Prevention of Future Deaths reports · 2025

Samuel Brookes

Regulation 28 report to prevent future deaths, reference 2025-0190, written 15 Apr 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report15 Apr 2025
Reference2025-0190
DeceasedSamuel Brookes
CoronerJohn Ellery
Coroner areaShropshire, Telford & Wrekin
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedThe Dudley Group NHS Foundation 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.

Russells Hall Hospital 
Dudley 
West Midlands 
DY1 2HQ 

Telephone: 01384 456111 
Date: 29 May 2025 

Private and Confidential 
Mr John Ellery 
H.M. Coroner’s Service Guildhall  
Frankwell Quay  
Shrewsbury  
Shropshire  
SY3 8H 

Dear Mr Ellery 

Re: Response to Regulation 28 Report to Prevent Future Deaths – The late Mr Samuel 
Joseph Brookes  

I am in receipt of your Regulation 28 Report to Prevent Future Deaths following the Inquest, 
and your ruling on 15 April 2025 in respect of the late Mr Samuel Joseph Brookes. I would like 
to extend again the deepest condolences of the Trust to Mr Brookes’ family. 

Please be assured the significant communication and safety concerns raised as part of this 
inquest have been taken most seriously by the Trust.  

Matters of concern:   
1.  The  hospital  arranged  for  the  late  Mr  Brookes’  transportation  home  without  evidence  of 
rearranging the required care. 
2. There was no record, documentation or process to show or demonstrate that the care had 
been rearranged.  
3. The transport company were responsible for transportation only and were not required to 
notify either the hospital, or if known, the care company of the late Mr Brookes’ safe return. It 
proceeded on the basis or assumption that care would have restarted within 4 hours or sooner.  
4. The late Mr Brookes did not have his alarm pendant around his neck and nor was his mobile 
phone  available  (it  was  in  another  room).  Accordingly,  when  the  late  Mr  Brookes  got  into 
difficulty, he could not raise the alarm or call for help.  

In  response  to  the  above  matters  of  concern,  an  immediate  cross  divisional  and 
multidisciplinary team approach has been taken to devise a robust improvement plan. Many 
of  the  actions  have  been  implemented  immediately  with  the  remaining  actions  progressing 
within agreed timeframes.  

A  copy  of  the  improvement  plan  is  enclosed  below;  this  includes  the  target  dates  for 
completion,  the  responsible  action  owners,  progress  made  to  date  and  assurances  on  the 
effectiveness of actions taken where available. 

 
 
 
 
 
 
 
 
 
 
 Some of the actions identified regarding patient transport, fall out of scope of the Trust. These 
will be taken forward by our Deputy Chief Operating Officer and Head of Site Operations and 
discussed with relevant integrated care system partners in relation to contractual obligations 
for ensuring patients discharged home are safe and have access to the agreed methods of 
communication e.g. mobile telephone, pendant alarm (should they have or require one).  

In  addition  to  our  improvement  plan,  the  Trust  has  re-established  with  a  renewed  and 
enhanced focus the Discharge Improvement Group. This Group has strategic organisational 
objectives  focussed  not  only  on  increasing  the  timeliness  of  patient  discharges  from  the 
organisation,  but  more  importantly  on  ensuring  that  each  discharge  is  carried  out  with  the 
highest  standards  of  safety  and  quality.  As  part  of  this  work,  dedicated  workstreams  have 
been  initiated to support  the  proactive and  coordinated  planning  of  discharges across  both 
simple  and  complex  care  pathways.  The  group  have  reviewed  and  agreed  clear  outcome 
measures to ensure the impact of actions can be measured, and that they are having a positive 
impact.  Metrics  to  monitor  safe  discharge  will  include  readmission  rates,  patient  and  carer 
satisfaction scores, the percentage of patients returning to their original place of residence, 
safeguarding concerns and the number of failed / incomplete discharges. 

In parallel, a thematic review of historical discharge-related incidents is underway to identify 
key  learning  points  and  inform  future  priorities.  The  Group  comprises  of  multidisciplinary 
representation,  including  colleagues  from  within the  acute  trust,  our  health  and  social  care 
partners,  the  local  authority,  and  a  representative  from  our  patient  community.  This 
collaborative approach is intended to provide confidence that discharge processes are being 
strengthened system-wide, with patient safety and continuity of care as central principles.  

