Prevention of Future Deaths reports · 2019

Graham Earl

Regulation 28 report to prevent future deaths, reference 2019-0323, 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
Reference2019-0323
DeceasedGraham Earl
CoronerAlison Mutch
Coroner areaManchester South
CategoryHospital Death (Clinical Procedures and medical management) related deaths
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

na

il

Officer of Greater Manchester Health and Social Care Partnership
1 | CORONER
2 | CORONER'S LEGAL POWERS

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO: Park View Group Practice, Chief
Executive of Stockport Clinical Commissioning Group (CCG), Chief

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

| 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 20" February 2019 ! commenced an investigation into the death of
Graham Earl. The investigation concluded on the 14!" August 2019 and
the conclusion was one of Narrative: Died from influenza exacerbated
by the complications of prescribed medication, namely Amiodarone.
The medical cause of death was 1a) Influenza Pneumonia on a
background of Pulmonary Fibrosis caused by Amiodarone therapy;
ll) Diabetes Mellitus (Type 2), Ischaemic Heart Disease, Atrial
Fibrillation |

4

CIRCUMSTANCES OF THE DEATH

Graham Earl had a history of Atrial Fibrillation. A Cardioversion
on 2"9 May 2018 successfully restored his heart rhythm.
Amiodarone was prescribed to maintain his rhythm. On 2"9
January 2019 he was diagnosed via a chest x-ray with
Pulmonary Fibrosis, a known complication of Amiodarone
therapy. He was not referred back to the cardiologist. Had he
been referred back, the Amiodarone would have been stopped.
He continued to deteriorate. On 14" February 2019 he was
acutely unwell and was admitted to Stepping Hill Hospital. He
was diagnosed with influenza, His Pulmonary Fibrosis
exacerbated the impact of the influenza. He deteriorated and
died at Stepping Hill Hospital on 16" February 2019.

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. The GPs involved did not understand or recognise the known link
between the therapy and Pulmonary Fibrosis and did not seek
guidance from the prescribing secondary care physician at an
early stage. The evidence was that the advice would have been to
stop prescribing immediately;

2. AGP amended the prescription subsequently without reference to
the secondary care doctor despite the fact that this is not a
medication started in primary care;

3. The indication was that GPs involved were not aware of what they
should do if there were side effects from the medication in terms of
escalation;

4. The drug is currently green on the CCG classification. tn other
CCG areas it is amber given the known side effects.

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.

2

7 | 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. 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 to the following
Interested Persons namely; SE on behaif of the family, 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.

9 | Alison Mutch OBE

HM Senior Coroner
| 30.09.2019

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