Prevention of Future Deaths reports · 2021

Maureen Johnson

Regulation 28 report to prevent future deaths, reference 2021-0298, written 7 Sep 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report7 Sep 2021
Reference2021-0298
DeceasedMaureen Johnson
CoronerChris Morris
Coroner areaManchester South
CategoryCommunity health care
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 FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 
Executive, National Institute for Health and Care Excellence. 

, Chief 

1  CORONER 

I am Chris Morris, Area Coroner for Manchester South. 

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://www.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 26th March 2021, Christopher Murray, Assistant Coroner, opened an 
inquest into the death of Maureen Johnson who died on 13th March 2021 
at Stepping Hill Hospital, Stockport, aged 85 years. The investigation 
concluded at the end of the inquest which I heard on 1st September 2021. 
A doctor treating Mrs Johnson confirmed that she had died as a result of: 

1.a) Acute Renal Failure; due to
1.b) Dehydration;
1.c) Gastroenteritis
II Hypertension.

By way of conclusion, I recorded that Mrs Johnson died as a 
consequence of Natural Causes.    

4  CIRCUMSTANCES OF THE DEATH 

Mrs Johnson was ordinarily a fit and active person who lived 
independently in her own home. Towards the end of February 2021, Mrs 
Johnson became unwell with diarrhoea, vomiting and abdominal pain.  
After around a week, Mrs Johnson’s symptoms had resolved, however 
returned again a number of days later.  

Mrs Johnson sought medical advice. In the two days prior to her death, 

1 

 two separate General Practitioners held telephone consultations with Mrs 
Johnson and formed the impression (albeit without examining her) that 
she had been suffering from a stomach bug which was resolving. 

On 13th March 2021, Mrs Johnson’s son (who had been in regular contact 
with his mother throughout) spoke to her on the telephone and was 
concerned she sounded short of breath. On attending her home, Mr 
Johnson found his mother to be seriously ill.   

An ambulance was called, and Mrs Johnson was taken to Stepping Hill 
Hospital where it was quickly recognised she had developed metabolic 
acidosis and was gravely ill. Despite attempts to provide emergency 
treatment, Mrs Johnson died later that afternoon.     

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.  –  

Given their physiological susceptibility to dehydration and its effects, it is 
a matter of concern that authoritative guidance does not currently exist as 
to the assessment of diarrhoea and vomiting suspected to be caused by 
gastroenteritis in the over 70s, as has previously been published in 
respect of children and infants younger than 5. 

Such guidance might usefully provide a comprehensive overview of 
symptoms and signs of clinical dehydration in the over 70s, and give 
clinicians advice as to the circumstances in which a face-to-face 
assessment is recommended.  

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 2st November 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 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 8  COPIES and PUBLICATION 

I have sent a copy of my report to the Chief Coroner and 

 on behalf of Mrs Johnson’s family and to Dr 
 of RPC (Solicitors to Mastercall) as the other Interested Persons 

 and 

to the Inquest.   

I have also sent a copy of my report to the CQC and Stockport CCG 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: 7th September 2021 

Signature:     
Chris Morris HM Area Coroner, Manchester South.   

3

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 National Institute for Health and Care Excellence (PDF)
2nd Floor 
2 Redmond Place 
London 
E20 1JQ 
United Kingdom 

2 November 2021 

Christopher Morris 
Area Coroner for South Manchester 
Coroner’s Court 
1 Mount Tabor Street 
Stockport 
SK1 3AG 

Sent via email: 

Our ref: EH-317942-N9Y1R5  

Dear Mr Morris, 

I write in response to your regulation 28 report of 7 September 2021 regarding the death of 
Maureen Johnson. I would like to express my sincere condolences to her family. 

In your report you state that ‘authoritative guidance does not currently exist as to the 
assessment of diarrhoea and vomiting suspected to be caused by gastroenteritis in the over 
70s, as has previously been published in respect of children and infants younger than 5.’   

While it is correct that we have not published a clinical guideline on gastroenteritis in adults, 
or children over the age of 5, there is a Clinical Knowledge Summary on gastroenteritis 
which we believe gives appropriate advice on the assessment of people who are suspected 
to have gastroenteritis, including questions that healthcare professionals should ask, the 
need to examine the person, the risk of dehydration, and symptoms to be aware of. 

While they do not constitute formal NICE guidance, we commission Clarity Informatics to 
develop the summaries, and make them available as a source of information for health 
professionals. 

As such, we do not believe that any action is required of NICE.  

Yours sincerely, 

Chief executive

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