I trust this information and enclosed action plan, provide assurances to you that the Trust has 
taken appropriate actions to mitigate any further patient safety issues regarding discharge and 
commencement of packages of care.  

I beg to remain sir your loyal and obedient servant. 

Group Chief Executive  

Enc. 

 
 
 
 
 
 
 
 
 
 
 
  
 
 THE DUDLEY GROUP NHS FOUNDATION TRUST 
IMPROVEMENT PLAN 

Source of Improvement Plan 

Improvement plan prepared 
and lead by  

Regulation 28 Report to Prevent 
Future Deaths. 

 – Interim Divisional 

Chief Nurse,  

, Interim Deputy 

Divisional Chief Nurse 

Lead  

 Chief of Medicine 
, Discharge Team 

, Head of Flow and 

Oversight Committee 

Quality Committee 

Improvement plan signed off by 

Executive Lead  

 – Chief Nurse, 
, Chief Operating 

Officer, 
Director 

, Medical 

Improvement Plan Agreed 

Capacity   
27th May 2025 

Anticipated date for completion 

July 2025 

KEY 

Completed and Assurance Received 

Action commenced but not yet completed   Action Overdue not completed in agreed time 
scales or at significant risk of note achieving 
time scales 

Assurance received 

Action 
Number 
1 

Recommendation / Area 
for Improvement Identified  
Disseminate the safety 
critical learning from the 
inquest findings 
highlighting to staff the 
key requirements of a 
safe and effective 
discharge. 

Action Agreed 

Lead 

Patient safety bulletin detailing the 
requirements of a safe and effective 
discharge to be compiled and 
submitted for publication across the 
Trust. 

Matron and 
Chief Nurse for 
Medicine 

Date for 
Completion 
01/05/2025 

Progress / Assurance 

y
e
K

Patient Safety Bulletin developed and submitted 
for publication 29/04/2025 

Patient Safety Bulletin to be 
disseminated across the organisation 

Communication 
Team 

01/05/2025 

Patient Safety Bulletin disseminated Trust wide 
07/05/2025 from Communication Team 

Reg28May25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Action 
Number 

Recommendation / Area 
for Improvement Identified  

Action Agreed 

Incident learning and key 
requirements of safe discharge to be 
shared with divisional teams to 
ensure learning is shared widely to 
prevent similar incidents occurring in 
the future. 

Lead 

Matrons  

Lead Nurses 

Chief of 
Medicine 

Date for 
Completion 
01/05/2025 

Progress / Assurance 

y
e
K

Information shared via email with lead nurses 
and Matrons cross divisionally including front 
line staff to disseminate learning to the wider 
teams  

Learning shared with Discharge Team 

Findings from the Regulation 28 
report to prevent future deaths and 
learning plan to be shared at the 
Trust Discharge Improvement Group 
for organisational oversight once 
approved at quality committee. 

Matron Elderly 
Care 

Discharge Team 
Lead  

Regulation 28 report to Prevention of 
Future Deaths outcome and learning 
plan to be shared with medical staff 
across the divisions ensuring clinical 
colleagues  

Chief of 
Medicine  

01/06/2025 

Shared with Group 14/5/2025 

21/05/2025 

14/5/25 shared with clinical colleagues via email  

Discharge facilitators to be allocated 
to specific ward areas, with shared 
space to be utilised for all staff. 

Discharge Team 
Lead 

01/05/2025 

C3/FMNU, C8, AMU, C1 all allocated ward-
based discharge facilitators who cross cover all 
areas in Medicine Division. 

Communication to be sent to all 
relevant staff disseminating the 
immediate requirement to fully 
complete the discharge checklist for 
all patients discharged from an 
inpatient bed  

Matron and 
Lead Nurses 

01/05/25 

Formal email sent to all leads and Matrons re 
completion of checklist in medicine. 

2 

3 

Discharge team to be 
ward based to support 
more effective 
communication between 
the teams. 

To mandate and monitor 
the completion of the 
discharge checklist across 
the Trust  

Reg28May25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Action 
Number 

Recommendation / Area 
for Improvement Identified  

Action Agreed 

Lead 

Request for immediate Power Bi 
report to be built to evidence daily 
discharges checklist completion for 
monitoring  

Interim 
Divisional Chief 
Nurse Medicine 

Date for 
Completion 
25/05/2025 

Progress / Assurance 

y
e
K

Power BI report designed and live. 
Communication sent to leads regarding 
responsibilities. 
Power BI report outputs to be overseen by the 
Discharge Improvement Group. 

