Prevention of Future Deaths reports · 2020

Kobi Wright

Regulation 28 report to prevent future deaths, reference 2020-0143, written 16 Jul 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report16 Jul 2020
Reference2020-0143
DeceasedKobi Wright
CoronerJacqueline Lake
Coroner areaNorfolk
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Child Death (from 2015)
Sourcejudiciary.uk record · original PDF
Responses published2

The report

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

Regulation 28: REPORT TO PREVENT FUTURE DEATHS 

. 
REGULATION 28 REPORT TO PREVENT DEATHS 

THIS REPORT IS BEING SENT TO: 

Dr 
c/o RadcliffesLeBrasseur
Ref:  WRC/KMD/900500.4069
85 Fleet Street 
London 
EC4Y 1AE 

1.  CORONER 

I am Jacqueline LAKE, Senior Coroner for the area of Norfolk 

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 14/08/2019 I commenced an investigation into the death of Kobi David WRIGHT  aged Less than 
1 day.  The investigation concluded at the end of the inquest on 9 July 2020.  The medical cause of 
death was: 

1a) 
1b) 
1c) 
2 

Preterm Stillbirth 
Complicated Instrumental and Caesarean Delivery 
-
Prematurity 

The conclusion of the inquest was: Stillbirth. 

4.  CIRCUMSTANCES OF THE DEATH 

Maternal membranes ruptured on 1 March 2019 and there was admission to James Paget University 
Hospital where monitoring was undertaken. On 3 March 2019 examination and reassessment took 
place. Following an examination at 13:30 and again at 13:50, forceps delivery was attempted. Kobi’s 
head was delivered vaginally but delivery of his body was unsuccessful. An attempt was made to 
deliver Kobi by caesarean section which was initially unsuccessful, and delivery by forceps re-
attempted. This was not successful and delivery by caesarean section was again attempted. Kobi was 
eventually delivered at 15:28 hours. He showed no signs of life and after attempts at resuscitation and 
assessment Kobi was declared dead. 

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.  D 

evidence was that the cervix was almost fully dilated at 12:30 and 13:50 examinations 

at which point it could be “pushed easily”, which was not supported by midwife’s evidence of 
examination at 13:30 (8cm) nor of what transpired at attempted delivery, namely that cervix 
“retracted” to 6 to 7cm; 

2.  Dr 

evidence was that during a telephone conversation at 13:57 he did not express 

concern about the CTG reading and did not give this as the reason to proceed to delivery of Kobi. 
This was in conflict to the evidence of Dr 
Consultant Obstetrician/Gynaecologist and to his 
first statement 16.7.2018 para 6. 

3.  Dr 

evidence at the inquest that he expressed concern about Kobi’s mother being pre-

 term, high risk with prolonged rupture of membranes was not contained in his first statement nor 
in his record of the conversation. In any event the evidence of Ms 
who gave evidence was that these would not be reasons in themselves to proceed to an early 
delivery at that time. 

and the expert Mr 

4.  Further 

second statement 21.4.2020, refers to some consideration being given to 

variable decelerations and variabilities contained in the CTG trace when making his decision to 
proceed to delivery at that time. It was accepted by Dr 

consultant and Mr 

Ms 

expert, that the CTG readings were within normal range and would not be a reason to 

proceed to delivery at that time. Their evidence was it would be appropriate in light of the full 
clinical picture and the CTG readings to “wait and see” how matters progressed. 

5.  Dr 

gave evidence that his arranging to take Kobi’s mother to theatre and prepare for 

delivery, and then carrying out a further vaginal examination at that time, would stand in for a later 
examination to see how matters were progressing. This was not regarded as good practice by the 
expert on the basis, it would be better to carry out a further examination after an hour, and then 
decide how to proceed with the delivery. 

6.  Dr 

did not accept the Consultant’s offer of assistance but regarded himself as fully 

competent to carry out the procedure. 

