Prevention of Future Deaths reports · 2019

Philip Hayes

Regulation 28 report to prevent future deaths, reference 2019-0363, written 30 Oct 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report30 Oct 2019
Reference2019-0363
DeceasedPhilip Hayes
CoronerKaren Dilks
Coroner areaNewcastle Upon Tyne
CategoryEmergency services related deaths (2019 onwards)
Organisation namedNorth East Ambulance Service 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.

Karen Dilks
Senior Coroner for the City of Newcastle upon Tyne

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

1. North East Ambulance Service
NHS Foundation Trust
Bernicia House
Goldcrest Way
Newburn Riverside Business Park
Newcastle upon Tyne
NE15 8NY

1 | CORONER

| am Karen Dilks, Senior Coroner, for the coroner area of city of Newcastle
upon Tyne

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.

http://www. legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7

and

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

3 | INVESTIGATION and INQUEST

On 24 April 2019 | opened an investigation into the death of Philip Richard
Hayes aged 60yrs.

The investigation concluded at the end of the inquest on 29 October 2019.

The conclusion of the Inquest was:

Medical cause of death: Aortic dissection

a

Conclusion: Natural causes

CIRCUMSTANCES OF THE DEATH

On 14 April 2019 in or around 13:13 Philip Hayes suffered an aortic
dissection.

Initial symptoms were chest and flank pain.
At 13:13 a 999 call was made to summon urgent assistance.
The call was triaged at 13:16 and categorised C2 response (18 minutes).

At 13:23, 13:27, 13:31, 13:45 and 13:59 further calls reporting new
symptoms and a deteriorating condition were made.

These subsequent calls did not result in a reassessment of the original
categorisation nor did the calls result in the case being referred for clinical
input.

Ambulance technicians arrived at 14:02 and paramedics at 14:15 (1 hour
and 2 minutes after the original call).

Philip Hayes was transported to the Northumbria Specialist Emergency
Care Hospital, arriving at 15:13.

His dissection was diagnosed following CT scan at approximately 23:56
when arrangements for his transfer to Freeman Hospital, Newcastle for
specialist vascular care were made.

Notwithstanding maximal care and treatment he died there on 18 April 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 could 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) Delay in ambulance dispatch
Call categorised C2 received response 1 hour 2 minutes after
original call

(2) Failure to conduct reassessment of C2 category notwithstanding 5
subsequent calls describing additional symptoms and a deteriorating
condition

(3) Inconsistency in approach and answers to algorithm question designed
to indicate risk of aortic aneurysm/rupture/dissection

(4) Calls triaged by health advisors with limited medical training and no
medical qualifications

(5) Inconsistency in approach to referral for clinical input

(6) Appropriateness of triage by algorithm. Insufficient if any weight given
to actual reported symptoms and indicators of a medical emergency

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.

~| YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of
this report, namely by 27 December 2019. 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 following
Interested Persons:

ws England

| 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.

30 oe Dut
S
Signed by Karen Dilks (Senior Coroner)

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