Prevention of Future Deaths reports · 2019

Gareth Warburton

Regulation 28 report to prevent future deaths, reference 2019-0411, written 4 Dec 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Dec 2019
Reference2019-0411
DeceasedGareth Warburton
CoronerDavid Reid
Coroner areaWorcestershire
CategoryState Custody related deaths
Organisation namedUniversity Hospitals Birmingham 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.

SPECIMEN: REPORT TO PREVENT FUTURE DEATHS (1)

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

1. The Governor, HMP Hewell, Hewell Lane, Redditch, Worcs B97 6QS.

CORONER

| am David Donald William REID, HM Senior Coroner for Worcestershire.

=i

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 18" April 2018 | commenced an investigation into the death of Gareth Wycliffe
WARBURTON, then aged 58. The investigation concluded at the end of the inquest on
3™ December 2019. The jury returned a narrative conclusion, with the medical cause of
death being:

1a Bronchiolitis Obliterans Syndrome;

1b Interstitial lung disease ( transplant ).

CIRCUMSTANCES OF THE DEATH

(1) Mr. Warburton had undergone a double lung transplant in 2005, and at the time of
his arrival at HMP Hewell on 1.4.17 was in good health, although taking a number of
different medications to ensure that his body did not reject the transplanted lungs;

(2) Due to a prescription error by a member of the prison healthcare team, Mr.

Warburton was incorrectly prescribed half his usual dose of an important anti-

rejection medication for the period 1.7.17 — 25.8.17. This error probably led to the

chronic rejection of his transplanted lungs, resulting in his death on 1.4.18;

In addition, the jury found that:

(i) A failure in the system in place for writing and screening those prescriptions
which were sent out to an external pharmacy probably contributed to Mr.
Warburton's death;

(ii) Inadequacies in staffing, role allocation and time management within the prison
healthcare team in mid-2017 possibly contributed to Mr. Warburton's death; and

(iii) Had opportunities to pick up on the prescription error on 14.7.17 and 27.7.17
been taken, it was "highly possible" that the chronic rejection of the transplanted
lungs would not have occurred.

(3

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) Letters dated 16.10.17 and 27.11.17 from 7M Vr. Warburton's
treating clinician at the Queen Elizabeth Hospital, Birmingham to then Governor
of HMP Hewell Gareth Sands, highlighting concern about the prescription error,
asking for more information about the error, and seeking assurances that Mr.
Warburton would continue to receive all required medication, were neither
acknowledged nor answered by the Governor;

(2) Furthermore, although such letters ought to have been passed on to the prison

healthcare team, the evidence suggested that this was not done. Investigations
carried out by current Governor Anthony Morrow failed to establish what had
happened to these letters;

(3) As to the suggestion that perhaps these letters were never received by the
prison, it was apparent that the same letters had been sent to, and received by,
members of Mr. Warburton's family;

(4) Accordingly, | am satisfied that it is probable that these letters did reach the
prison, but were not dealt with satisfactorily;

(5) | am concerned that, as long as there is a risk that letters which seek or contain
important information about a prisoner's health and welfare are not dealt with
and go unanswered, there remains a risk to prisoners’ lives at HMP Hewell.

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" January 2020. |, the coroner, may extend that period if requested.

Your response must contain details of action taken or proposed to be taken, setting out
the timetable for such 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:

Leigh Day — solicitors for Mr. Warburton's family;

Hill Dickinson — solicitors for Care UK ( providers of healthcare at HMP Hewell );
Capsticks — solicitors for the University Hospitals Birmingham NHS Foundation Trust.

| have also sent it to the Prison and Probation Ombudsman, 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.

DATE: 4% De wel AY SIGNED BY CORONER] , W are
C eins L is

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