Prevention of Future Deaths reports · 2023

Melissa Kerr

Regulation 28 report to prevent future deaths, reference 2023-0330, written 13 Sep 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report13 Sep 2023
Reference2023-0330
DeceasedMelissa Kerr
CoronerJacqueline Lake
Coroner areaNorfolk
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.

declared  dead.  There  is limited  documentary evidence  as  to the  procedures  performed. 
Expert  evidence  was  heard that certain techniques  used  during  the  Brazilian  Buttock  Lift 
procedure  increased  the  risk of  fat em bolus occurring,  namely  the choice  of  access incision 
for  the  augmentation  cannula  and the  decision to  inject  fat  into the superficial  muscle. 

5  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.  Expert evidence  was heard  that the  findings in this case  are  consistent  with  findings in 
other  cases  where patients have  died following autologous fat transfer to the gluteal area 
during an operation colloquially known as  Brazilian  Buttock  Lift.  I understand from  the 
evidence  heard  that  due  to the  high  mortality associated with  this procedure  a voluntary 
moratorium  on  the  practice  of  this procedure has  been introduced  in  the  UK. 
Recommendations  for safer  practices  have  emerged  that  recommend significant changes  to 
practice. 
2.  I  am  concerned  that patients  travelling to Turkey for this procedure  are not  being  made 
aware  of  the  risks  and  the  high mortality rate  associated with  this surgery 
3.  I  am  also concerned that patients  are travelling abroad where  there  are  no  or  limited 
controls with  regard  to such surgery taking  place.  Evidence was heard  there  Ms  Kerr  was 
not  seen  by a  surgeon  before the  date  of  the procedure.  There  was  limited psychological 
and physical assessment  prior  to the  procedure proceeding. 
4.  I  appreciate the  UK  Government  has  no  control over  what  happens  abroad.  However  I 
am  concerned  that citizens  are  travelling abroad  for such  procedures  unaware  of  the risks 
involved  and  that practices  are used which  are  regarded  as  unsafe  in  the  UK. 

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  November  07,  2023.  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 

  - Mother. 

I  have  also  sent  it to 

Private  Medicana  Haznedar  Hospital 
The  British Association  of  Aesthetics  and  Plastic  Surgeons 

  - Expert 

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. 

Regulation 28 - After Inquest 
Document Template Updated 30/07/2021

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 Department of Health and Social Care (PDF)
From Maria Caulfield MP 
Parliamentary Under Secretary of State 
Department of Health & Social Care 

39 Victoria Street 
London 
SW1H 0EU 

15 November 2023  

Mrs Jacqueline Lake  
HM Senior Coroner   
County Hall  
Martineau Lane  
Norwich  
NR1 2DH  

Dear Mrs. Lake,  

Thank you for your letter issued on 13 September 2023 to the Secretary of State for Health 
and Social Care about the death of Melissa Hannah Kerr. I am replying as Minister for 
Mental Health and Women’s Health Strategy.  

Firstly, I would like to say how deeply saddened I was to read of the circumstances of 
Melissa’s death. I can appreciate how distressing her unexpected death must be for family 
and loved ones, and I offer my heartfelt condolences. It is vital that we take the learnings 
from what happened to her in order to prevent future deaths.   

My officials are investigating the issues surrounding global medical tourism. Our efforts to 
understand the consequences of international health tourism are global, but we have a 
strong interest in Türkiye given the number of UK nationals travelling to the country for 
medical treatments.   

The Department has been consulting with the Foreign, Commonwealth and Development 
Office, NHS England, the Devolved Governments and other relevant stakeholders to 
obtain a better picture of the impact of medical tourism on patient safety and the NHS. My 
officials will also be visiting Türkiye shortly to meet with their counterparts. The intention is 
to discuss the regulatory framework, and the protections that are in place for UK nationals, 
and to identify concrete areas where the UK and Turkish authorities should work together 
to reduce the risks to patients in the future.  

Specifically, I have noted in your report the lack of standard pre-assessment questions 
provided to Ms Kerr in Türkiye. We remain aware countries providing healthcare tourism 
often conduct pre-assessment checks that may not match UK regulatory standards and we 
want to encourage all providers treating UK nationals to meet international best practices 
on pre-operative procedures whenever possible. Such transparency and standardisation 
are important to reduce potential risks to patients and improve patient care in the UK and 
overseas.   

 
 
 
 
 
  
 
 
  
 
 
 
 
 
 
 It is particularly important that those considering having the ‘Brazilian Butt Lift’ (BBL) 
procedure are made fully aware of the risks and have time to reflect fully on their decision 
ahead of surgery. As you note in the report, the risks associated with this procedure are 
high. The risk of death for BBL surgery is at least 10 times higher than many other 
cosmetic procedures, and it has the highest death rate of all cosmetic procedures. As you 
note, the British Association of Aesthetic Plastic Surgeons (BAAPS) has advised its 
members not to carry out Brazilian butt lift surgery until more is known about safer 
techniques for the procedure.  

The Government is considering how we can most effectively communicate with those 
considering medical treatment abroad, to ensure people are better informed about the 
risks ahead of surgery and understand the need to ensure appropriate aftercare, including 
considering when it may be safe to travel home.  

I hope this response is helpful in setting out how seriously the UK Government is taking 
the issues raised in your report.  

Yours sincerely, 

MARIA CAULFIELD

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