Prevention of Future Deaths reports · 2021

Louise Cooper

Regulation 28 report to prevent future deaths, reference 2021-0431, written 21 Dec 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report21 Dec 2021
Reference2021-0431
DeceasedLouise Cooper
CoronerAlan Wilson
Coroner areaBlackpool & Fylde
CategoryCommunity health care · Hospital Death (Clinical Procedures and medical management) related deaths
Organisation namedLancashire & South Cumbria NHS Foundation Trust
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 

THIS  REPORT IS  BEING  SENT TO: 

Gillian Keegan  MP 

Minister of State (Minister for Care and  Mental Health) 

Department of Health & Social Care 

CORONER 

I am  Alan Anthony Wilson Senior Coroner for Blackpool  & Fylde 

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/paragra ph/7 
http://www. legislation .gov. u k/ u ksi / 2013 / 1629/p art/ 7 / made 

INVESTIGATION  and  INQUEST 

The death of Louise Cooper on  16/05/20 at her home address was  reported to me and 
I opened an  investigation, which concluded by way of an  inquest held on  17th 
December 2021. 

I determined that the medical cause of Ms. Cooper's death was  1 a  Severe 
Malnourishment 

In  box 3 of the Record  of Inquest I recorded as follows: 

Louise Cooper had  been diagnosed with Anorexia  Nervosa for many years.  She has 
received care for this condition during a number of in-patient admissions, the last of 
which ended in July 2019.  Over subsequent months she  continued to receive care from 
an  eating disorder service until she was  discharged on  2 January 2020.  Louise  knew that 
the Clinical  Psychologist with whom she  had worked for a number of years was  due to 
go on  maternity leave. She  did  not wish to work with any other members of the Eating 
Disorder Service  [EDS]  team. When discharged  her Body Mass Index [BMI] is  estimated 
to have been at a significantly low level of 12.5. She was  discharged on the 
understanding that she would receive ongoing monitoring from her General 
Practitioner. The GP  surgery was  notified about the discharge but due to an 
administrative issue the need for Louise to be  monitored was  not appreciated. She  did 
not receive the necessary monitoring. During the weeks preceding Louise's  death, her 
health went into further decline. This was in  part contributed to by the Coronavirus 
pandemic in  March 2020 which  left her more isolated. Having last exchanged text 
messages with Louise on  the 15th  May 2020, a friend attended her home address at 
approximately 12:30pm on  the 16th  May 2020 to deliver some shopping as  previously 

 arranged.  Unable to obtain a reply he forced entry and  he found  Louise to be deceased 
on  her bed  in  the rear bedroom. A subsequent post mortem examination confirmed 
she  had died from the consequences of severe malnourishment. 

The conclusion of the Coroner was a Narrative Conclusion as follows: 

Having  been  discharged  from  an  eating disorder service  on  2nd  January  2020,  Louise 
Cooper's condition  had  not been  monitored by medical  professionals by the time she 
died on 16th  May 2020 as a result of complications of her previously diagnosed anorexia 
nervosa. 

CIRCUMSTANCES OF THE  DEATH 

In  addition to the contents of section 3 above, the following is  of note: 

• 

• 

• 

Louise was known to have suffered with anorexia nervosa for many years. During 
the  weeks  preceding  Louise's  death,  those  close  to her report  a decline  in  her 
health. 

It is  reported that she  stated to friends that the nationwide lockdown due to the 
Covid-19 Pandemic had  removed  all  of the mechanisms that she  had for coping 
with  her  condition.  A  Trust  review  would  later  find  that  as  Louise  was  self­
isolating due to Covid - 19, this may have impacted upon her mental and physical 
wellbeing due to reduced  social contacts. 

Louise did not received the monitoring she was expected to receive during 2020. 
The court found that had she received that monitoring as  envisaged, there was a 
good chance she  would not have died when she  did,  but was  unable to say that 
she  would have survived 

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. -

• 

Louise  was  known  to  have  suffered  with  anorexia  nervosa  for  many years  and 
during that time her treatment had  included  a number of in-patient admissions 
at times when her extremely low weight became concerning.  Neither Louise  nor 
her Father felt that these admissions were in  fact helping her to improve. 

• 

Louise  had for some time also  received treatment from an  eating disorder 
service.  Her treatment had  included supported eating whereby once per week a 

 professional would sit with her whilst she  ate a meal. She  responded  positively 
to this.  Indeed, it is  of note that when  her Father attended our court not long 
after her death, he commented that had  Louise been able to have a 
professional with her once per day whilst she  ate, then the outcome for her 
may have been  different and the costs of providing such  a service  would have 
been far less than the significant costs of admitting her for periods of treatment 
in  a hospitals.  He  described her regular hospital admissions as  a "revolving 
door" which was not helping her. 

•  The  Consultant Clinical  Psychologist responsible for her care at the eating 

disorder service had tried to commission an  increase in the level of supported 
eating for Louise  but unsuccessfully. She told the court Louise needed this 
support at least once per day. 

•  There will be  many patients such  as  Louise who appear to make minimal if any 
improvement in a hospital setting but who may benefit - according to the 
clinicians treating them - from sustained  supported eating. If that option is  not 
available, these patients may be  left with  no realistic chance of any meaningful 
improvement. 

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. 

YOUR  RESPONSE 

You  are  under a duty to respond to this report within 56 days of the date of this report. 
Given the approaching holiday period I have extended this period to Friday,  28th 
February 2022.  I, the coroner, may extend the period further. 

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. 

COPIES  and  PUBLICATION 

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

  [Friend/ Executor] 

Lancashire & South Cumbria NHS  Foundation Trust 

• 
• 
•  Poplar House Surgery 
•  Blackpool Clinical Commission Group/ Fylde  &  Wyre Clinical Commissioning 

Group 

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. 

21/12/2021 

Signature__ A~°'-"-____ _____ 
Alan  Anthony Wilson Senior Coroner Blackpool &  Fylde

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