Prevention of Future Deaths reports · 2020

Ivan O’Neill

Regulation 28 report to prevent future deaths, reference 2020-0269, written 2 Dec 2020. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Dec 2020
Reference2020-0269
DeceasedIvan O’Neill
CoronerGraeme Irvine
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 extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

MISS N PERSAUD 
SENIOR CORONER 

EAST LONDON 

Walthamstow Coroner's Court, Queens Road Walthamstow, E17 8QP 
Telephone 020 8496 5000 Email coroners@walthamforest.gov.uk 

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS (1) 

Ref:  -

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Ministerial Correspondence and  Public Enquiries Unit, Department of 

Health and  Social Care, 39 Victoria Street, London, SW1 H 0EU 

2. 

Chief Executive, Barts Health NHS Trust, Royal London 
hapel Road, London, E11BB Email: 

CORONER 

I am Graeme Irvine, Area Coroner for the coroner area of East London 

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:ljwww.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 22nd  April 2020 I commenced an  investigation into the death of Ivan Merryfield 
O'Neill aged 74 years. The investigation concluded at the end of the inquest on 20th 
November 2020. The conclusion of the inquest was a narrative conclusion: 

"On 21st April 2020 Mr Ivan Merryfield O'Neill attended hospital for dialysis. 
An accidental dislodgement ofa venous needle that takes blood under pressure 
to the dialysis machine occurred,  which led to a significant bleed.  Staffon the 
unit were unaware ofthe bleed,  until an alarm from  the dialysis machine 
sounded due to a drop in pressure.  Mr O'Neill was.found to be unres  onsive 

1 

 having sustained a cardiac arrest due to hypovolemic shock, despite 
resuscitation attempts his life was pronounced extinct at 09.30 hours." 

The cause of death was recorded as; 
1a; Hypovolemic Shock 
1 b; End-Stage Kidney Disease 
II; Polyneuropathy, Frailty and COVID 19 

4 

CIRCUMSTANCES OF THE DEATH 

During a regular dialysis appointment, Mr O'Neill bled to death when a venous 
needle became dislodged from the site ofhis arteriovenous fistula. 

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 could 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.  Mr O'Neill was known to be a restless patient during a dialysis session.  This 

factor must have increased the risk of needle dislodgement. 

2.  Mr O'Neill was a frail patient with little reserve and would be more likely to swiftly 

lose consciousness following a bleed. 

3.  Mr O'Neill was placed in a position which was outside of a clear line of sight 

from the nurses station. 

4.  The automatic alarm triggered by the dialysis equipment was insufficiently 

sensitive to promptly alert staff to a bleed until between 200 - 2000 mls of blood 
had already been lost. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and  I believe you and  your 
organisation 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 27th  January 2021. 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 the family of Mr O'Neill and the CQC.  I have also sent it to the Director of 
Public Health who may find  it useful or of interest. 

I am also under a duty to send a copy of your response to the Chief Coroner and all 
interested persons who in my opinion should receive it. 

I may also send a copy of your response to any other person who I believe may find  it 
useful or of interest. 

1 

2 

 The Chief Coroner may publish either or both in a c~plete or redacted or summary 
form.  He may send a copy of this report to any per  bh who he believes may find it useful 
or of interest. 

• 

l 

You  may make representations to me, the corone  at the time of your response,  about 
the release or the publication of your response. 

/ 
I 

9 

2nd  December 2020 

-

3

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