Prevention of Future Deaths reports · 2017

Paul Gander

Regulation 28 report to prevent future deaths, reference 2024-0092, written 8 Dec 2017. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Dec 2017
Reference2024-0092
DeceasedPaul Gander
CoronerVeronica Hamilton-Deeley
Coroner areaWest Sussex, Brighton and Hove
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedBrighton and Sussex University Hospitals 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.

VERONICA HAMIL TON-DEELEY DL, 
LL.B. 
Her Majesty's Senior Coroner 
for the City of Brighton & Hove 

Assistant Coroners 
CATHARINE PALMER LL.B (HONS) 
KAREN HENDERSON, BSC,BM,MRCPI,FRC __ 
GIL VA D.J.TISSHA W,  BA(LA W)HONS 

THE CORONER'S OFFICE 
WOODY ALE,  LEWES  ROAD 
BRIGHTON 
BN23QB 

Telephone: Brighton (01273)  292046 
Fax: Brighton (01273)  292047 

CORONERS SOCIETY OF  ENGLAND AND WALES 

ANNEX A 

REGULATION  28:  REPORT TO  PREVENT FUTURE DEATHS (1) 

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

THIS  REPORT IS  BEING SENT TO: 

1. 

2. 

,  Brighton and Sussex University Hospitals Trust, 

Royal Sussex County Hospital, Eastern Road,  Brighton. 

Trust,  Royal Sussex County Hospital,  Eastern  Road,  Briahton 

  Head of IT,  Brighton and Sussex University Hospitals 

CORONER

I am Veronica HAMIL TON-DEELEY,  Senior Coroner, for the City of Brighton and 
Hove 

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  Fifteenth June 2017 I commenced an investigation into the death of Paul  Eric 
GANDER.  The investigation concluded  at the end of the inquest on Twenty 
seventh November 2017.  The conclusion  of the inquest was a NARRATIVE 
CONCLUSION. 

CIRCUMSTANCES OF THE  DEATH 
See Record of Inquest 

CORONER'S CONCERNS 

During the course of the  inquest the evidence revealed  matters giving rise to 
concern.  In  my opinion there is a risk that future deaths will  occur unless action  is 
taken.  In the circumstances  it is my statutory duty to  report to  you. 

I 

1 

2 

3 

4 

5 

 VERONICA HAMILTON-DEELEY DL, 
LL.B. 
Her Majesty's Senior Coroner 
for the City of Brighton & Hove 

Assistant Coroners 
CATHARINE PALMER LL.B (HONS) 
KAREN HENDERSON, BSC,BM,MRCPI,FRC_ 
GILVA D.J.TISSHAW, BA(LAW)HONS 

THE CORONER'S OFFICE 
WOODYALE, LEWES ROAD 
BRIGHTON 
BN23QB 

Telephone: Brighton (01273)  292046 
Fax: Brighton (01273)  292047 

The MATTERS OF  CONCERN are as follows:  -

(1) 

That at a weekend  and out of hours the Consultant Orthopaedic and Trauma 

Surgeon involved was not able to access the electronic records of other 
departments within the hospital. 

This is completely unacceptable. 
This information is  imperative. 
Arrangements must be made to ensure that full  access is given to properly 
authorised personnel to all  hospital records. 

ACTION SHOULD BE  TAKEN 

In my opinion action should  be taken to prevent future deaths and  I believe you 
AND 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 25th  February 2018.  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. 

6 

7 

8 

COPIES and PUBLICATION 

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

,  Solicitor 

1. 
2. 
3.  Secretary of State for Health,  Department of Health 
4. 
5.  Care Quality Commission 
6.  Clinical Commissioning Group 

,  Chief Executive,  NHS England 

I am also under a duty to send the Chief Coroner a copy of your response. 

. 

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. 

