Prevention of Future Deaths reports · 2020

Sarah Young

Regulation 28 report to prevent future deaths, reference 2020-0119, written 10 Feb 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Feb 2020
Reference2020-0119
DeceasedSarah Young
CoronerEmma Whitting
Coroner areaBedfordshire and Luton Coroner Service
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBedford Hospital NHS Trust · Cambridge University Hospitals NHS Foundation Trust
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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

47189-2019

Senior Coroner - Emma Whitting
Bedfordshire & Luton
REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:
Mr Stephen Conroy, Chief Executive, Bedford Hospital NHS Trust
CORONER

1

I am Emma WHITTING, Senior Coroner for the area of Bedfordshire and Luton Coroner
Service

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.
http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made

3

INVESTIGATION and INQUEST

On 30 April 2019 I commenced an Investigation into the death of Sarah YOUNG aged
34. The investigation concluded at the end of the Inquest on 28 January 2020. The
conclusion of the Inquest was a Narrative Conclusion: The Deceased died from an
extensive cerebral sinus thrombosis; the delay in her receiving the appropriate medical
treatment may have reduced her chances of survival but could not be said to have
contributed to her death.

The medical cause of death was:

Ia Bilateral Venous Infarction
Ib Cerebral Venous Sinus Thrombosis

4

CIRCUMSTANCES OF THE DEATH
On 9 April 2019, after suffering with headaches for 2 days, the Deceased was admitted
by ambulance to Bedford Hospital with increasing confusion, immobility and fluctuating
levels of consciousness. Following her arrival at the Emergency Department at 16.43
hours, she underwent a CT head scan. The Neurosurgical Team were contacted and
advised that, as there was a suspicion of a venous sinus thrombosis, she should also
have a CT venogram and receive a neurological review. Although she subsequently
required care under the Intensive Care Unit and underwent a CT venogram at 21.28
hours, she did not receive a neurological review until 16.15 hours on 10 April 2019; the
neurological review resulted in advice to start her on intravenous heparin which was
commenced at 17.17 hours that same day. Her condition did not improve and she was
declared to have suffered brain-stem death at 12.30 hours on 12 April 2019. Although
earlier treatment with intravenous heparin could have increased her chances of
##DW<<corAddress>>
Tel ##DW<<corTel>> | Fax ##DW<<corFax>>

 survival, the medical opinion available at the Inquest was that it would not have
prevented her death.

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) Although Sarah was referred to the Medical Team at 20:00 on 9 April 2019 whilst
she still in the Emergency Department awaiting the CT venogram, she was never seen
by them. The evidence to the Inquest from the Medical Registrar on call that evening
was that “if a decision to admit to ITU is made, an immediate or urgent medical review
is not required, as the patient is under the direct care of the ITU team” yet the evidence
from one of the ITU Consultants in charge of her care was that the ITU Team do rely on
the Medical Team to assist in progressing a diagnosis( including involving a Neurologist
where required) and that it was a matter of regret for him that there had not been
more Medical advice in this case;
(2) Although the Neurosurgical Team had advised the Bedford Emergency Department
Team at 19.45 hours on 9 April 2019 that a Neurological opinion should be sought
alongside the CT venogram, such opinion was not sought until 16.15 hours on 10 April
2019 (the following day) and, even then, only after further prompting from the
Neurosurgical Team. The Inquest heard that a Neurological opinion was likely to have
involved immediate consultation with the on-call Neuroradiologist which would have
resulted in a much earlier diagnosis and treatment of the Cerebral Venous Sinus
Thrombosis;
(3) The Inquest heard that referrals to the Bedford Neurologist (only available during
Monday - Friday working hours) are not always picked up through the standard referral
system and often require personal 1:1 contact between clinicians.
ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe you,
Stephen Conroy, have the power to take such action.

6

7

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 06 April 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 Roland Sinker, Chief Executive of Cambridge University Hospitals NHS
Foundation Trust and

(Deceased’s brother).
Bedfordshire and Luton Coroner Service
Tel 0300 300 8383 | FAX

 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

Emma WHITTING
Senior Coroner for
Bedfordshire and Luton Coroner Service
Dated: 10 February 2020

Bedfordshire and Luton Coroner Service
Tel 0300 300 8383 | FAX

Related reports

Other reports by Emma Whitting

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Bedford Hospital NHS Trust

See every Prevention of Future Deaths report matching Bedford Hospital NHS Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.