Prevention of Future Deaths reports · 2021

John Berrow

Regulation 28 report to prevent future deaths, reference 2021-0080, written 7 Jan 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Jan 2021
Reference2021-0080
DeceasedJohn Berrow
CoronerCaroline Saunders
Coroner areaGwent
CategoryOther related deaths
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.

Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

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

1. Chief Executive, Specsavers uk

CORONER
! am Caroline Saunders, Senior Coroner for the Area of Gwent
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

INVESTIGATION AND INQUEST

On 18/10/19 an investigation was opened into the death of
John BERROW

The investigation concluded at the end of the inquest on: 1/12/20
The conclusion of the inquest was recorded as: Natural Causes
The medica! cause of death was:

1a) Subarachnoid haemorrhage

1b Ruptured berry cerebral aneurysm

CIRCUMSTANCES OF THE DEATH

On 11" October 2019 John Berrow attended the Specsavers Opticians in
Newport because he was suffering from unequally sized pupils. John stated
that his eyesight was altered and he complained of increased pressure or
heaviness.

An examination was performed by PY the optometrist who

noted the disparity in size. Mr Campbell considered whether John’s symptoms
could be as a result of an aneurysm or increased intracranial pressure, but the
tests he performed reassured him that John’s neurological function was intact.

|_| [RR diagnosed a condition known as Adie’s pupil an unusual

neurological disorder in which the ability of the pupil to constrict is impaired,
usually in one eye. This is not an emergency and as a result John was referred
on a routine basis to the eye hospital.

John left the opticians at about 13:00hrs

John then went to the Queen’s Hotel in Newport and collapsed at about
15.25pm, he was resuscitated and taken to hospital. On arrival at hospital all
attempts were made to fully resuscitate John but sadly his condition was
irretrievable and John died at 16:50 hours.

The cause of John’s death was confirmed as a ruptured Berry Aneurysm. The
neurological symptoms including unequal pupil size that John exhibited at his
assessment at Specsavers should have resulted in John being advised to attend
hospital for assessment. Given the severity and nature of his collapse however,
there is no evidence that John’s death would have been avoided.

CORONER’S CONCERNS

During the course of the inquest, 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: -

| oral evidence at the inquest hearing. In evidence

he admitted that he failed to consider unequal pupils alone as a sign of
increased intracranial pressure due to a bleed or aneurysm and has rectified
this in his current practice.

He also stated that there were no practical reference tools or clinical manuals
available to him within Specsavers and was dependent upon referring to
Google to assist him in his clinical decision making.

| was also informed that whils shared his experience locally, that
there is no mechanism for disseminating information relating to clinical
incidents or to improve learning from similar events amongst practitioners at
Specsavers.

ACTION SHOULD BE TAKEN

ae

| In my opinion action should be taken to prevent future deaths and | believe you have “|
the power to take such action.

| should be grateful if the following information be provided to me:

Confirm the resources available for clinical staff working at Specsavers to access up to
date clinical information relating to potentially life threatening conditions.

Confirm how information relating to Mr Berrow’s death and his presentation is to be
disseminated to minimize the risks of missing symptoms allied to Berry Aneurysms in

the future.
7 YOUR RESPONSE |

You are under a duty to respond to this report within 56 days of the date of this
report, namely 4/3/2023 |, the Coroner, may extend this 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 necessary

COPIES AND PUBLICATION

| have sent a copy of my report to the Chief Coroner and the following Interested
Person (s)

. The family of John Berrow
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 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 7/1/2021

Signed

Chorcler

Caroline Saunders

Her Majesty’s Senior Coroner for the Area of Gwent.

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 Specsavers (PDF)
Specsavers

4 March 2021
Dear Ms Saunders
Regulation 28 report — John Berrow (deceased)

Your letter of 7 January 2021 enclosing your Regulation 28 report has been forward to me as the Professional
Services Consultant for Specsavers. I write on behalf of the Specsavers Optical Group to respond to the

matters raised in your report.
Firstly, I would like to offer my condolences to Mr Berrow’s family for their loss.

So far as reference tools and clinical manuals are concerned, we do not provide paper textbooks and
manuals within the stores as these will become out-of-date — however, computers are provided and staff are
able to access clinical evidence, guidance, journals and optometry textbooks via the College of Optometrists
website. This has the benefit of being up-to-date. Staff also have access to peers and more senior colleagues
within the store or through the professional services team, which can give advice. My understanding is that
the optometrist accessed the publically available local referral guidelines online to ensure that he followed

the current, up-to-date referral guidelines. Each area will have its own guidelines.

This was an unusual presentation. We appreciate the importance of sharing experience and learning across
the Company. We are liaising with Specsavers Professional Training team to commission a specialist
optometrist or neuro-ophthalmologist to deliver training materials (concentrating on this topic) which will
be recorded and disseminated via an online webinar or other similar mechanism which will be available to all
Professional staff within the Company. We also hope to make the training available for the wider optical
community outside the Company so that there is an opportunity for non-Specsavers practitioners to learn

any and all matters arising out of Mr Berrow’s sad death.

If I can provide any further information, please do not hesitate to contact me.

Yours sincerely

Di
Professional Services Consultant

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