Prevention of Future Deaths reports · 2021

Margaret Toye

Regulation 28 report to prevent future deaths, reference 2022-0004, written 23 Dec 2021. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report23 Dec 2021
Reference2022-0004
DeceasedMargaret Toye
CoronerGraeme Irvine
Coroner areaEast London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBarts Health NHS 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.

MR G IRVINE 

ACTING SENIOR CORONER 

EAST  LONDON 

Walthamstow Coroner's Court, Queens Road  Walthamstow, E17  SQP 

REGULATION  28:  REPORT TO  PREVENT FUTURE  DEATHS  (1) 

REGULATION 28  REPORT TO  PREVENT FUTURE DEATHS 

THIS  REPORT IS  BEING SENT TO: 

•  Ministerial Correspondence and  Public Enquiries Unit,  Department of Health 

and  Social Care,  39 Victoria Street, London,  SW1 H 0EU 

And 

• 

Royal  Hospital,  Whitechapel Rd,  London  E1  1 BB 

,  Chief Medical Officer,  Barts Health  NHS Trust,  The 

1 

CORONER 

I am  Graeme Irvine,  acting  senior coroner,  for the coroner area of East London 

2 

CORONE~SLEGALPOWERS 

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. 
htt-g_:LLwww.legislation.gov. ukLuk-g_gaL2009L25Lsched uleLSL-g_a ragra-g_hL7 
htt-g_:LLwww.legislation.gov.ukLuksiL2013L1629L-g_artL7 Lmade 

3 

INVESTIGATION and  INQUEST 

On the 22nd April 2021  I opened  an  investigation touching  upon the death of Margaret 
Rose Toye,  aged 81  years old . I opened an  inquest on  the  5th  May 2021.  The  inquest 
concluded  on  the 21 st December 2021 . 

The conclusion of the  inquest was Natural Causes,  the  record  of inquest stated : 

"On  the  10th  April 2021  Mrs  Margaret Rose  Toye  sustained an  unwitnessed fall in  the 
community and suffered a left neck of femur fracture . Following surgery to  repair the 
fracture on  12th April 2021  Mrs  Toye  received ward based care and on  20th April she 
died following  a cardiac arrest." 

1 

 
 
 
 
 The cause of death was recorded as; 

1a Cardiac Failure 
1 b lschaemic Heart Disease 
1 c Coronary Artery Atherosclerosis 
II  Fractured  Left Neck of Femur 

4 

CIRCUMSTANCES OF THE DEATH 

Following  a fall  in  the street on  10th April 2021 , Mrs Toye was taken  by ambulance to 
hospital where she underwent a  surgical  repair of the fracture on  12th April 2021. 
Despite recovering  from  surgery well,  whilst care for on the ward  Mrs Toye sustained  a 
cardiac arrest on  20th April  2021 . 

· 

5 

CORONER'S CONCERNS 

During the course of the inquest the evidence revealed  matters giving  rise to  concern . In 
my opi nion 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 fol lows.  -

1.  Following  admission , Mrs Toye was not assessed for risks of malnutrition  by use 
of the MUST score system . Such  an  assessment was required for all  patients. 
Erroneously, her notes recorded  that she scored  Oon  the MUST scale which 
meant that no other staff members began an  assessment throughout her 
admission . It is  likely that during  admission Mrs Toye would  have scored 4  on  a 
MUST assessment, as  such a  number of mitigations would  have been 
introduced to  maximise her nutritional  intake. 

2.  Contemporary audits of compliance of Must scoring  on the ward  in question 
demonstrate that one in  ten  patients are not being  assessed for risks of 
malnutrition . 

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 th is  report within  56  days of the date of this report, 
namely by 17th  February 2022, 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, the family of Mrs Toye,  the Care Quality Commission . I have also sent it to the 
Director of Public Health who may find  it useful or of interest. 

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. 

2 

 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  believe  may find  it  useful 
or of interest. 

You  may make representations to  me,  the  coroner,  at the time of y 
the  release or the  publication of your response . 

9 

[DATE]  23rd  December 2021 

[SIGNED  BY CORONER] 

3

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