Prevention of Future Deaths reports · 2019

Mary Jones

Regulation 28 report to prevent future deaths, reference 2019-0322, written 30 Sep 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report30 Sep 2019
Reference2019-0322
DeceasedMary Jones
CoronerAlison Mutch
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedManchester University 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: The Chief Executive of Manchester
University NHS Foundation Trust

1 | CORONER
| am Alison Mutch, Senior Coroner, for the Coroner Area of Greater
Manchester South
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

INVESTIGATION and INQUEST

On 5" March 2019 | commenced an investigation into the death of Mary
Jones. The investigation concluded on the 23% August 2019 and the
conclusion was one of Narrative: Died from the recognised
complications of an accidental fall in combination with underlying
frailty.

The medical cause of death was 1a) Hospital acquired pneumonia on
a background of congestive cardiac failure and acute kidney injury ;
2) Left fractured neck of femur (operated on), Frailty

CIRCUMSTANCES OF THE DEATH

Mary Jones had an accidental unwitnessed fall. She was
admitted to the Manchester Royal Infirmary (MRI) where she
was operated on. She was transferred to Trafford General
Hospital for rehabilitation. She was increasingly confused post-
admission, probably due to dehydration and pain. On 3 March
2019 she deteriorated rapidly having acquired an acute
pneumonia on a background of congestive heart failure and
acute kidney injury which in combination led to her death on 3%
March 2019 at Trafford General Hospital.

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. Mary Jones was a frail elderly lady who was moved from the MRI
to Trafford General post-operatively for rehabilitation under the
Trust structure. It was a planned transfer. However due to limited
transport availability she arrived at Trafford General out of hours
after waiting for transfer. As a result she was clerked in and risk
assessed out of hours despite the recognised risks of moving frail
elderly patients out of hours. The inquest was told that this is not
uncommon as transfers such as these are made via ambulance
and are low priority and moved where needed;

2. The falls risk assessment was completed outside the Trust target
time primarily as a result of the late arrival;

3. The documentation within the nursing notes, particularly the fluid
charts was poor quality, making it difficult to understand what had
happened in relation to the hydration of Mrs Jones;

4. The documentation issue was exacerbated by the Trust IT merger
having resulted in the loss of a number of key documents. It was
unclear how the Trust were managing the risks around lost
medical records where the IT merger was at the root of the issue;

5. Despite her frailty there was no evidence available at the inquest
of a referral to a dietician/nutritionist. There was to have been a
referral to SALT in February but no trace could be found of the
referral;

6. There was no evidence of clear clinical review of the outcome of

the fluid charts.

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 25!" November 2019. |, 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 following
Interested Persons namely 1 EEE on behalf of the family
and; 2) Trafford Clinical Commissioning Group, who may find it useful or
of interest.

| 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.

Alison Mutch OBE
HM Senior Coroner
30.09.2019

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