Identify and inform staff of their 
responsibilities to monitor and action 
the BI reports 

Audits to be added to AMAT system 
(Trust Audit and Management 
Tracking System) to monitor 
compliance with the completion of all 
discharge checklists.  

For lead nurses to complete audits 
with divisional oversight.  

Audits are to continue with outcomes 
to be fed into trust Discharge 
Improvement Group. 

Corporate  
Quality lead 

01/06/2025 

Interim Deputy 
Divisional Chief 
Nurse  

Interim assurance measures whilst actions 
progress: 
Spot check audit completed w/c 28/04/2025 
evidenced improved compliance with completion 
of checklists within ward areas. 

Divisional Chief Nurse auditing the compliance 
of completion Surgery. 

Discussed in matrons meeting on the 17/4/25 
and 24/4/25 in Medicine Division – informed on 
the spot check audit requirements and the 
reporting of this.  Made aware of plans additions 
to the AMAT system for long term audit 
completion.   

Discharge audit added to AMAT commenced 
01/05/2025  

Reg28May25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Action 
Number 
4 

Recommendation / Area 
for Improvement Identified  
When discharging 
patients, transport 
company to be made 
aware when the patient 
has pendant alarm and 
that this must be left 
within reach when leaving 
the property 

Action Agreed 

Lead 

Urgent communication to be sent to 
all transport services to share 
learning from the Regulation 28 and 
the requirement to ensure pendant 
alarm is within reach. 

Trust Lead for 
Capacity 

Date for 
Completion 
10/05/2025 

Progress / Assurance 

y
e
K

Trust Lead for Capacity has communicated 
request to trust patient transport system private 
provider Cartello and driving miss daisy 
transport. Non-emergency transport (NEPT) 
meeting held 13/05/2025, support sought 
regarding communication with EMED, 
Worcester, escalation lead contact details to be 
sent to Lead for Capacity. 
Efficiency group set up across Black Country 
where governance and incidents will be shared 
going forward. 

Review of current contracts held with 
system partners and outside 
providers to ensure actions agreed 
within Trust can be met through 
contractual arrangements. 

Trust Lead for 
Capacity 

Deputy Chief 
Operating 
Officer 

15/06/2025 

Reg28May25 

 
 
 
 
 
 
 
 
 
 Action 
Number 

Recommendation / Area 
for Improvement Identified  

Action Agreed 

Lead 

Date for 
Completion 
02/05/2025 

Progress / Assurance 

y
e
K

Spot check completed within Medicine Division 
on 29/04/2025; positive assurance gained that 
checklists are being completed, printed and sent 
with patients. 

Email sent to all leads and Matrons and 
DCN/DDCN. 

Interim 
Divisional Chief 
Nurse - 
Medicine 

Interim Deputy 
Divisional Chief 
Nurse - 
Medicine 

Associate 
Director 
Discharge 

30/06/2025 

14/5/25 process has commenced aiming for 
completion in June 2025. 

Communication to be sent out to all 
matrons and teams detailing that the 
nurse discharge checklist is to be 
printed and handed to transport 
company and sent with the 
discharged patient on discharge.  
Communication to detail that the 
discharge checklist must include key 
patient safety details, pendant alarm 
information, mobility status and to 
utilise the free text box with any other 
important information for the 
transferring crew (to include 
availability of mobile phone). This 
communication should include the 
necessary checks to be completed 
by transferring crews to ensure 
patients have necessary equipment 
in reach to make emergency 
calls/have access to pendant alarms. 
Within 8 weeks a Transfer of Care 
Hub to be set up. This is a national 
recommendation which brings 
together under one roof system 
partners in Dudley to improve 
discharge for complex patients, 
through colocation of intermediate 
care, local authority and complex 
discharge team in trust: it is expected 
that working together will streamline 
our processes and outcomes for the 
patients and their families. 

To improve 
communication between 
all relevant services 
including acute, primary 
care, community services, 
social care, housing and 
voluntary to coordinate 
care and support for 
patients during and 
following discharge 
process to support and 

Reg28May25 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Action 
Number 

Recommendation / Area 
for Improvement Identified  
prevent unnecessary 
readmissions 

Action Agreed 

Regular feedback and updates to be 
provided to Discharge Improvement 
Group via the Care Transfer Hub 
workstream, which will feed up to 
Quality Committee for board 
oversight. 

