Prevention of Future Deaths reports · 2020

Leslie Clewarth

Regulation 28 report to prevent future deaths, reference 2020-0229, written 10 Nov 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Nov 2020
Reference2020-0229
DeceasedLeslie Clewarth
CoronerKevin McLoughlin
Coroner areaWest Yorkshire
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedMid Yorkshire Hospitals NHS Trust
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)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. Mid Yorkshire Hospitals NHS Trust

1 | CORONER

lam Kevin McLoughlin, Senior Coroner, for the Coroner area of West Yorkshire (E).

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.

3 | INVESTIGATION and INQUEST

On 23/04/20 | commenced an investigation into the death of Leslie Clewarth aged 86.
The investigation concluded at the end of the Inquest on 06/11/20.

The Inquest reached a narrative conclusion to the effect that Leslie Clewarth died in
hospital from natural causes: 1a. aspiration pneumonia, ib. small bowel obstruction 1c.
adhesions within the peritoneal cavity and Il. ischaemic heart disease.

4 | CIRCUMSTANCES OF THE DEATH

The family of Mr Clewarth were called before 7am on 07/04/20 due to the deterioration
in his condition. They were permitted to remain at his bedside throughout the day,
notwithstanding the COVID19 visiting restrictions then in force.

Concerns were raised by his daughter and her husband in relation to:

(1) The NG tube previously inserted was no longer in place.

(2) The syringe driver was empty at some point after 4pm that day. In consequence,
he was deprived of essential medication and hence died in agony after choking
on faecal material aspirated.

{3) After he had died an injection of Buscopan was made.

(4) He had not been treated for a severe coronary condition despite being in
hospital for many weeks.

Medical records which should have documented these matters were missing or
inadequate.

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) Without adequate records showing the care provided or dosage administered, it
was not possible to corroborate the testimony of nurses who had attended to Mr
Clewarth on the afternoon he died. This fuelled the suspicions raised by his
daughter and her husband.

(2) Drugs which were left unused after Mr Clewarth’s death were not accounted for.

Without proper records there is a risk that essential care may not be provided or is
erroneously duplicated, thus potentially putting a patient's safety or health at risk.

ACTION SHOULD BE TAKEN

in my opinion action should be taken to prevent future deaths and [ believe your
organisation has 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 15 January 2021. | have extended this period on account of the ongoing
COVID crisis and the forthcoming holidays.

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 following Interested

lam 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.

10th November 2020 7 1
Kec Mey —— Sane Co tanert

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 Mid Yorkshire Hospitals NHS Trust 1 (PDF)
Your ref: 
Our ref: 
Date: 13 January 2021 

Mr K McLoughlin 
Senior Coroner 
Coroner’s Office and Court 
71 Northgate 
Wakefield 
WF1 3BS 

Dear Mr McLoughlin 

Medical Director 
Trust Headquarters and Medical Education Centre 
Aberford Road 
Wakefield 
WF1 4DG 

PA:

Re: Inquest touching the death of Leslie Clewarth (deceased) 

I am responding on behalf of the Trust to the Regulation 28 Report to Prevent Future 
Deaths issued by yourself to The Mid Yorkshire Hospitals NHS Trust on 10th November 
2020. 

The Matters of Concern raised in your report were: - 

1)  Without adequate records showing the care provided or dosage administered, it 
was not possible to corroborate the testimony of nurses who had attended to Mr 
C on the afternoon he died.  This fuelled the suspicions raised by his daughter 
and her husband. 

2)  Drugs which were left unused after Mr C’s death were not accounted for 

Without proper records there is a risk that essential care may not be provided or is 
erroneously duplicated, thus potentially putting a patient’s safety of health at risk. 

I would like to thank you for bringing these matters to our attention. I absolutely agree 
that clear documentation is key to ensuring patient safety.  

In order to respond to this Regulation 28 notice we have taken the opportunity to review 
our  Trust  Syringe  Pump  Policy,  the  Trust  Syringe  Pump  combined  prescription  and 
administration  chart  and  the  relevant  sections  of  our  Trust  Medicines  Management 
Policy.  In addition we have audited 10 cases from gate 34 where patients were having 
medication administered via a syringe pump that was subsequently discontinued at the 
end of their life against the syringe pump policy.   

Chairman – 

Chief Executive – 

 
 
 
 
 
  
 
 
        
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 In light of the above reviews we have determined that the syringe pump policy and the 
prescription / administration chart should be revised to provide clearer guidance and 
support better adherence to the policy. In particular this relates to the recording of any 
medication remaining in the syringe at each check and the amount discarded  at the 
change  or  end  of  the  use  of  the  syringe  driver  and  a  prompt  to  support  staff  in 
recognising when the next syringe change will be required. Once the revised policies 
have gone through the appropriate governance routes in the Trust there will be further 
training delivered to support their use. 

Once again thank you for bringing these matters to our attention. 

Yours sincerely  

Medical Director

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