Prevention of Future Deaths reports · 2020

Ashley Walker

Regulation 28 report to prevent future deaths, reference 2020-0019, written 31 Jan 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report31 Jan 2020
Reference2020-0019
DeceasedAshley Walker
CoronerSean McGovern
Coroner areaWarwickshire
CategoryEmergency services related deaths (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

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: 

1.  Chief Executive – West Midlands Ambulance Service 

1 

CORONER 

I am S McGovern, senior coroner, for the coroner area of Warwickshire. 

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 19 August 2019  I commenced an investigation into the death of, Ashley WALKER, 
25 years old. The investigation concluded at the end of the inquest on 30 January 2020. 
The conclusion of the inquest was suicide. 

4 

CIRCUMSTANCES OF THE DEATH 

On 17 August 2019, Mr Walker telephoned West Midland Ambulance Service (WMAS) 
and informed them he had ingested 
to his property and arrived at 1324. On arrival Mr Walker’s Glasgow Coma Score was 3 
which increased to 6 after the administration of oxygen. The crew continued to treat Mr 
Walker until 1345 when they were directed to leave as the scene was said to be 
hazardous to their health. The scene was not hazardous and there was no requirement 
for the crew to leave. Mr Walker was left unattended for 45 minutes until the fire crew 
extricated him from the building. He was not breathing when he was extricated. I heard 
evidence that he had ‘ a real chance of survival’ had the crew not left.  

. An ambulance crew was dispatched 

5 

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)  It is apparent that a communication error confused the ingestion of 

 with a spillage of 

. 

(2) 

 toxicity is a recognised method of suicide and I heard evidence 
from a WMAS staff member that there is an effective antidote (methylene blue) 
but this was not available on the ambulance. 

6 

ACTION SHOULD BE TAKEN

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 In my opinion action should be taken to prevent future deaths and I believe you as Chief 
Executive of the WMAS have the power to take such action.  

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 27 March 2020. 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. 

8 

COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and to the following Interested 
Persons – (a) Family of Mr Walker (via his mother 

) 

I 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 

31 January 2020                                              
Senior Coroner S McGovern

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 West Midlands Ambulance Service 1 (PDF)
Your Ref: 01062-2019   
Our Ref: COR 3383 

Mr S McGovern 
Warwickshire Justice Centre 
Newbold Terrace 
Leamington Spa  
CV32 4EL 

21 February 2020 

Dear Mr McGovern 

Re: Regulation 28 Report to Prevent Future Deaths - Ashley Walker (Deceased) 

Thank you for your email dated 4 February 2020 attaching your Regulation 28 Report.   

Please see our response to your concerns below: 

Concern 1 
It is apparent that a communication error confused the ingestion of sodium nitrate with a 
spillage of sodium nitrate. 

Response  
Following this incident we have instructed all of our staff to remove the WISER (Wireless 
Informaton  System  for  Emergency  Responders)  App  from  all  work  mobile  phones  and 
tablets. The App will now only be used following training by Tactical Incident Commandars 
(TICs),  the  National  Inter-Agency  Liaison  Officer  (NILO)  and  team  leaders  in  our 
Hazardous Area Response Team (HART). This is to ensure the risk of harm to both our 
patients and staff is reduced and to mitigate confusion at scene, as crews on scene will 
only be able to access advice from trained officers. 

As  a  Trust  we  have  also  produced  further  guidance  in  relation  to  Individual  Chemical 
Exposure  (ICE)  incidents  which  highlight  the  clinical  management  differences  between 
individual ingestion and chemical spills for all of our Officers. 

Concern 2 
Sodium  nitrate  toxicity  is  a  recognised  method  of  suicide  and  I  heard  evidence  from  a 
WMAS staff member that there is an effective antidote (methylene blue) but this was not 
available on the ambulance. 

Response  
We  are currently reviewing whether it would be feasible for our Hazardous Area Response 
Team  (HART)  paramedics  to  carry  and  administer  methylene  blue  along  with  other 
medications  to  clinically  manage  cases  where  there  has  been  chemical  ingestion  of 
sodium  nitrate.    The  Lead  Paramedic  for  the  Trust  has  raised  this  nationally  with  the 
National Ambulance Resilience Unit (NARU) clinical sub-group, with a view to making this 
standard practice nationally.  

 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 Can I please take this opportunity to pass on my sincere condolences to the family of Mr 
Walker. 

I hope this response provides you with the appropriate level of assurance that as a Trust 
we have dealt with the concerns highlighted within your report. 

If you require any further assistance, please do not hesitate contact me. 

Yours sincerely 

Professor Anthony C. Marsh  
Chief Executive Officer

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