Prevention of Future Deaths reports · 2021

Louie Johnston

Regulation 28 report to prevent future deaths, reference 2021-0342, written 14 Oct 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Oct 2021
Reference2021-0342
DeceasedLouie Johnston
CoronerGraeme Irvine
Coroner areaEast London
CategoryHospital Death (Clinical Procedures and medical management) related deaths · Child Death (from 2015)
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.

MRG IRVINE 
ACTING  SENIOR CORONER 

EAST LONDON 

Walthamstow Coroner's Court, Queens Road  Walthamstow, E17 8QP 

REGULATION  28:  REPORT TO  PREVENT FUTURE DEATHS  (1) 

REGULATION  28  REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS  BEING  SENT TO: 

1. 

, CEO, BHRUT NHS Trust,  Queens  Hospital, Rom Valley 

Way,  Romford,  RM7  0AG 

2.  Department of Health  & Social Care 

1 

CORONER 

I am Graeme Irvine, acting  senior 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. 
htt12:LLwww.legis lation .gov.ukLuk12gaL2009L25Lschedu1eLSL12aragra12hL7 
htt12 :LLwww.legis lation .gov.ukLuksiL2013L1629L12artL7 Lmade 

3 

INVESTIGATION and  INQUEST 

On  1st  May 2020, I commenced an  investigation into the death of Louie Neil Johnston, 
aged  1 week.  The investigation concluded at the  end  of the inquest on  6th  October 
2021.  The conclusion of the inquest was that Louie died from; 

1 a Diffuse Hypoxic/lschaemic Encephalopathy 
1 b Acute chorioamnionitis with  feta!  inflammatory response 
1 c Ascending  maternal genital tract infection 

A narrative conclusion was arrived at. 

 
 
 
 
 4 

CIRCUMSTANCES OF THE DEATH 

Louie  Neil Johnston died  in  hospital on  28th April 2020 as  the  result of diffuse hypoxic 
ischaemic encephalopathy, a condition caused  by  an  inadequate supply of oxygen to 
the brain  during  his delivery on  17th April  2020. Avoidable  delays in  that delivery caused 
or contributed  to  his death . 

Factors that produced the  delay included ; 

1. Disregard of part of a cardiotocography (CTG) trace that monitors uterine activity, 
which  led  to  uterine hyper-stimulation not being  considered as the cause for a drop in 
the baby's heart rate , 
2. A prolonged  attempt to  deliver using  a ventouse cup, 
3. A sequential  decision to  proceed to  a forceps delivery after the  ventouse cup delivery 
failed , instead  of an  immediate category  1 caesarean  section. 

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.  CTG trace monitoring  equipment that was in  use in  the  labour ward  required 

staff to  switch  from  a CTG trace screen to  a K2  electronic recording  screen 
during  delivery. This meant that a graphic representation  of the  CTG trace was 
not clearly visible at all times. Instead , midwifery staff were required  to  crouch 
down and  record  numeric data from the CTG displayed on  a small  LED  screen. 
The Trust identified this as counter-productive and  raised  the  issue with the 
manufacturer of the  system . To date, the system  has not been  updated . 

2.  A review of staff training  records indicated that an  obstetric registrar involved  in 

the delivery was  not up to  date with  mandated  annual CTG training.  Additionally, 
the obstetric consultant had  not completed annual training  which  required the 
session to  be  repeated  following  the  death of Louie Johnston. Systems in  place 
at the Trust did  not ensure that all  medical staff had  completed  requisite training . 

6 

ACTION  SHOULD BE  TAKEN 

In  my opinion  action should  be taken  to  prevent future deaths and  I believe you 
[AND/OR  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 9th  December 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 , Louie's family and  HSIB [and to  the  LOCAL SAFEGUARDING BOARD (where 
the deceased  was  under 18)].  I have also sent it to the local  Director of Public  Health 
who  may find  it useful or of interest. 

2 

 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  I t your response,  about 
the  release  or the  publication of your response. 

9 

[DATE]  14/10/2021 

[SIGNED BY CORONER] 

11 

3

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