7.  Dr 

proceeded with a forceps delivery of the baby’s head. The body did not follow and the 

had not encountered before. Nor had Mr 

the expert 
cut the cervix and rotated the head and tried unsuccessfully to deliver the 
expert said in evidence the baby’s head on its own 

cervix “retracted” (which Dr 
witness). Dr 
shoulders through the incision. Mr 
should never be rotated due to the damage this can cause. 
instructed a midwife to replace the baby’s head. 
then attempted to deliver the baby via caesarean section, which was unsuccessful. 
then attended and arranged for the Paediatric Team to be called. She was eventually 

8.  Dr 
9.  Dr 
10.  Ms 

able to deliver the baby 

11.  There was a conflict in the evidence as to whether Ms 

applied both forceps blades. The 

evidence of Ms 
was preferred in that she was the one performing the procedure and would 
be best placed to know what she was doing and she had throughout been a good and competent 
witness. 

12.  There was no evidence that Dr 

had undergone training in emergency obstetrics in the 

recent period prior 3 March 2019. Dr 
instigation of North Devon District Hospital. 

has undergone training since 3 March 2019 but at the 

6.  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you 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 09 September 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: 

Chief Executive, James Paget University Hospital 

parents via Morgan Jones & Pett, Solicitors 

I have also sent it to 

Ethical Guidance Department, General Medical Council, Regents Place, 350 Euston Road, London 
NW1 3JN 
The Chief Executive, North Devon District Hospital, Raleigh Heights, Barnstaple EX31 4JB 
Department of Health 
Care Quality Commission 
Healthcare Safety Investigation Branch (HSIB) 
Healthwatch Norfolk 
Child Death Overview Panel 

 who may find it useful or of interest. 

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.  Dated: 16 July 2020 

Jacqueline LAKE
Senior Coroner for Norfolk 
Norfolk Coroner Service 
Carrow House 
301 King Street 
Norwich  NR1 2TN

Responses

2 responses 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 James Paget University Hospital (PDF)
r1'1:;1 

James Paget 
University Hospitals 
NHS  Foundation Trust 

Lowestoft Road 
Gorleston 
Great Yarmouth 
Norfolk 
NR31  6LA 

Main Switchboard: 01493 452452 

Direct Dial: 
Direct Fax: 

E mail:  complaints@jpaget.nhs.uk 

www.jpaget.nhs.uk 

26 August 2020 

2BAUG 2020 

Ms Jacqueline Lake LL.M 
Senior Coroner for Norfolk 
Carrow House 
301  King Street 
Norwich 
NR1  2TN 

Dear Ms Lake 

Re:  Regulation 28 Report to Prevent Future Deaths following the inquest into the 
death of Kobi  David Wright. 

T~ank you for your letter dated  16 July 2020 following your inquest into the death of Kobi 
David Wright.  Firstly,  I would like to reiterate my condolences on  behalf of the Trust to  Kobi's 
family for his sad  passing. 

Following the evidence heard at your inquest, the medical cause of death was given as: 

1a) Pre term  Stillbirth 
1 b) Complicated  Instrumental and  Caesarean Delivery 
1c) -
2) Prematurity 

1.understand that you  have made 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. 

The Trust has carefully considered the issues set out in  your letter ih  order to respond to 
your concerns. 

The Trust 'is  continuing to take steps to recruit substantive doctors as first preference. 
Unfortunately,  it is not always possible to employ only substantive staff,  and to ensure safe 
staffing levels are maintained across the services,  it is at times necessary to employ locum 
doctors. 

The Trust's Executive Lead for Workforce is currently reviewing the recruitment process fo 
ensure that suitably trained -and experienced doctors are comprehensively inducted at the 
hospital. This review will  be  concluded and the changes implemented by the end  of 
September 2020. 

