Prevention of Future Deaths reports · 2019

Miriam Tighe

Regulation 28 report to prevent future deaths, reference 2019-0234, written 4 Jul 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Jul 2019
Reference2019-0234
DeceasedMiriam Tighe
CoronerRachel Galloway
Coroner areaManchester (West)
CategoryCare Home Health related deaths · Community health care · Hospital Death (Clinical Procedures and medical management) related deaths
Organisation namedPennine Care 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

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

(1) Royton & Crompton Family Practice

(2) | (Home Manager), Edge Hill Residential Home
(3) Pennine Care NHS Foundation Trust

(4) Clinical Commissioning Group (Oldham)

CORONER

| am, Rachel Galloway, assistant coroner, for the coroner area of South Manchester

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

3 | INVESTIGATION and INQUEST ~ |

On the 29th April 2019 t commenced an investigation into the death of Miriam Tighe
The investigation concluded on the 2" May 2019 where I left a narrative conclusion

“Miriam Tighe died as a consequence of naturally occurring disease,
exacerbated by high levels of sedation and immobility in the months prior to her
death, which worsened her underlying frailty”

The medical cause of death was recorded as:

1a) Vascular Dementia
Il) Old age; Frailty

4 | CIRCUMSTANCES OF THE DEATH

In August 2016 Miriam Tighe became a resident at Edge Hill Residential Home,
315 Oldham Road, Oldham following a period of hospital admission at the Royal
Oldham hospital. After a short time, she appeared to settle at the home. In late
October 2016, Miriam Tighe was noted to be experiencing episodes of
aggression and agitation and various medications were prescribed from that
time in an effort to address her symptoms. Different medications with sedative
effect were prescribed by GPs and by the Psychiatrist. Mrs Tighe continued to
receive Promazine medication after the Psychiatrist had advised that this should
be stopped on the 16" November 2016 and again on the 16" December 2016
From November 2016, Mrs Tighe was regularly over-sedated, leading to
increased immobility and deconditioning. Immobility was further contributed to
by limited stimulation and the promotion of a sedentary lifestyle by staff under
the instruction of the home manager. In tur, this contributed to and worsened
Miriam Tighe’s underlying frailty. On the 30" December 2016 Miriam Tighe was
sedated with promazine. After consultation with the GP, an ambulance was
called and she was taken to ROH The home manager refused to accept
Miriam Tighe back at the home on the basis that an EMI nursing bed was

required. MT was admitted to hospital whilst an EMI bed was found. On the 6"
February 2017 she was discharged into the care of Kings Park Residentiat
Home, Kings Road, Ashton-Under Lyne for nursing care. On the 19" February
2017 she was admitted to Tameside Hospital. Miriam Tighe remained in
hospital and received palliative care until she Passed away on the 28th February
2017.

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. tn the
circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows. —

Promazine was sought by the home manager at Edge Hil! ideotial Home and
prescribed by the GPs at Royton & Crompton family practice after| (Psychiatrist
working in the Memory Clinic (part of Pennine Care NHS Foundation Trust)) had advised
that such medication be stopped on the 16" November 2016 and, again on the 16th
December 2016. On both occasions, Promazine continued to be prescribed by the GP
and continued to be administered under the control of the manager at Edge Hill
Residential Home. In the event, | found that Miriam Tighe had been aver-sedated during
her time as a resident at Edge Hill Residential Home. The psychiatrist had
recommended alternative sedative and antipsychotic medication, which was also being
administered to Miriam Tighe. It was clear that the GPs and the Psychiatrist were not
aware of decisions being made by each other In October to December 2016, which led
to unsafe prescribing of sedatives and antipsychotic medication.

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 28" August 2019. |, the assistant 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 m report to the following Interested Persons namely |
(2 ° (4) Edge Hill Residential home, (5)
ennine Care NHS Foundation Trust, who may find it useful or of interest.

tam 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.

Rachel Galloway
HM Assistant Coroner
04.07.2019

2

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