Prevention of Future Deaths reports · 2023

Ann Pearce

Regulation 28 report to prevent future deaths, reference 2023-0484, written 28 Nov 2023. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report28 Nov 2023
Reference2023-0484
DeceasedAnn Pearce
CoronerJoanne Andrews
Coroner areaWest Sussex, Brighton and Hove
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedUniversity Hospitals Sussex NHS Foundation Trust
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: REPORT TO PREVENT FUTURE DEATHS 

NOTE:  This form is to be used after an inquest. 

REGULATION 28 REPORT TO PREVENT DEATHS 

THIS REPORT IS BEING SENT TO: 

1 

 – Chief Executive University Hospitals Sussex NHS 

Foundation Trust 

1  CORONER 

I am Joanne ANDREWS, Area Coroner for the coroner area of West Sussex, Brighton 
and Hove 

2  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. 

3 

INVESTIGATION and INQUEST 

On 13 April 2022 I commenced an investigation into the death of Ann Dorothy 
PEARCE aged 61.  The investigation concluded at the end of the inquest on 27 
November 2023.  The conclusion of the inquest was a narrative which stated: 

Ann Dorothy Pearce sustained a fracture of her tibial spine on 26 March 2022 having 
fallen from her bicycle in Burgess Hill that day. She was taken to the Princess Royal 
Hospital for treatment and discharged on 28 March 2022. On 1 April 2022 she 
became unwell at home and an ambulance attended and took her to the Princess 
Royal Hospital for treatment where she was diagnosed with a massive pulmonary 
embolism. She was treated but sadly died on 1 April 2022. 

4  CIRCUMSTANCES OF THE DEATH 

Ann Dorothy Pearce was taken to the Princess Royal Hospital for treatment and was 
discharged on 28 March 2022. During her admission she was immobilised in a brace 
and on discharge was only partially weight bearing. The Venous Thromboembolism 
Prevention Policy of University Hospitals Sussex NHS Foundation Trust version 1.4 
required that this should be undertaken on admission and reviewed on the daily ward 
round. No Venous Thromboembolism assessment was undertaken during her 
admission or on discharge. She became unwell at home on 1 April 2022 and was 
taken to hospital for treatment but sadly died from a massive pulmonary embolism 

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

 that day. 

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: 

Evidence at the inquest revealed that the Venous Thromboembolism Prevention 
Policy of University Hospitals Sussex NHS Foundation Trust version 1.4 did not make 
provision for assessment of risk to patients who attended hospital but were not 
admitted. There was no evidence of any other policy or procedure which did so. 

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe your 
organisation has 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 January 23, 2024.  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 

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 person who I believe may find it useful 
or of interest. 

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

 
 
 
 
 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 by the Chief Coroner. 

9  Dated: 28/11/2023 

Joanne ANDREWS 
Area Coroner for 
West Sussex, Brighton and Hove 

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 University Hospitals Sussex NHS Foundation Trust (PDF)
,~1:kj 

University Hospitals Sussex 
NHS  Foundation Trust 

University Hospitals Sussex NHS 
Foundation Trust 
Trust Headquarters 
Royal  Sussex County Hospital 
Eastern  Road 
Brighton
BN2 5BE 

HM Area Coroner Ms Joanne Andrews 
Parkside Chart Way 
Horsham 
RH12  1XH 

Letter by email only 

17 January 2024 

Dear Ms Andrews 

Inquest into the death of Ann Dorothy Pearce 

Thank you for your letter of 28 November 2023, enclosing your formal report under Regulation 
28 to Prevent Future Deaths. 

My heartfelt sympathy and condolences to Mrs Pearce's family. We have taken considerable 
actions and made extensive improvements to patient safety following Mrs Pearce's death and 
the inquest, and  I will set these out below. 

We  have  developed  a Trust  policy for Thromboprophylaxis  in  Ambulatory Trauma  Patients 
discharged from the Emergency Department. 

In  addition,  patient advice leaflets have been  designed for clinicians to give to  patients.  The 
patient advice leaflets are as follows: 

Immobilisation advice leaflet 
Anticoagulation treatment with  Dalteparin 
Anticoagulation treatment with  Enoxaparin 

A Trust Theme of the  Week message  has been  sent to all  staff on  'VTE  in  lower limb  injury 
and  immobilisation'  to  ensure  our clinical  teams  are  up  to  date  and  this  includes the  top  3 
'need to  know'  points as follows: 

1.  All  patients will  need  baseline  bloods  (FBC,  U&Es,  LFTs  and  coagulation  profile) within 

the last three months to aid  prescribing of thromboprophylaxis. 

 
 
 
 2.  If there are no contraindications,  patients will  need  to  be  prescribed  and  discharged with 
30 days of LMHW, or rivaroxaban if LMWH is contraindicated; if suspected Achilles tendon 
rupture then a 42 day course should be prescribed. 

3.  All  patients  will  need  advice  leaflets  on  reducing  the  risk  of  VTE  with  lower  limb 
treatment  with  Dalteparin  or  enoxaparin,  or 

immobilisation  and  anticoagulation 
rivaroxaban. 

The  key  learning,  patient leaflets,  and  new policy are  being  widely shared  and  discussed  in 
department,  team,  and  divisional  safety huddles  and  meetings.  Mrs  Pearce's case  has  had 
an  immense impact throughout the Trust and  the  learning has been  disseminated widely as 
her legacy to  improve  patient safety.  Once  again,  my sincere  condolences to  Mrs  Pearce's 
family.  I hope you  are assured by the changes we have made. 

Yours sincerely, 

Chief Executive

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