 At present, the i;nedical  staffing team  request information from framework agencies to ensure 
the Trust has all compliant information  before employment of any doctor is agreed.  This 
information includes a copy of the CV,  two current references,  GMC and  DBS checks,  and 
Occupational Health (OH) records which are also r~viewed  with the Trust's OH  provider. A 
copy of the  individual's mandatory training  log  is provided by the agency: the agency's 
Responsible Officer will  e·nsure that training is up to date. 

The CVs,  training certificates and  references are approved  by the speciality's consultant 
body before employment to ensure they are safe to fulfil the vacancy.  Following your 
inquest, the reviewing  consultant will,  in  writing,  respond to the staffing team  confirming they 
are satisfied that the clinician  meets their requirements. This confirmation will  include the 
date and time the documentation was verified. 

Additionally, the Trust has started to work with the clinical  leads to  devise c;1  detailed person 
specification of all  essential and  desirable qualities for each speciality. This specification will 
be shared with the agency, with the expectation that only clinicians that meet these criteria 
will  be nominated for employment. 

In  a situation where a locum doctor is  required  at short notice,  and they do not meet all 
essential criteria, the staffing team will  carry out a risk assessment, with the clinical team,  to 
decide whether the clinician  can  be employed.  This risk assessment will consider any 
mitigating factors,  for example if they are named on the specialist register.  If it is appropriate 
for the clinician to work at the Trust, the risk assessment will  be signed  by the clinical  lead or 
th_eir deputy and  shared with the supervising clinician. 

On  day one at the Trust, locum doctors attend mandatory training  and engage in  a 
supervisory period in  their department to ensure they are orientated.  During this period,  the 
clinician will work alongside a substantive staff member to familiarise themselves with  local 
practice and  ensure they have the appropriate skills required for their employed position. 
This staff member will  be  responsible for observing experience and  skills during this period, 
and will  raise any concerns to the appropriate clinical  lead for action.  If a locum doctor is 
unable to participate in  a supervisory period,  this will also be risk assessed  by the staffing 
team  before working. 

After a period  of frequent employment, the Trust's current practice is to offer a substantive 
contract to the clinici.an.  The Trust supports its  permanent staff to continue with their 
professional development and offer training courses and  study leave to aid  this. This helps 
increase the pool of substantive doctors at the Trust providing  consistency within the 
services. 

The Trust works hard to maintain an  open culture and encourages staff to raise concerns to 
appropriate manag·ement;  this includes any capability issues. The hospital  is focussed  on 
patient safety and promptly investigates any concerns regarding a clinician's competence. 
The Trust's Medical  Director actively considers whether steps outside of the  hospital's local  · 
policy is  required and  if referrals to the GMC are required. 

I would  like to thank you for bringing your concerns to my attention.  If you  require anything 
further,  then ·please do not hesitate to contact me. 

 I understand that this letter may be shared witt, Kobi's family and  I would  like to take this 
· opportunity to again personally extend my sincere condolences for their loss. 

Yours sincerely 

Chief Executive
Response from Radcliffes Le Brasseur (PDF)
By Email 

STRICTLY PRIVATE & CONFIDENTIAL 

Jacqueline Lake  
Senior Coroner for Norfolk  
Norfolk Coroner Service  

Sent by Email Only 

7th Floor, 85 Fleet Street  
London  
EC4Y 1AE 
www.rlb-law.com 
Direct Dial +44 (0)20 7227 6746 

Tel +44 (0)20 7222 7040 
Fax +44 (0)20 7222 6208 
LDE 113 London Chancery Lane 
info@rlb-law.com 



9 September 2020 

Our Ref:  BM/BM/900500.4069 

Your Ref:   

23239827v1 

Dear Madam 

MDDUS: Dr 
Regulation 28 Report to Prevent Future Deaths  
Inquest touching on the death of Baby KW 

We write further to receipt of the Regulation 28 report addressed and for the attention of Dr 
following the inquest heard before you between 7 – 9 July 2020 touching on the death of Kobi David Wright.   

