Prevention of Future Deaths reports · 2024

Noura Hardy

Regulation 28 report to prevent future deaths, reference 2024-0400, written 18 Jul 2024. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report18 Jul 2024
Reference2024-0400
DeceasedNoura Hardy
CoronerGareth Jones
Coroner areaWest Sussex, Brighton & 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

1

CORONER

I am Gareth JONES, Assistant 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 21 March 2023 I commenced an investigation into the death of Noura HARDY aged 73.
The investigation concluded at the end of the inquest on 18 June 2024. The conclusion of
the inquest was that:

Noura Hardy died on the 14th of March 2023 at Royal Sussex County Hospital in Brighton of
a cardiac arrest following a septal ablation procedure complicated by perforation of a
coronary artery.

4

CIRCUMSTANCES OF THE DEATH

Ms. Hardy suffered from severe left ventricular hypertrophy. She was admitted to
hospital in March 2023 for a septal ablation procedure. Her coronary artery was
perforated before the procedure. She subsequently died of a cardiac arrest.

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 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:

In addition to her heart difficulties, Ms. Hardy had taken steroids for a long period of time
for temporal arteritis. She was put on a waiting list for her heart treatment in June 2022
but not treated until March 2023, nine months later. The evidence of the Cardiac Surgeon

who gave evidence at the Inquest was that the long term steroid use

significantly weakened her heart muscles such that she suffered a perforation which
subsequently led to her death. If she had been treated earlier, the muscles may not have
been weakened to such an extent that she died. The local Trust (UHS Foundation Trust)

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

 assures me that waiting lists for heart treatment are now between 9 and 22 weeks which is
reassuring. However I am still concerned about waiting lists for heart treatment being too
long and consider this a national problem. Excessive waiting lists for heart treatment can
be fatal.

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 September 12, 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.
COPIES and PUBLICATION

8

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



 University Hospitals Sussex NHS Foundation Trust

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: 18/07/2024

Gareth JONES
Assistant 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 Dhsc (PDF)
Our ref: 

HM Coroner Gareth Jones 
Record Office 
Orchard Street 
Chichester  
PO19 1DD 

By email: 

Dear Gareth,  

From 

Minister of State for Health 

39 Victoria Street 
London 
SW1H 0EU 

12 September 2024 

Thank  you  for  the  Regulation  28  report  of  18  July  sent  to  the  Department  of  Health  and 
Social Care about the death of Ms Noura Hardy. I am replying as the Minister of State for 
Health with responsibility for elective care.       

Firstly, I would like to say how saddened I was to read of the circumstances of Ms Hardy’s 
death, and I offer my sincere condolences to their family and loved ones. The circumstances 
your report describes are very concerning and I am grateful to you for bringing these matters 
to my attention. 

The report raises concerns over the length of time Ms Hardy was on a waiting list for heart 
treatment - for nine months from June 2022 until her untimely death in March 2023. Clinical 
evidence  given  at  the  inquest  states  that  the  long  term  interim  steroid  use,  whilst  on  the 
waiting  list,  significantly  weakened  Ms  Hardy’s  heart  muscles  such  that  she  suffered  a 
perforation which subsequently led to her death.  

I want to assure you that tackling waiting lists is a key part of our Health Mission and a top 
priority  for  this  government,  as  we  get  the  NHS  back  on  its  feet.  We  have  committed  to 
achieving the NHS Constitutional standard that 92% of patients should wait no longer than 
18 weeks from Referral to Treatment (RTT), by the end of this parliament.  

We recognise that it is unacceptable that some patients are waiting 9 months for definitive 
cardiology  treatment.  The  NHS  and  Department  are  providing  additional  regional  and 
national support and scrutiny to the most challenged trusts with the largest backlogs of long 
waiters and will continue to work towards the target in NHSE’s 24/25 planning guidance to 
eliminate waits of over 65 weeks by September 2024.  

Furthermore, this government is committed to change the NHS so that it becomes not just 
a sickness service, but able to prevent ill health in the first place. A focus will be on ensuring 
fewer lives are lost to the biggest killers and reducing deaths from heart disease and stroke 
by a quarter within ten years. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
 
 
 
 
 
 In  preparing  this  response,  Departmental  officials  made  enquiries  with  NHS  England 
(NHSE)  in  order  to  gain  a  more  detailed  response  at  local  level  and  received  the  below 
information: 

With  regard  to  reviewing the  long-term use of  steroids,  University Hospitals Sussex  NHS 
Foundation Trust confirmed that the patient was noted to be significantly breathless and had 
steroid-dependent arteritis, and reviews were part of her ongoing care and treatment for her 
conditions.  

The consultant explained in his evidence that cardiology waiting times were longer due to 
the  hangover  effect  of  covid,  and  that  Ms.  Hardy  suffered  a  complication  which  would 
happen regardless of the waiting list times. Waiting time information on the NHS My Planned 
Care website states the current waiting times are: 
-  First outpatient appointment – 24 weeks. 
-  Waiting time for treatment (outpatient or inpatient) – 23 weeks.  

I hope this response is helpful. Thank you for bringing these concerns to my attention.   

Yours sincerely, 

MINISTER OF STATE FOR HEALTH

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