Prevention of Future Deaths reports · 2024

Susan Edwards

Regulation 28 report to prevent future deaths, reference 2024-0303, written 4 Jun 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report4 Jun 2024
Reference2024-0303
DeceasedSusan Edwards
CoronerDavid Reid
Coroner areaWorcestershire
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedWorcestershire Acute Hospitals NHS 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 

THIS REPORT IS BEING SENT TO: 

, Chief Executive, Worcestershire Acute Hospitals NHS Trust, 

Charles Hastings Way, Worcester WR5 1DD; 

1  CORONER 

I am David Donald William REID, HM Senior Coroner for Worcestershire. 

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. 

http://www.legislation.gov.uk/ukpga/2009/25/schedule/5/paragraph/7 
http://www.legislation.gov.uk/uksi/2013/1629/part/7/made 

3 

INVESTIGATION and INQUEST 

On 17 October 2023 I commenced an investigation and opened an inquest into the 
death of Susan Lynne EDWARDS. The investigation concluded at the end of the 
inquest on 28 May 2024 

The conclusion of the inquest was that Mrs. Edwards “Died as the result of a 
recognized complication of an accidental fall”. 

4  CIRCUMSTANCES OF THE DEATH 

In answer to the questions “when, where and how did Mrs. Edwards come by her 
death?”, I recorded as follows: 

“On 7.10.23 Susan Edwards, who had fractured her left neck of femur in a fall in 
hospital in August 2023, and who had been admitted to Worcestershire Royal Hospital 
on 10.9.23 and treated for a likely urinary tract infection, suffered a sudden 
deterioration in her condition. Despite treatment, she declined and died in hospital 
later the same day. Post mortem examination has established that she died as the 
result of developing a large pulmonary embolus.” 

5  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. 

The MATTERS OF CONCERN are as follows.  –  

1)  On 19 September 2023 a Venous Thromboembolism Risk Assessment made 

clear that Mrs. Edwards should be provided with mechanical 
thromboprophylaxis. This instruction was not entered on Mrs. Edwards’ 
anticoagulation drug card, and Mrs. Edwards was not provided with any form 
of mechanical thromboprophylaxis between that date and her death 18 days 
later on 7 October 2023. No nurse or reviewing doctor picked up on this 
omission. 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Although I was satisfied that, in this case, the provision of mechanical 
thromboprophylaxis would probably not have prevented Mrs. Edwards’ death, 
I am concerned that: 
(a)  no system appears to be in place at Worcestershire Royal Hospital to 

ensure that such an instruction is carried out; and  

(b)  as long as that remains the case, the lives of patients who require 

thromboprophylaxis during a hospital admission may be put at risk. 

6  ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you, as 
the Chief Executive of Worcestershire Acute Hospitals NHS Trust, 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 30 July 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: 

(a) 

, Mrs. Edwards’ daughter. 

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.  

9 

4 June 2024 

David REID 
HM Senior Coroner for Worcestershire 

2

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 Worcestershire Acute Hospitals NHS Trust (PDF)
Ref: 

30 July 2024 

Mr David Reid 
HM Senior Coroner 
Worcestershire Coroners Court 
The Civic 
Martin’s Way 
Stourport on Severn 
Worcestershire 

Sent via email:  

Dear Mr Reid 

Re Regulation 28 Report to Prevent Future Deaths  

Please accept this letter in response to your Regulation 28 Report to Prevent Future 
Deaths received on the 7th June 2024, following the Inquest touching on the death of 
Mrs Susan Edwards.  

In your Regulation 28 report you identified the following matters of concern relating 
to the Worcestershire Acute Hospitals NHS Trust (WAHT). 

1)  On  the  19th September  2023  a  Venous  Thromboembolism  Risk  Assessment 
made  clear 
that  Mrs.  Edwards  should  be  provided  with  mechanical 
thromboprophylaxis.    This  instruction  was  not  entered  on  Mrs.  Edwards’ 
anticoagulation drug card, and Mrs. Edwards was not provided with any form 
of mechanical  thromboprophylaxis  between that  date and  her  death  18  days 
later  on  7th  October  2023.    No  nurse  or  reviewing  doctor  picked  up  on  this 
omission. 

You further stated that although you were satisfied that, in this case, the provision of 
mechanical  thromboprophylaxis  would  probably  not  have  prevented  Mrs.  Edwards’ 
death, you were concerned that: 

a)  No system appears to be in place at Worcestershire Royal Hospital to ensure 

that such an instruction is carried out; and 

b)  As  long  as  that  remains  the  case,  the  lives  of  patients  who  require 

thromboprophylaxis during a hospital admission may be put at risk. 

Responding to the concerns raised; 

  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1.  We have focused on educating our staff in order to provide clear instructions 

around this area and will implement the following: 

o  There will be a Lesson of the week around what constitutes both 

hosiery and mechanical prophylaxis, and it will be reiterated to staff 
that they must sign the prescription chart to confirm that this 
prophylaxis is on/in place. 

o  Anti-coagulation nurses are going to provide some teaching to the 

junior doctor workforce to ensure their understanding of the practical 
impact of the different types of prophylaxis. 

o  Anti-coagulation nurses have also offered to provide teaching to ward 

nurses.  

o  Reminder of the above is to be verbalised across all areas via safety 

huddles. 

2.  Monitoring: 

o  Checks of the prescription charts will be included on the matron’s 
audits (to check that the prescription has been signed as in/on) 

o  Continue to audit via the matron’s audit already in place and divisional 

governance teams will continue their surveillance and escalate 
accordingly.  

3.  Long term plan is this will be on the electronic patient medical prescribing / 

administration system. 

I hope that the above addresses your concerns about the quality of our initial review.  
I  have  no  representations  in  respect  of  publication  of  the  Regulation  28  or  this 
response by the Chief Coroner. 

I shall be grateful if you could kindly send a copy of my response to anyone to whom 
you copied your Regulation 28 report.  

Yours sincerely                   

Chief Executive

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