From the outset we confirm that very shortly after the inquest (and before the Regulation 28 report was 
 referred himself to the General Medical Council in view of the inquest outcome.  The 
received) Dr 
 is engaging with.   
Council have opened an investigation which Dr 

 in response to the concerns 
Nevertheless, we enclose for your consideration a document from Dr 
 has spoken with his colleagues at the North Devon District 
that are highlighted in your report.   Dr 
Hospital and has been proactive in his efforts to improve his knowledge and partake in training for obstetric 
emergencies.  

In particular, we would highlight that Dr 
, in addition to having completed the K2 Training Program, 
which includes a competency assessment tool, has made preparations to attend PROMPT training (Practical 
Obstetric Multi-Professional Training) when it resumes.   This has included him purchasing a copy of the 
PROMPT training manual which he is reviewing ahead of the course.  However, while awaiting that training, 
 is also re-reviewing the K2 courses that he completed prior to the inquest, but this time with the 
Dr 
inquest findings in mind.  Dr 
s reflections confirm that he has two simulator sessions outstanding to 
be undertaken in relation to the assessment of CTGs before he will again have completed this training.  The 
 in simulated ‘live atmosphere’ scenarios to make decisions in 
simulator sessions will challenge Dr 
 anticipates completing these simulator sessions in the next few 
respect of CTG management.  Dr 
weeks.    

Unfortunately, the availability of training courses to attend in person are limited as a result of the global 
, the Labour Ward 
Covid-19 pandemic.  However, Dr 
Lead at the North Devon District Hospital.  We enclose a letter from Mrs 
 which confirms that she 
holds  a  number  of  positions,  including  Risk  Management  Lead,  College  Tutor  and  Training  Programme 
Director  South  West  Peninsula.    We  therefore  suggest  she  is  very  well  placed  to  assess  Dr 
  and 
comment upon his practice, having been approach by him proactively seeking obstetric emergency training.  

 has attended two sessions with Mrs 

RadcliffesLeBrasseur LLP is authorised and regulated by the Solicitor's Regulation Authority (SRA number 
668181)  and  is  a  limited  liability  partnership,  registered  in  England  and  Wales  (registration  number 
OC428287) having its registered office at 7th Floor, 85 Fleet Street, London, EC4Y 1AE, where a list of 
Members of the LLP may be inspected.  We use the word 'partner' to refer to a Member of the LLP.  We 
use the name "RadcliffesLeBrasseur" and the abbreviation "RLB" to refer to RadcliffesLeBrasseur LLP. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Jacqueline Lake  

09 September 2020 

Page 2 



  was  a  presentation which  covered  the  obstetric 
The  first  session  Dr 
  attended  with Mrs 
s  reflection  document  that  he  was  tested  on  his 
emergency  topics.  It  will  be  noted  from  Dr 
understanding  of  how  he  would  manage  the  various  emergency  situations  by  Mrs 
  asking  him 
questions about the presentation and that he found this exercise useful.  This was a joint session with other 
junior doctors.  

The second teaching session was a one to one simulation training session which focussed on instrumental 
deliveries, deeply impacted head and risks of prematurity, being areas pertinent to the matters highlighted 
in the Regulation 28 report.   Dr 
 reflection confirms that he was asked to demonstrate the correct 
application of forceps in breach deliveries with the head in different positions.  

 confirms that Dr 

Mrs 
him perform a forceps delivery she is satisfied he is competent.  She also provides an example of Dr 
calling for assistance, appropriately, even though that assistance was not later required.   

 is booked to attend the PROMPT course, and that having observed 

In addition to the training with Mrs 
s request that he attend at 
Exeter Hospital, a busier unit than at North Devon Hospital, because it is likely to expose him to obstetric 
 to gather greater exposure to emergency care, 
emergencies.  This has been arranged in order for Dr 
albeit he will be an observer. This training is scheduled to occur in the next few weeks in accordance with 
the  consultant’s  availability.  In  the  meantime,  Dr 
  continues  to  keep  himself  updated  with  the 
guidance from the Royal College of Obstetrics and Gynaecology.  

