Prevention of Future Deaths reports · 2023

Bavaniammah Theiventhiran

Regulation 28 report to prevent future deaths, reference 2023-0444, written 13 Nov 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report13 Nov 2023
Reference2023-0444
DeceasedBavaniammah Theiventhiran
CoronerAnna Crawford
Coroner areaSurrey
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedSurrey and Sussex Healthcare 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.

IN THE SURREY CORONER’S COURT 
IN THE MATTER OF: 

__________________________________________________________ 

The Inquest Touching the Death of Bavaniammah Theiventhiran    
A Regulation 28 Report – Action to Prevent Future Deaths 
__________________________________________________________ 

1  THIS REPORT IS BEING SENT TO: 

Chief Executive  
Surrey and Sussex Healthcare NHS Trust  
Trust Headquarters  
East Surrey Hospital 
Canada Avenue 
Redhill 
RH1 5RH 

2  CORONER 

Miss Anna Crawford, H.M. Assistant Coroner for Surrey 

3  CORONER’S LEGAL POWERS 

I make this report under paragraph 7(1) of Schedule 5 to The Coroners 
and Justice Act 2009. 

4 

INQUEST 

An inquest into Ms Theiventhiran’s death was opened on 20 April 2023.  
The inquest was resumed and concluded on 9 November 2023.    

The medical cause of Ms Theiventhiran’s death was: 

1a. Congestive Cardiac Failure 

1b. Valvular Heart Disease, Ischaemic Heart Disease and Acute on 
Chronic Kidney Disease 

2. Fracture Neck of Femur due to Fall on 26 February 2023 (Operated 2 
March 2023)  

The inquest concluded with a narrative conclusion as follows: 

 
 
 
 
  
 
 
 
 Ms Theiventhiran was 80 years old.  Her past medical history included 
Ischaemic Heart Disease, Valvular Heart Disease and Chronic Kidney 
Disease.  

On 26 February 2023 Ms Theiventhiran tripped over a suitcase at her 
home address and was admitted to East Surrey Hospital on the same day 
and diagnosed with a fractured left neck of femur.   

On her admission to hospital Ms Theiventhiran was placed on the trauma 
list for surgery.  However, the surgery did not place until 2 March 2023.  
There was no clinical reason to delay her surgery.   

Following the surgery Ms Theiventhiran developed an Acute Kidney 
Injury and on 6 March 2023 she died at East Surrey Hospital.   

Her death was due to Congestive Cardiac Failure caused by a 
combination of her Chronic Heart Disease and Acute on Chronic Kidney 
Disease.  The fall and fracture, along with the amount of time that elapsed 
between the fracture and the surgery taking place, placed prolonged 
stress on Ms Theiventhiran’s already compromised heart, exacerbating 
her congestive cardiac failure and thereby contributing to her death.  

5  CIRCUMSTANCES OF THE DEATH 

The court heard that the NICE Guideline on the Management of Hip 
Fractures recommends that hip surgery take place on the day of the injury 
or the day thereafter on the basis that early surgery for hip fractures is the 
most appropriate form of pain relief, potentially quickening rehabilitation 
and reducing complications. 

The Court heard evidence that Ms Theivanthiran was clinically fit for 
surgery following her admission to East Surrey Hospital on 26 February 
2023.  However, her surgery did not take place until 2 March 2023 because 
other trauma patients were prioritised ahead of her, either because they 
had been admitted on an earlier date, or because they had been assessed 
as having a higher clinical need.  

The Court heard evidence that the most recently monthly figures 
recorded by East Surrey Hospital indicate that fewer than 50 per cent of 
its neck of femur patients had been operated upon with the timeframes 
set out in the NICE Guideline on the Management of Hip Fractures. 

 
 
 
 6  CORONER’S CONCERNS 

The MATTER OF CONCERN is: 

The NICE Guideline on the Management of Hip Fractures recommends 
that hip surgery take place on the day of the injury or the day thereafter in 
order, amongst other things, to reduce complications.  The most recent 
monthly figures indicate that East Surrey Hospital it is not meeting this 
timeframe for over half of patients who present to the hospital with a 
fractured neck of femur.  The Coroner is concerned that in failing to 
comply with the NICE Guideline in this way, the Trust is placing such 
patients at risk of early death.  

7  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I 
believe that the people listed in paragraph one above have the power to 
take such action.  

8  YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of its date; I 
may extend that period on request. 

Your response must contain details of action taken or proposed to be 
taken, setting out the timetable for such action. Otherwise you must 
explain why no action is proposed. 

9  COPIES 

I have sent a copy of this report to the following: 

1.  Chief Coroner  
2.  Ms Theiventhiran’s family  

 
 
 
  
 10  Signed: 

ANNA CRAWFORD  

Anna Crawford 
H.M Assistant Coroner for Surrey 
Dated this 13th day of November 2023

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