Prevention of Future Deaths reports · 2021

Peggy Copeman

Regulation 28 report to prevent future deaths, reference 2021-0182, written 28 May 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 May 2021
Reference2021-0182
DeceasedPeggy Copeman
CoronerJacqueline Lake
Coroner areaNorfolk
CategoryEmergency services related deaths (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses published1

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:

Premier Rescue Ambulance Services
Unit 17 Corlish Way
East Galmington Trading Estate
Taunton
TA1 5LZ

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

On 08/01/2020 I commenced an investigation into the death of Peggy Joan COPEMAN aged 81. The
inquest has not yet been heard

4. CIRCUMSTANCES OF THE DEATH

Mrs Peggy Copeman was placed under s 2 MHA on 10.12.2019 and was taken to Cygnet Hospital,
Taunton on 12.12.2020. She was being transported back to Norfolk on 16.12.2019 by Premier
Rescue Ambulance Service (PRAS). PRAS transfers patients to or from a healthcare facility or other
such location, providing care during transit. During the journey Mrs Copeman had altered breathing.
When driving along the M11 a short distance prior to junction 9, Mrs Copeman was noted to have
mucous coming from her nose and the ambulance pulled over on the hard shoulder. Mrs Copeman
was noted to be unresponsive. Telephone calls were made to Cygnet House and PRAS and then
emergency services were called. Mrs Copeman was declared dead at the scene.

5. CORONER’S CONCERNS

During the course of the inquest, the evidence revealed matters giving rise to concern.
there is a risk that future deaths could occur unless action is taken.
statutory duty to report to you.

In the circumstances, it is my

In my opinion

The matters of concern are as follows:

1. PRAS Conveyance Policy provides that staff escorting patients “are to be fully trained in Basic
Life Support (BLS) and are deemed to be competent to apply the techniques when needed.
Staff can notice any changes or deteriorating patients and act appropriately in line with BLS
training. Starting with Primary assessments followed by secondary assessment then
commencing CardioPulmonary Resuscitation (CPR) while waiting for ambulance to arrive … “

2. The evidence so far is that during transit, Peggy did not respond when being called or when
moving her head and on being noted as being unresponsive, emergency services were not
called immediately but calls were initially made to Cygnet and then PRAS. CPR was started
on being told to do so by emergency services

3. On attendance by Paramedics it was noted that due to the position of the patient in the back

of the van, CPR was ineffective

4. A report has been obtained from a Consultant Cardiologist and General Physician as an
expert witness who is of the firm view that the staff transporting Mrs Copeman did not
recognise she was in respiratory distress and/or cardiac arrest and that she had effectively
died whilst sat between them

5. Only one member of staff out of three had training in CPR
6. An internal investigation (undated) carried out shortly after the incident did not raise concern

about these matters

7. A statement provided by the Compliance Manager, PRAS, dated 7 May 2021 concludes that

 “the ambulance was adequately staffed to enable the journey to be safely carried out”, despite
only one member of staff being trained in CPR contrary to PRAS’s own Conveyance Policy

6. ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe your organisation has 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 20 July 2021.
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.

I, the coroner, may extend the period.

8. COPIES and PUBLICATION

I have sent a copy of my report to the Chief Coroner and to the following Interested Persons:

(daughter) and

a)
b) Cygnet Healthcare
c) Norfolk and Suffolk NHS Foundation Trust
d) Care Quality Commission
e)

(husband)

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.

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.

9. Dated: 28 May 2021

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

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 Premier Rescue Ambulance Service Ltd (PDF)
Response of Premier Rescue Ambulance Service Ltd 

to 

Regulation  18 Notice 

This  Response  is  sent in  response  to Regulation  18 Notice dated  28th  May 2021 

and  is  sent on  behalf of Premier Rescue Ambulance Service  Ltd. 

1.  In  response  to  the  concerns  raised  by  the  Coroner,  Premier  Rescue 

Ambulance Services Ltd., have made a decision that ALL members of staff, 

including  drivers,  are  tG  have  training  in  relation  to  CPR. 

