died on 6"" November 2018 as a consequence of:
1a) Congestive Cardiac Failure;

b) Ischaemic Heart Disease

2) Left Hip Replacement and Hospital Acquired Pneumonia.

There was no evidence before the court to suggest that the fall on 3" November 2018 contributed
to, or materially hastened, Mr Jackson's death.

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. —
ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and ! believe you and your
organisation have the power to take such action.

1. Notwithstanding the actions which have been taken following the Trust's investigation into
the circumstances of Mr Jackson’s fall, a spot-check recently undertaken by the Matron on
Ward 6 found 2 out of 32 patients had not had Risks of Falls Assessments completed in
accordance with Trust requirements;

2. A further matter of concern arose from the manner in which nursing records are made at
Trafford General Hospital, with an emphasis on proforma care plans which simply require
signing and dating by nurses, observation charts, and sheets upon which variances from the
care plans can be recorded. It is a matter of concern that the absence of any requirement
upon the nurse looking after a patient for a given shift to make a structured narrative record
of what transpires over that period represents a missed opportunity to capture nuanced
changes in a patient’s condition, and communicate these to others.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report, namely by
23" April 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

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner and vo on behalf of Mr
Jackson’s family.

| have sent a copy of my report to the Care Quality Commission, who may find it useful or of interest.
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.

Dated:

Signature:

Chris Morris HM Area Coroner, ManchesterSouth.

Related reports

Other reports by Chris Morris

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Manchester University NHS Foundation Trust

See every Prevention of Future Deaths report matching Manchester University NHS Foundation Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.