Prevention of Future Deaths reports · 2022

Colin Swain

Regulation 28 report to prevent future deaths, reference 2022-0076, written 10 Mar 2022. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report10 Mar 2022
Reference2022-0076
DeceasedColin Swain
CoronerJacqueline Devonish
Coroner areaSuffolk
CategoryAlcohol, drug and medication related deaths · Emergency services related deaths (2019 onwards)
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

Regulation 28: REPORT TO PREVENT FUTURE DEATHS

NOTE: This form is to be used after an inquest.
REGULATION 28 REPORT TO PREVENT DEATHS

I am Jacqueline DEVONISH, Area Coroner for the coroner area of Suffolk

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.

INVESTIGATION and INQUEST

On 08 June 2021 I commenced an investigation into the death of Colin Michael SWAIN aged
42. The investigation concluded at the end of the inquest on 04 March 2022. The
conclusion of the inquest was that Mr Swain died from Hypoxic brain injury due to
aspiration of the gastric contents following alcohol intoxication. It was not possible on the
balance of probabilities to determine the point at which Mr Swain‘s brain was starved of

such that he would stop breathing, and whether turning him from his side to his
back for CPR commencement caused or contributed to his death.

CIRCUMSTANCES OF THE DEATH

On 22 May 2021 Colin Swain, who had a history of alcohol excess, but did not drink in the
presence of his family, was found collapsed in his front garden after going outside for a
cigarette and a drink. The toxicology results indicated a level of alcohol associated with a
coma. During the emergency call to the ambulance service the call handler was informed
that he had been drunk, had fallen hitting his head and was unconscious. His breathing was
assessed by the call handler and found to be agonal. The advice was to commence CPR for
which he needed to be on his back. He was at that time on his side with his head down. Mr
Swain vomited as he was turned, and advice was given to clear his mouth. Immediately
upon turning him to his back Mr Swain stopped breathing.

Bystander CPR followed until the ambulance service attended and achieved ROSC to
transfer him to hospital. On admission the CT scan indicated hypoxia and he was presumed
to have consumed enough alcohol to produce an obtunded state of consciousness with
alcohol as the precipitant cause of death. Airway protected reflexes could fail in these
circumstances, and in the absence of medical help, laryngospasm could be lethal. The
clinical evidence was that he had aspirated his stomach contents which would itself have
caused hypoxia worsened by a degree of laryngospasm closing the airway completely. The
anoxic insult which can occur within 4 minutes lasted long enough to stop his heart.

The paramedic attending the scene gave evidence that in agonal breathing the only course
guailable to 2 bystander was to commence CPR pending arrival of an ambulance. For that to
D had to be laid on their back.

CORONER'S CONCERNS

During the course of the investigation my inquiries 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) When a patient has been known to have been drinking alcohol, whether there is an
algorithm in the MPDS detector which takes this into consideration.

(2)If the MPDS does provide support for alcohol intoxication, whether this includes support
in how to clear the mouth and nose to good effect. If it does not, whether this something
which could be included in the Tool.

(3 Whether turning an unconscious patient onto their back after vomiting is good practice,
in the absence of clinician support

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.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by May 05, 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.

COPIES and PUBLICATION

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

Wife
f Mother

T have also sent it to
who may find it useful or of interest.

Tam 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 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

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