 it has been arranged at Dr 

, a Consultant Obstetrician and Gynaecologist  at the North 
Lastly, we  enclose  a letter from Mr 
Devon  District  Hospital.    Mr 
  having  worked 
alongside  him  during  the  on-call  cover  of  Obstetrics  and  Gynaecology  and  also  in  various  clinics  and 
 knows the limitations of his practice and will ask for 
theatres.  Importantly, he too notes that Dr 
assistance if required.  He reports Dr 
 to have run labour ward emergencies with confidence.  Mr 
Eskandar  is  aware  that  Dr 
  is  making  every  effort  to  update  himself  in  all  aspects  of  obstetric 
emergencies following the inquest.  

’s  letter  confirms  that  he  has  observed  Dr 

Please note that both Mr 
providing a letter on behalf of Dr 
inquest but were both content to provide a letter in support of Dr 
actions.  

 received a copy of the Regulation 28 report before 
.  They were therefore both aware of the concerns raised at the 
s wider practice and remedial 

 and Mrs 

 response to the inquest findings, you will be 
We trust that in providing this information about Dr 
reassured that Dr 
 has taken this matter very seriously indeed and has committed to improving his 
knowledge and practice so as to ensure that the tragic circumstances of this case are never again repeated. 

Yours faithfully 

RadcliffesLeBrasseur LLP 

RadcliffesLeBrasseur LLP 

Encl.  

 
 
 
 Dr. 

Reflection on HM Senior Coroner Report 

1. 

I have carefully considered the report of the Coroner and the evidence presented during the 
inquest.  I was troubled to understand that  the  Coroner had concerns about my evidence, 
practice and emergency training.   I have as a consequence taken steps to address what I can 
and undertaken further training in obstetric emergencies.  I also self-referred to the General 
Medical Council and will engage with any subsequent investigation by the Council.   

2.  On reflection of this case, I accept that it was an option to adopt a ‘wait and see’ approach 
to manage the patient rather than to proceed to a trial of instrumental delivery.  I recognise 
that instead of allowing an hour for the patient to be prepared for theatre, where there is no 
clinical urgency, it would be  better practice  to leave  the patient in the room and examine 
her  an  hour  later  and  again  consider  the  options  at  that  time.    Where  I  am  in  any  doubt 
about the best way to proceed I have learnt to involve more the consultant on call. 

3.  My concern about the CTG was from the previous ones and the part I have seen after I have 
spoken  to  the  consultant  (shortly  before  2  pm),  but  I  agree  that  the  CTG  was  normal  as  I 
have documented in the notes before speaking with the consultant.  I must accept that from 
, she understood that 
my explanation, regardless of what I had intended and told to Dr 
I was  raising a concern about  the CTG  being abnormal at that time  and that informed her 
agreement to proceed to a trial instrumental delivery.  This was not correct.  I have learnt as 
a result of this process to discuss more details about the patient with the consultant on call 
and  ask  him/her  for  the  advice  and  document  this  conversation  separately  in  the  notes 
where the consultant is not able to also review the underlying information e.g. the CTG, for 
themselves. 

4. 

In  this  case  Dr 
,  asked  me  if  I  am  happy  to  proceed  with  the  procedure,  as  all  the 
consultants do when I ring them. I did not expect any problem doing the forceps or the CS as 
I have performed 1000’s of each during my career and I always tell the consultant to come 
and join me if I am expecting problems and will definitely call him/her if I am facing any. So 
in this case I had no reason to ask Dr 
 to attend at the time of examination in theatre.  I 
would not hesitate to ask for assistance or supervision if I have any concern about possible 
complications.  

