Prevention of Future Deaths reports · 2021

Imre Thomas

Regulation 28 report to prevent future deaths, reference 2021-0097, written 4 Apr 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Apr 2021
Reference2021-0097
DeceasedImre Thomas
CoronerNicholas Rheinberg
Coroner areaLancashire and Blackburn with Darwen
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Alcohol, drug and medication related deaths
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.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  NHS England P.O.Box 16738, Redditch, B97 9PT 
2.  NHS England, North West Preston Business Centre, Watling Street Road, 

Fulwood, Preston, Lancashire, PR2 8DY1 

1 

CORONER 

I am Nicholas Leslie Rheinberg, assistant coroner for the coroner area of Lancashire 
and Blackburn with Darwen 

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 

Following his death at HMP Garth on 12th September 2019 an investigation was 
commenced in respect of Imre Paul Thomas born on 3rd October 1973. The investigation 
concluded at the end of the inquest on 29th March 2021. The conclusion of the inquest 
jury was that the deceased died by misadventure of asphyxia due to aspiration as a 
result of tramadol and multiple drug toxicity.   

4 

CIRCUMSTANCES OF THE DEATH 

Sometime prior to 2014 the deceased had fractured bones in his hand. At some point 
the area had become infected and the deceased was suffering increased levels of pain. 
In August 2017 the deceased attended a GP appointment at HMP Garth. Pain killing 
medication in the form of dihydrocodeine was prescribed and an appointment with a 
consultant orthopaedic surgeon was arranged for November of that year. The 
appointment was cancelled. In between August 2017 and the deceased’s death in 
September 2019 a total of nine orthopaedic appointments were cancelled, three by the 
hospital, two by the deceased and four by the prison because the prison was unable to 
arrange an escort. The deceased complained of increasing levels of pain which he 
claimed was not met by the prescribed dihydrocodeine. The deceased took to acquiring 
painkilling medication from other prisoners and his death on 12th September 2019 was 
as a result of an overdose of tramadol and other prescription medication illicitly obtained. 

HMP Garth and HMP Wymott stand adjacent to each other on a site in Leyland 
Lancashire. Together they have a population of over two thousand prisoners. Each 
week between them they send approximately 35 prisoners out for hospital appointments 
thereby employing a minimum of seventy officers as escorts at a significant cost to the 
NHS. As was seen in the present inquest, hospital visits are cancelled for a variety of 
reasons including lack of officer escorts and hospital cancellations. Such cancellations 
carry with them a risk of harm to prisoner patients and the cumulative effect of 
cancellations could potentially give rise to serious untreated illness or death. There are 
several clinic rooms at the healthcare departments of both prisons which could be used 
for specialist clinics by visiting hospital consultants thereby avoiding cancellations to the 
benefit of both prisoner patients and hospitals saved from cancelled or late 
appointments together with cost savings in respect of prison officer escorts. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 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.  –  
Cancelled hospital appointments putting vulnerable prisoners at risk. As the 
commissioning body you are asked to investigate the possibility of organising special 
prison clinics for visiting hospital consultants. 

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 1st June 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 namely the family of the deceased and the Greater Manchester NHS Trust. I 
have also sent it to the heads of Healthcare at HMP Garth and HMP Wymott 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 4th April 2021                                  SIGNED Nicholas Rheinberg 

                                                        Assistant Coroner 

2

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