Prevention of Future Deaths reports · 2019

Blaithin Buckley

Regulation 28 report to prevent future deaths, reference 2019-0465, written 16 Sep 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Sep 2019
Reference2019-0465
DeceasedBlaithin Buckley
CoronerJacqueline Devonish
Coroner areaNorthamptonshire
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Mental Health related deaths
Sourcejudiciary.uk record · original PDF
Responses published1

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.

ANNEX A

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

na General Council

1 | CORONER

i
i

| am Jacqueline Devonish, assistant coroner, for the coroner area of Northamptonshire

2 | CORONER’S LEGAL POWERS

i | 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 11 September 2019 | commenced an investigation into the death of Blaithin Grianne
Buckley, aged 26. The investigation concluded at the end of the inquest on 13
September 2019. The conclusion of the inquest was that her death was a Misadventure
and that the medical cause of death was:

ta. Hypoxic brain injury

1b. Out of hospital cardiac arrest

ic. Hanging

| 2. Emotionally Unstable Personality Disorder

| The jury found that the death had been contributed to by a breach of procedure at St
: Andrews in failing to lock the phone booth; an inadequate level of patient history
transferred from Wootton Lawn to St Andrews (in particular the previous history of
ligature by phone cord): an insufficient process for calling the ambulance service
following the incident.

14 | CIRCUMSTANCES OF THE DEATH

Ms Buckley died on 30 April 2018 at Northampton General Hospital following being

| found hanging in a phone booth on the Bayley Ward at St. Andrews Healthcare on 26
April 2018 at 23:20, whilst on 5 minute observations. Contrary to the Trust policy, the
| phone booth door had been left unlocked.

| The Trust medical emergency team was alerted to the incident through ascom at 23:23.

CPR and life support commenced to good effect. Upon being found Ms Buckley had

| | been conscious. She then fell unconscious with fixed and dilated pupils. The

experienced medical emergency team returned a pulse and rapid heart beat whilst

awaiting arrival of an ambulance. The first ambulance arrived at 00:02, having been
called at 23:44. Ms Buckley was transferred to Northampton General Hospital at 00:42

| | in a comatose condition. Brain stem testing on 30 April 2018 recognised that life was

i extinct.

mm

The critica! care consuitant at Northampton General Hospital gave evidence that he
suspected that an earlier arrival at hospital would not have altered the outcome as 5
minutes was sufficient to establish perrnanent brain damage.

=

| CORONER'S CONCERNS

1
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) The delay in calling for an ambulance to transfer Ms Buckley to the General
Hospital in a clear medical emergency.

There was no evidence before inquest to explain the delay between 23:20 and 23:44. |
Whilst it had been accepted that senior clinicians, with greater medical knowiedge that
the paramedics, formed the medical emergency team, St Andrews as a mental health
setting was required to transfer Ms Buckley to A&E in any event. i

it was unclear whether the policies/procedures requiring the mobilisation of the medical
emergency tearn included guidance on whether an ambulance should be called, and
when.

ACTION SHOULD BE TAKEN

in my opinion action shauid be taken to prevent future deaths and | believe you or 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 16 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 following Interested
Person - | have also sent it to ho may find it useful or
of interest.

| arm aiso 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

_ fesponse, about the release or the publication of your response by the Chief Coroner.

| 16 September 2019 Jacgueliot Devenish

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from St Andrews Healthcare R Pdf (PDF)
St Andrew's 
HEALTHCARE 

Executive Directorate 

T:01604 616409 

Jaqueline Devonish 
Assistant Coroner 
Constabulary Block 
Angel Square,  Angel Street 
Northampton 
NN11ED 

8 November 2019 

Dear Ms Devonish 

Ref:  Blaithin Grianne Buckley deceased 

Further to the Regulation 28 notice received by St Andrew's Healthcare dated 15 September 2018,  I  am 
providing a response to the matter of concern which was the delay in calling for an ambulance to transfer 
Ms  Buckley to the General  Hospital. While the evidence provided to the Court indicated that an earlier 
arrival  at  the  General  Hospital  would  not  have  altered  the  outcome  in  this  instance,  St  Andrew's 
recognises that there is a need for greater clarity around the recognition of a medical emergency and how 
and when an ambulance is called.  To that end the Charity has taken the following steps: 

1)  The  Charity  uses  the  National  Early  Warning  System  (NEWS)  recording  system  to  aid  the 
recognition of the deteriorating patient. A 'red -top alert' - ie a Charity wide alerting notice - has 
been sent out concerning the use of the National Early Warning System (NEWS) chart.  This alert 
has been further discussed at governance meetings at different levels to increase awareness and 
to confirm the ongoing and correct use of the chart.  -Action completed on 10 September 2019. 
2)  NEWS  training  is  mandatory for all  staff as an  e-learning  module  and  the training  has  been 
refreshed  and  continues to be rolled  out as part of the  Immediate Life Support training for all 
registered nursing staff. 

3)  The policy concerning the management of a deteriorating patient is being reviewed and refreshed 
to provide clarity on the actions to be taken in the event of a patient experiencing deteriorating 
physical  health and requiring medical  intervention.  This is due for implementation on or before 1 
January 2020. 

4)  One specific and significant change in the procedure that has already been implemented is that 
when a  medical  emergency is called,  an  ambulance is also called  rather than leaving  it to the 
discretion of the nursing team as was previously the case.  This will enable a faster response to 
medical emergencies. Action completed on 7 November 2019 

5)  Responses to  medical  emergencies  including  ambulance attendances will  be monitored  in the 
relevant governance meeting chaired by the Director of Physical  Healthcare (the monthly physical 
healthcare group) with necessary escalation where problems or challenges are found. 

6)  These changes have been shared with  NHSE specialist commissioning (the lead commissioner 
for St Andrew's) and will continue to be monitored  in the regular bi-monthly NHSE St Andrew's 
Quality meetings. 

[ ~\ INVESTORS 
~JIN PEOPLE 

Registered Office St Andrew's Healthcare, B,lling Road, Northampton NNl SDG 

Telephone 01604 616000  Website www srah.org 
Registered Charity Number 1104951  Old Charity Number 202659  Company Number 5176998 

 
 EALTHCA~E 

Executive Directorate 

Please do contact me if you require any further clarification or information about this matter and the 
actions we are taking to address this issue. 

Yours sincerely 

Executive Medical Director 
St Andrew's Healthcare 

f' '\ INVESTORS 
~_JIN PEOPLE 

Registered Office St Andrew's Healthcare.  8,11,ng Road,  Northampton NN1  SDG 

Telephone 01604 616000  Website www.stah org 

Registered Charity Number 1104951  Old Charity Number 202659  Company Number 5176998

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