5. 

I  instructed  the  senior  midwife  to  replace  gently  the  head  into  the  vagina  while  I  was 
changing my gloves and gown to start the C.S. I accept I should have done this myself but I 
was running against time to start the C.S before the baby started to breath as in this case we 
would  have  been  in  a  more  difficult  situation.  I  learnt  that  in  the  future  in  any  similar 
situation I will replace the head myself inside the vagina using Zavanelli manoeuvre.   

 
 
 
 
 
 
 
 6.  Regarding my training, I have always kept myself with up to date knowledge and completed 
my  CPD  hours  requested  by  the  Royal  College.  Before  the  incident,  I  have  attended  many 
CTG and departmental meetings to discuss emergency obstetrics and how to avoid mistakes.  
I recognise that as a professional and particularly as a locum it is my responsibility to ensure 
my training is up to date.  After the incident and before the hearing, I have continued to be 
up to date with my CPD points.  I have set out below some of the relevant courses/ training 
that I have attended: 

Post March 2019 (pre-inquest) 

a. 

I  have  attended  the  Annual  International  Royal  College  Conference  in  June  2019 
where all the updates in our speciality are discussed.   

b.  K2  training  courses:  As  Prompt  courses  were  not  available  in  2020  because  of  the 
Covid 19 pandemic, I did the alternative K2 courses in March and April 2020. I have 
passed  all  the  14  courses  covering  all  the  Obstetric  emergencies.    Each  one  lasts 
from  30  minutes  to  4  hours.  Having  videos,  diagrams  and  texts  and  then  10-20 
questions which one  has to get  80% marks to pass in each course.  These  cover  14 
subjects of obstetric emergencies such as antenatal and intrapartum CTG, errors and 
limitation  of  fetal  monitoring,  shoulder  dystocia,  Maternal  haemorrhage  and 
collapse, cord presentation and cord prolapse.  

c. 

In perinatal and audit meetings we discuss any problems that led to adverse effects 
on the mother and the fetus and how to avoid them in the future. 

d.  The  CTG  meetings,  I  attended  over  the  years,  help  me  to  identify  abnormal  CTG’s 
and  the  proper  action  as  discussed  with  the  group  of  doctors  in  the  department. 
Also courses are useful for me to update my knowledges in the management of all 
obstetric emergencies. Many of these meetings are now done online as the number 
attending is very limited due to Covid 19 pandemic. Some Trusts now using a type of 
software to allow the consultant to see the CTG when he is away from the hospital 
but this is not available to all hospitals. 

Post July 2020 

a.  After  the  inquest,  I  have  asked  my  consultants  at  North  Devon  District  Hospital 
about  arranging extra training in Emergency Obstetrics.  I have  attended a session 
,  the  Clinical  Lead  for  Labour  Ward  covering  all  obstetric 
with  Mrs 
emergencies such as Sepsis, Pre-eclampsia, eclampsia, Thromboembolism, Obstetric 
Haemorrhage, Cord prolapse and shoulder dystocia on 6 August 2020.  This session 
was showing online statements and diagrams and she asked me many questions on 
each subject  as what  to do in these  emergencies and about  how  to  manage these 

 
 
 
 
 
 
 cases and I have passed them all.  This was quite useful to update myself on all these 
subjects. 

b.  On  13  August  2020  I  attended  a  simulator  course  covering  Breech  delivery  and 
forceps delivery for different positions as OP, OA and for the after coming head in 
vaginal breech delivery. I  was  given a  model  of fetus,  pelvis and pair of  forceps to 
demonstrate  how  to  deliver  the  breech  in  different  positions  and  to  apply  the 
forceps and deliver the head in different positions as OA or OP or the aftercoming 
head of the breech. 

c. 