2 

 
 VERONICA HAMILTON-DEELEY DL, 
LL.B. 
Her Majesty's Senior Coroner 
for the City of Brighton & Hove 

Assistant Coroners 
CATHARINE PALMER LL.B (HONS) 
KAREN HENDERSON, BSC,BM,MRCPI,FRC __ 
GILVA D.J.TISSHA W,  BA(LA W)HONS 

THE CORONER'S OFFICE 
WOODY ALE, LEWES ROAD 
BRIGHTON 
BN23QB 

Telephone: Brighton (01273)  292046 
Fax: Brighton (01273)  292047 

9 

Date: 

am  December 2017 

SIGNED BY: 

1;:4 (~

Senior Coroner Brighton and Hove 

3
Also filed under 2024-0092: 2024-0092-Brighton-and-Sussex-University-Hospitals-2.pdf
20 March 2018 

Brighton  and  Sussex 
University Hospitals 
NHS Trust 

Brighton & Sussex University Hospitals 
St Mary's Hall 
Eastern Road
Brighton 
BN2 5JF 

Miss  Veronica  Hamilton-Deeley 
HM  Senior Coroner for Brighton and  Hove 
Coroner's Office, Woodvale 
Lewes  Road 
BRIGHTON 
BN2  3QB 

Dear Miss  Hamilton-Deeley 

The Late Mr Paul  Gander 

Thank you  for your letter of 8 March 2018,  together with the  report of your 
expert

  and  the article on  this  rare complication. 

With  regards  to my response  of 21  February 2018  to your Regulation  28  report,  I 
am  content for you  to send  it to the  Interested Persons  and  the others  you  list 
in your letter. 

As  you  know,  I take each  and  every death extremely seriously and  the  response 
set out our review,  and  the changes  we  have  made subsequently. 

Once again,  my heartfelt condolences  go  to Mr Gander's family and  friends. 

Yours  sincerely 

Chief Medical Officer and  Deputy Chief Executive
Also filed under 2024-0092: 2024-0092-Brighton-and-Sussex-University-Hospitals.pdf
Brighton and Sussex 
University Hospitals 
NHS Trust 

Brighton & Sussex University Hospitals 
St Mary's Hall 
Eastern Road 
Brighton 
BN2 5JF 

Miss  V Hamilton-Deeley,  HM Senior Coroner 
Coroner's Office,  Woodvale 
Lewes  Road 
BRIGHTON 
BN2  3QB 

Dear Miss Hamilton~Deeley 

The Late Paul Gander 
Date of birth: 23.02.1958 

Thank you  for your letter of 8 December 2017,  together with the two Regulation 
28  reports and  for drawing your concerns to my attention. As  you  know,  we  are 
always willing to review our practices in order to identify improvements which 
can  be  made in  the light of experience. 

I 

II understand that although the Trust was  legally represented  at the Inquest 

there was  no  reference at the Inquest to potential Prevention of Future Deaths 
(PFD's)  Reports being issued.  The Trust is concerned at this omission  and 
considers that it has effectively lost the opportunity to avoid  parts of the report 
by  not being given  the opportunity to make  representations at the time. 

This lost opportunity is applicable with regard  to your concerns arising from  the 
Regulation 28  dealing with clinical practice issues,  initially in that there were 
no agreed  protocols for the escalation of patients who develop complications 
from  saphenous vein  harvesting sites,  particularly in regard  to whether there 
should  have  been  a referral to either the Vascular team  or the Trauma and 
Orthopaedic team.  You  have stated that 'very much  time was wasted while this 
matter was  resolved'  and  that this  'was unacceptable'. 

The  Protocol within the Trust has  always been  that the Trauma and  Orthopaedic 
team  deal with all compartment syndrome injuries,  with the exception of 
compartment syndrome secondary to an  acute or acute-on-chronic vascular 
ischaemia.  This evidence was  fully explored at the Inquest. 

 
 
 
 
 Thank you  once again for raising your concerns with me.  However on  behalf of 
The Trust I must regretfully also  raise our own  concerns that some  of the 
language contained within the PFD  on  this issue,  in  particular the use  of the 
term  'maverick'  could be  seen  as  going against the Advice  in  the Chief 
Coroner's Guidance Note number 5 which states that Coroners should only use 
moderate,  neutral,  well-tempered language. 

Finally I would be  most grateful if you  would please  pass on  my sincere 
condolences to the family and  friends of Mr.  Gander. 

Yours  sincerely 

Chief Medical Officer and  Deputy Chief Executive 

Page 3 of 3

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