As  a 

consequence  of  this  de.cision, 

  has  attended  the 

following courses: 

a)  First  Aid  Assessors  and  Internal  Quality  Assurance  CPD  Training  31st 

January 2020 

b)  level 3 Award  in  Education and Training- 10th  February 2020 

c)  Cardiopulmonary Resuscitation and Automated  External  Defibrillation 

- 29th  January 2020 

d) · First Aid  at Work Instructor - 31st January 2020 

e)  First Aid  at Work- 31st January 2020 

f) 

Immediate Management of Anaphylaxis Instructor- 30th January 2020 

g)  Oxygen Therapy Administration - 30th  January 2020 

h)  Oxygen Therapy Administration Instructor - 30th January 2020 

i)  Defibrillation Instructor - 29th January 2020 

Certificates attached 

 As  a consequence  of the training, 

  is  now authorised  to 

train others within Premier Rescue  Ambulance Services Ltd. 

2.  As  a consequence of the training, 12 staff have  received  internal training 

and  the 8 remaining staff hold  valid  external certificates.  Upon  expiry of 

those external certificates, internal training will  be  provided. 

A copy of the relevant Training Manual is  attached. 

3.  In the current case  Premier  Rescue  Ambulance  Service  Ltd.,  accept  that 

only one member of staff had  been fully trained in  basic life support.  The 

above  courses and  training seeks to address that deficit. The  intention  is 

that in  future ALL  members of staff conveying patients will have  received 

basic  life  support training,  including drivers  of the  vehicles.  The  course 

will  cover  recognition  of  cardiac  arrest  and  recognising  distress  in 

patients. 

4.  Premier Rescue  Ambulance Service  Ltd.,  merely observe that the request 

to transfer Peggy Copeman  was  received  late in the afternoon of the lSth 

December  with  a  request  to  transfer  her  on  the  morning  of the  16th 

December.  Accepting instructions such  as this in  such  a short timeframe 

has  been  identified  by the  Company as  a weakness  in  procedures  which 

led to two untrained staff accompanying one trained member of staff. 

5.  The  Company  regret  their  initial  investigation  did  not  highlight 

  or 

  as  not  having  CPR  training.  They  have  now 

revised 

their  internal 

investigation  procedure  and 

they  are  now 

investigating the possibility of a qualified  independent assessor  carrying 

out such  a role in  the future should the need  arise.  In  the meantime, any 

internal investigation pending such  an  appointment will be carried out by 

 
 . who is a State Registered Nurse and has undergone 
iuff trilmtng by NUCO  as Htwt ~ ly .   The dlanges. m lnter'181 
imrestiptlo11area> beimplemented: immediately. 

6.  !n:the meantimerltie<tara.Quality Commission•have seNed aSNl)ensio11 
· ~ upon prem(er ~e~we Ambu1anee Sl':ITTlite ltd.; p-g a  hl.lltto 
tOll\leyante danypatfent until at least.the.end d.July. 
~ter,•fte$(Ue Amt>•teseMi:~ Ltd;, have now imp1emem:ed a Poli~ 
Ulat~arenQ l~ger p!'li}pa~ tQ. a.~tor~nsl)J)rt patient$ wh<> are 
not awake and re!ilponsive at the tommencemellt d  tile journey., This is 

so'the\!tan ~ally ~~anytha~s.in ffil!irbehavio~ron theJQ~ey, 
They  wm  also.  tf:!<l1J~re  a  sip~ ~ument ~ a  qtialffi~  Medltal 
Practitioner confirming a  patie.nt's  ftmess to travel  11nd  also  require  a 

d$i'led ll$tofmer:t~~nspa~t$~ reteMng·so ilsto.enablet~t-0 
<:alTJ  mat  1t .risk a~ent as to whether It  Is  asrpmprlate tor those 

p.itfflats·m..betransfetredby·Premier~eA.mbijlil~Servi<:eltd•.The 
detaiki!d  list d  meditatJQilS willbe .r~ewed by 

 and 

.  ·Tuose.Potides h.webHII implemented 1mmedtately. 

Signed:

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