I  will  be  attending  the  PROMPT  (PRactical  Obstetric  Multi-Professional  Training) 
course  when  it  is  again  available.    This  is  practical  training  that  has  to  date  been 
postponed as a result of Covid. However, I have in anticipation of completing such 
training purchased a copy of the PROMPT  training manual which I am working my 
way through.  I was told that Prompt is not going to be offered in its classical way 
this year, but  as I have  completed the K2 courses  in March / April this year, I was 
told that I can complete the course on line to get the certificate. I did last week the 
same 14 K2 subjects mentioned before but as assessments which I need to get over 
80% to pass. I passed all of them at high marks. I am left only with 2 CTG simulators 
which  I  will  do  next  in  the  next  few  weeks  and  then  I  will  complete  what  Prompt 
needs  and  will  get  the  certificate.  The  simulator  puts  me  in  what  is  called  live 
atmosphere  with  conditions  that  I  have  to  assess  and  decide  on  the  management 
which is very useful. 

d. 

I requested to go to a busy unit for a day to learn more about emergency obstetrics 
and they will kindly arrange for me to go to Exeter in the next few weeks when it is 
convenient for the Consultant.  This will allow me to see more obstetric emergencies 
in one day and share in the management decision. 

e. 

In the next year I will attend the live prompt course which helps me to improve in 
the management of obstetric emergencies and to improve communication skills. 

Royal College Guidance and GMC Good Medical Practice  

I always endeavour to comply with the Royal College guidance and the GMC Good Medical Practice 
guidance which includes: 

1.  Make the care and the safety of the patient my first concern. 
2.  To be competent and keep my professional knowledge and skills up to date by attending 

regular clinical meetings and courses.  

3.  Take prompt action if I think the patient safety is being compromised and ask for help if 

required. 

4.  Establish  and  maintain  good  relationship  with  the  patients,  the  nursing  staff  and  my 

colleagues.  

5.  Being open, honest and acting with integrity as a doctor. 

 
 
 
 
 
 Regarding the Royal College Guidelines: 

a. 

b. 

c. 

I  have  read  all  their  green-top  guidelines  which  are  emailed  to  me  frequently 
and  mainly  in  obstetric  emergencies  as  shoulder  dystocia,  Antepartum  and 
postpartum  haemorrhage,  shoulder  dystocia,  umbilical  cord  prolapse  and 
maternal collapse. 
I  do  regularly  the  Tog  questions  which  are  sent  to me  by  the  Royal  College.  It 
consists of a subject followed by a series of multiple choice  questions and you 
have to get 80% to pass and get your CPD points. They cover many subjects in 
Obstetrics & Gynaecology. 
I attend the annual international meeting of the Royal College when held in the 
UK  as  I  did  in  June  2019  in  London.  It  is  an  excellent  chance  to  attend  many 
lectures  and  discussions  with  small  group  meetings  about  the  updates  in  our 
speciality. 

I will continue to keep my practice under review as I never want a repeat of this sad case.  I wish to 
again send my condolences to the family of Kobi Wright.  

 
 
 I can confirm that I am writing the following statement following a request from Mr 
and I am happy for my letter to be provided to HM Senior Coroner for Norfolk and the General 
Medical Council. 

I have been provided with a copy of the Regulation 28 Report to Prevent Future Deaths concerning 
 but I have not seen the patient’s notes or the investigation report by the hospital. 
Dr 

My name is Miss 
Gynaecology Consultant in 2016 in North Devon District Hospital. 

, I qualified as a doctor in 2003, and I became an Obstetrics and 

I am the Labour Ward Lead in North Devon District Hospital and the Training Programme Director on 
the South West training programme. 

 has worked in North Devon District Hospital on and off since the 25th of November 2019 in 

Dr 
a middle grade locum capacity. 

He has been very proactive at requesting Obstetric emergency training and has attended two 
sessions with me. 

The first session of Obstetric emergencies he attended included a presentation for Obstetric 
emergencies such as sepsis, shoulder dystocia, APH, PPH, cord prolapse. The session was also 
attended by new junior doctors in the department and it is part of the induction for new junior 
doctors. 

