Prevention of Future Deaths reports · 2022

Neil Hickman

Regulation 28 report to prevent future deaths, reference 2022-0064, written 28 Feb 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 Feb 2022
Reference2022-0064
DeceasedNeil Hickman
CoronerMary Hassell
Coroner areaInner North London
CategoryHospital Death (Clinical Procedures and medical management) related deaths
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:  Prevention of Future Deaths report 

Neil HICKMAN (died 21.08.21) 

THIS REPORT IS BEING SENT TO: 

1.

Chief Medical Officer
East Kent Hospitals University NHS Foundation Trust
Kent & Canterbury Hospital
Ethelbert Road
Canterbury
Kent CT1 3NG

1  CORONER 

I am:   Coroner ME Hassell 
 Senior Coroner  
 Inner North London 
 St Pancras Coroner’s Court 
 Camley Street 
 London  N1C 4PP 

2  CORONER’S LEGAL POWERS 

I make this report under the Coroners and Justice Act 2009, 
paragraph 7, Schedule 5, and  
The Coroners (Investigations) Regulations 2013, 
regulations 28 and 29. 

3 

INVESTIGATION and INQUEST 

On  25  August  2021,  one  of  my  assistant  coroners,  Sarah  Bourke, 
commenced  an  investigation  into  the  death  of  Neil  Hickman  aged  63 
years.    The  investigation  concluded  at  the  end  of  the  inquest  earlier 
today.  I made a determination at inquest of death by natural causes. 

4  CIRCUMSTANCES OF THE DEATH 

Neil  Hickman  was  treated  at  Kent  and  Canterbury  Hospital  (K&C)  for 
myelodysplastic syndrome and then was referred to University College 
London  Hospital  (UCLH)  for  stem  cell  transplant.    However,  he  died 
before the transplant could take place.  His medical cause of death was: 

1 

 disseminated angio-invasive mycotic infection 
immunosuppression 

1a 
1b 
1c  myelodysplasia 

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.  

Mr  Hickman  was  given  frequent  platelet  transfusions  at  K&C,  but  his 
ferritin levels were not measured.  When he was referred to UCLH, his 
ferritin level was found to be hugely raised.  He was then treated with 
chelation therapy and ultimately his ferritin returned to a safe level, so 
this  did  not  impact  upon  the  outcome.    However,  it  might  for  another 
patient. 

I think the reason that K&C does not measure the ferritin levels in such 
a situation is because K&C does not have funding for chelation therapy 
to  treat  iron  overload.    However,  if  iron  overload  is  detected,  then  a 
referral centre such as UCLH can be called for advice, and the patient 
and their family can be informed so that they have the option of seeking 
private treatment. 

6 

ACTION SHOULD BE TAKEN 

In  my  opinion,  action  should  be  taken  to  prevent  future  deaths  and  I 
believe that you 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 25 April 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 following. 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 • 
•  University College London Hospitals NHS Trust 
•  HHJ Thomas Teague QC, the Chief Coroner of England & Wales 

, wife of Neil Hickman 

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 

DATE                                                  SIGNED BY SENIOR CORONER 

28.02.22                                              ME Hassell 

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 Kent and Canterbury Hospital (PDF)
S 

Trust Offices 
Kent & Canterbury Hospital 
Ethelbert Road 
Canterbury, Kent 
CT1 3NG 

ME Hassell 
HM Senior Coroner 
Inner North London 
St Pancras Coroner’s Court 
Camley Street 
London 
N1C 4PP 

Your Ref:   

30 March 2022 

From: Susan Acott, Chief Executive 

Dear Madam 

Mr Neil Hickman – PFD Response 

Thank  you  for  your  Prevention  of  Future  Death  (PFD)  Report  dated  28  February  2022  sent 
pursuant to paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 concerning the death 
of Mr Neil Hickman on 21 August 2021. 

I understand that during the course of the inquest you heard evidence that revealed matters giving 
a  rise  to  a  concern  that  needs  to  be  addressed  to  prevent  a  future  death.    Specifically,  you  are 
concerned  that  when  Mr  Hickman  was  referred  for  a  bone  marrow  transplant,  his  ferritin  levels 
were not checked despite him undergoing frequent blood transfusions. 

Your PFD Report was discussed in the Haematology Departmental business meeting on 10 March 
2022.    It  has  now  been  agreed  that  all  Myelodysplastic  Syndrome  patients  that  are  undergoing 
frequent red cell transfusions and being referred for a bone marrow transplant will have their ferritin 
levels measured.  This will ensure that  if iron overload is detected, appropriate measures can be 
initiated  including  referral  to  a  specialist  centre  for  urgent  treatment.  This  action  has  been 
implemented with immediate effect. 

Lastly, I would like to thank you for bringing your concern to our attention and can assure you and 
Mr Hickman’s family that the Trust will continue to improve on the high standards we set ourselves 
in East Kent Hospitals. 

Yours sincerely 

Chief Executive

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