Prevention of Future Deaths reports · 2020

Ibiyemi Ereoah

Regulation 28 report to prevent future deaths, reference 2020-0048, written 2 Mar 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Mar 2020
Reference2020-0048
DeceasedIbiyemi Ereoah
CoronerNadia Persuad
Coroner areaEast London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBarts Health NHS 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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

Dr Alistair Chesser, Chief Medical Officer, Trust Executive Office, Barts Health
NHS Trust, Ground Floor, Pathology Block, 80 Newark Street, London, E1 2ES

1 | CORONER

lam Nadia Persaud, Senior Coroner for the Coroner area of East London

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.
htto:/Avww.legislation.gov.uk/uksi/2013/1629/part/7/made

3. | INVESTIGATION and INQUEST

On the 16" July 2019 | commenced an investigation into the death of Mrs Ibiyemi
Ereoah. The investigation concluded at the end of the Inquest on the 26! February
2020. The conclusion of the Inquest was that she died as a result of natural causes
contributed to by neglect.

CIRCUMSTANCES OF THE DEATH

Mrs Ereoah attended Newham Hospital on the 31 October 2017 with lower abdominal
pain and anaemia. She underwent a number of investigations and concerns were
raised in relation to a possible sarcoma. Her case was discussed at an MDT meeting
where the concern of a possible sarcoma was downgraded to a likely benign fibroid.

The consideration of the case at the MDT was inadequate. Her gynae-oncologist was
not in attendance to present the case; there is no clear rationale as to why the concern
was downgraded. A hysteroscopy performed on the 15" December 2017 was
inadequate, as samples of the tumour and muscle wall should have been obtained.
Inappropriate reliance was placed upon the biopsy result, to exclude the possibility of a
sarcoma. In February 2018 Mrs Ereoah was booked for a total abdominal hysterectomy.
She was inappropriately deemed unfit for surgery and did not undergo surgery at that
time. There was 4 month delay in obtaining a consultant anaesthetic review of her
operative fitness. Had Mrs Ereoah undergone surgery in February 2018, her death on
the 17" September 2018 would have been avoided. Mrs Ereoah continued to present to
hospital with severe anaemia between February 2018 to August 2018. She underwent a
total abdominal hysterectomy on the 30" August 2018. Shortly after surgery she was
diagnosed with a high-grade uterine sarcoma. She was discharged from Newham
hospital and readmitted to Queens hospital on the 10 September 2018. She passed
away as a result of a metastatic leiomyosarcoma on 17 September 2018.

5 | CORONER’S CONCERNS
The MATTERS OF CONCERN are as follows:

1. Many of the concerns arising in this case were considered to be due to an
insufficiency of gynae-oncology consultant cover at Newham University hospital.
The lack of adequate Consultant cover was deemed to have contributed to the
lack of advocacy at the MDT meeting; the inability to challenge the MDT

conclusion and the lack of Consultant overview of the recurrent admissions. In
July 2019, the Trust agreed two key actions to address this deficiency:

¢ Clinical Leads at the RLH and NUH to review gynaecological oncology staffing
and job planning, to ensure adequate administration time; cover when on
leave/programmed for other duties, such as hot weeks.

e There should be an urgent organisational development/service level review of
the NUH gynae-oncology team that is independent of the site.

As at the date of the Inquest, neither of these necessary actions had been
completed.

2. Mrs Ereoah was deemed unfit for surgery by a clinical nurse specialist on the
16'" February 2018. The nurse requested a consultant review which should
have taken place within 3-5 weeks. It did not take place until 16 weeks later.
The Inquest heard evidence that there was no system in place to ensure that all
consultant reviews were carried out within a timely manner.

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 26" April 2020. |, 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 husband of the
deceased. | am also forwarding a copy to the Care Quality Commission and Director of
Public Health

| 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] 2. 3. LOIAT [SIGNED BY CORONER] SS AW) | -—

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