The second teaching session was a one to one “hands on” simulation training session with myself on 
instrumental deliveries, deeply impacted head and risks of prematurity. 

Unfortunately our PROMPT course has been cancelled due to Covid however we are looking into 
restarting this and respecting social distancing rules. 

I have booked Dr 

 on our next PROMPT course in the NDDH. 

I am also aware that Dr 

 has completed his K2 training for CTG and Obstetric emergencies. 

I have observed Mr 
competent manner. 

 perform a forceps delivery in theatre of a term baby and he did that in a 

I am aware of an incident where he performed a second stage Caerarean section following a 
Consultant’s decision in north Devon District Hospital and he had difficulty in delivering the head at 
Caesarean section. 

He called the Consultant and he dis-impacted the baby’s head himself and delivered the baby before 
the Consultant arrived. 

 has been very proactive to attend Obstetric emergency training with myself and is keen to 

Mr 
keep up to date. 

Mrs 

 
 
 
 Consultant Obstetrician & Gynaecologist 

Labour Ward Lead 

Risk Management Lead 

College Tutor 

Training Programme Director South West Peninsula 

Tel : 

email: 

web: www.northdevonhealth.nhs.uk 

 
 
 
 
 
 
 
 
 
 
 
 
 Department of Obstetrics & Gynaecology                                                                                  North Devon District Hospital 
         Raleigh Park 
Mr 
Consultant Obstetrician & Gynaecologist                                                                                                      Barnstaple, Devon 
Tel: (01271) 322786    Fax: (01271) 311653                                                                                                                   EX31 4JB 

Tel: 01271 322577 
Fax: 01271 311541                                                 

Minicom: 01271 322746 
www.northdevonhealth.nhs.uk 

OE/KM 

28th August 2020 

Re: Dr 

I am writing this statement following a request from Radcliffe SLE Brasseur LLP to provide a statement 
 which can be provided to the HM Senior Coroner for Norfolk and General Medical Council. 
for Mr 

I  have  been  made  aware  that  Dr 
provided with a copy of the regulation 28 report. 

  was  criticised  at  an  inquest  in  July  2020  and  I  have  been 

I am a Consultant Obstetrician and Gynaecologist at Northern Devon Healthcare Trust.  I am the Lead 
Clinician for the Obs & Gynae Department.  I have FRCOG and MFSRH.  I have 33 years of experience 
in obstetrics and gynaecology.   

Dr 
joined our Obs & Gynae Department as a Locum SAS Doctor from November 2019.  He has 
been involved in the Middle Grade Rota and he worked with me during the on-call cover of Obstetrics & 
Gynaecology and also in various clinics and theatres.  I am aware that Dr 
 has completed the K2 
Training  Programme of  Obstetric  Emergencies  which is  a  substitution  of the PROMPT Training during 
the  Covid-19  pandemic.    Also,  I  am  aware  that  Dr 
  had  a  simulator  training  session  with  the 
Labour  Ward  Lead  including  the  obstetrics  emergencies and instrumental  deliveries.   He is up to date 
with his RCOG CPD.  He is intending to go to Royal Devon & Exeter Hospital to have further training in 
this busy hospital.   

During  his  stay  in  our  Department,  I  found  Dr 
  a  competent,  experienced  Obstetrician  and 
Gynaecologist.    He  ran  labour  ward  emergencies  with  confidence  and  I  am  not  aware  of  any  major 
incidents during his time with us.  He is aware of his limitations and he asks for help when indicated.  He 
is  aware  of  his  current  circumstances  and  he  is  making  every  effort  to  make  himself  updated  with  all 
aspects of obstetric emergencies which I feel he is competent in doing so. 

Yours sincerely  

Mr 
Consultant Obstetrician & Gynaecologist 

 FRCOG MFSRH 

1

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