Prevention of Future Deaths reports · 2024

Marjorie McEvoy

Regulation 28 report to prevent future deaths, reference 2024-0050, written 2 Feb 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report2 Feb 2024
Reference2024-0050
DeceasedMarjorie McEvoy
CoronerAndre Rebello
Coroner areaLiverpool and Wirral
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedThe Clatterbridge Cancer Centre 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  Clatterbridge Cancer Centre (Liverpool) 

1  CORONER 

I am Andre REBELLO, Senior Coroner for the coroner area of Liverpool and Wirral 

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 05 September 2023 I commenced an investigation into the death of Marjorie MCEVOY 
aged 64.  The investigation concluded at the end of the inquest on 02 February 2024. 

The cause of death found was: 

1a Gastrointestinal haemorrhage 

1b Treatment for squamous cell carcinoma 

II Bronchopneumonia and Chronic Obstructive Pulmonary Disease 

The conclusion of the inquest was that: 

Marjorie MCEVOY died from a misadventure namely a rare but recognised 
complication of treatment for cancer. 

4  CIRCUMSTANCES OF THE DEATH 

Mrs Marjorie McEvoy had a medical history of chronic obstructive pulmonary disease, 
Rheumatoid arthritis and Anal squamous cell carcinoma T2N1. She was on radical 
treatment with Capecitabine and Mitomycin for radical intent. The cycle commenced on 
10/07/2023. Afterwards developed severe mucositis with led to her poor oral intake, 
diarrhoea and tongue swelling. She was seen by advanced nurse practitioners as well as 
consultant oncologists. She was admitted in hospital and given antibiotics, IV fluids and 
supportive care. She also presented Pancytopenia, which was more likely than not 
chemotherapy related. During admission developed a gastrointestinal bleed related to 
mucositis. She had multiple blood transfusions and investigations. She recovered initially 
however had further gastrointestinal bleed on 18th August 2023. She was certified as 
having died at 04.05 on the 21st August 2023. It is more likely than not that her severe 
reaction to the treatment was such that stopping the treatment was unlikely to have 
prevented her death. The quality of the clinical notation from advanced nurse practitioners 
did not put the oncology team in the best position to react to her care needs. 

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

 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: 
(Brief summary of matters of concern) 

During the course of this investigation it became apparent that the clinical notation by 
advanced nurse practitioners were inadequate in that they did  not explain the patient’s 
presentation to enable escalation of care. These notes should be to a similar standard as 
those of doctors. 

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 March 29, 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 have also sent it to. 

Chief Coroner (reg28) 
NHS England & NHS Improvement  (PFDs) 

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. 

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 
release or the publication of your response by the Chief Coroner. 

9  Dated: 02/02/2024 

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

 
 Andre REBELLO 
Senior Coroner for 
Liverpool and Wirral 

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 The Clatterbridge Cancer Centre (PDF)
r.!1:kj 

The Clatterbridge 
Cancer Centre 
NHS  Foundation Trust 

Clatterbridge Road 
Bebington 
Wirral 
CH63 4JY 

HM Senior Coroner Andre Rebello 
Liverpool Coroners Court 
Gerard Majella Court House 
Boundary Street 
Liverpool 
L54 2QD 

Dear Mr Rebello 

Re:  In the matter of Marjorie McEvoy - Response to Regulation 28  Report 

We refer to the matter of Marjorie McEvoy which was heard on 2 February 2024.  At the 
conclusion of the inquest,  you considered your duty under  Regulation 28 was engaged,  and 
issued a report accordingly. 

The Trust would like to start by once again offering its sincerest condolences to the family 
and friends of Mrs McEvoy for their loss.  The Trust recognises that the death of a loved one 
is a sad situation,  and takes every opportunity to identify organisational learning 
opportunities wherever required. 

Trust response to concerns raised 

The Trust is a learning organisation and always wishes to improve patient care and safety. 
The Trust recognises the importance of the Prevention of Future Deaths process for 
improving the national picture of patient care,  and hopes that this response can assist as 
part of that national discussion. 

The concern you raised in your report was: 

During the course of this investigation it became apparent that the clinical notation by 
advanced nurse practitioners were inadequate in that they did not explain the patient's 
presentation to enable escalation of care.  These notes should be to a similar standard as 
those of doctors. 

Following the issue of your report,  the Trust can confirm that it has taken the following 
actions: 

1.  On  12 February 2024, the Trust held a debrief meeting with all staff involved in the 
inquest.  This briefing discussed the inquest findings and learning points,  including 
your concern,  above.

Related reports

Other reports by Andre Rebello

See all →

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track The Clatterbridge Cancer Centre NHS Foundation Trust

See every Prevention of Future Deaths report matching The Clatterbridge Cancer Centre NHS Foundation Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.