Lead 

Associate 
Director of 
Discharge 

Date for 
Completion 
30/06/2025 

Progress / Assurance 

y
e
K

Reg28May25 

 
 
 
 
 Draft written 

Discharge 
planning 
SOP written 
by 15/5/25 

SOP out for 
consultation 
31/5/25 

Ratification 
15/6/25 

5 

Discharge team to review 
and up-date the discharge 
planning Standard 
operating procedure 
(SOP) (previously 
Complex Discharge 
Operational Policy) to 
specific requirements of 
safe discharge. 

To include how to 
manage different pathway 
discharges safely and to 
ensure there is a process 
in place for when 
discharges fail on planned 
day of discharge. 

Process will detail 
escalation steps when 
contact with relevant 
parties cannot be made. 

Reg28May25 

To review and up-date the discharge 
planning SOP ensuring widespread 
consultation when developed. 

Discharge team 
lead 

To ensure that the following process 
is included: 
In hours discharge facilitator to call 
care agency to inform them when 
patient will be discharged and 
confirm package of care to 
commence. This should be 
documented on sunrise to include 
care agency name, contact number 
and member of care agency staff 
communicated with 
Out of hours, ward staff to contact 
care agency on the number provided 
by Discharge team, to inform them of 
the failed discharge. Attempts of 
contact to be documented on 
sunrise. Inform site team if 
unsuccessful in attempts to speak 
with agency. 
At the next opportunity within hours, 
discharge team to contact care 
agency to confirm when package of 
care will start and document on 
sunrise with name of care agency 
and staff member communicated 
with. 
To share SOP with teams for 
comment to ensure the following is 
addressed 

•  Out of hours protocol 
•  Who to contact and when 
•  When no response from care 
agency what is the next point 
of communication/escalation 

 
 
 
 
 Action Agreed 

SOP to be shared at Specialty 
Governance meetings and for 
minutes to be shared with the team  

Lead 

Matrons and 
Lead nurses 

Date for 
Completion 
01/07/2025 

Progress / Assurance 

y
e
K

Request made to produce a crib sheet for all 
staff in regard to accessing SOPs through 
Microsoft Share point. This has been actioned to 
matrons leads and directorate managers on the 
14/5/25. 

Action 
Number 
6 

Recommendation / Area 
for Improvement Identified  
To ensure that above 
procedures are shared 
with the wider team, 
understood and 
embedded into practice. 

7 

Improve discharge team 
documentation in clinical 
record to evidence safe 
discharge 

Reg28May25 

New SOPs and guidance to be 
shared trust wide.  

Matron and Divisional Chief Nurses 
to undertake in hours and out of hour 
ward visits to speak with staff and 
assess their knowledge on the safe 
discharge SOPs. 

Education and guidance to be made 
available on each ward on how to 
search and access this information  

Urgent meetings to be held with all 
discharge team staff to highlight the 
importance of accurate and clear 
documentation on all patient / care 
contacts. Sharing good examples 
and expectations in terms of 
communication with providers of care 
and next of kin/families 

Routine spot check audits to be 
scheduled and undertaken by 
Directorate Manager to ensure 
documentation requirement is 
evidenced in the clinical record and 
provide assurance action 
acknowledged 

Discharge Team 
Lead 

01/06/2025 

Divisional 
Director of 
Operations 
(CCCS) 

Discharge Team 
Lead 

01/06/2025 

Divisional 
Director of 
Operations 
(CCCS) 

Conversations held with Discharge Team to 
highlight documentation to include care agency 
details, company name and phone number.  
Discharge facilitator to document for every 
planned discharge; Care agency company 
name, name of staff member spoken to at the 
care agency, written confirmation of start date 
and time of package of care. Team meeting held 
26/5/2025 

Audit is on AMAT, has been completed for April 
and results shared with the team. Handed back 
to Service Leads and will be undertaken monthly 
moving forward 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Action 
Number 
8 

Recommendation / Area 
for Improvement Identified  
Teach and model to staff 
what a good discharge 
looks like. 

Action Agreed 

Lead 

Lead Nurses 
and Matrons 
across Medicine 
Division 

Jenny Bree, 
Corporate Lead 
for Improvement 

Reset week to be held w/c 12/5/25 
across Medicine Division to reinforce 
processes, and incidents. 

This will involve testing of the 
improvements set out in the 
improvement plan, and ensure 
ongoing oversight and monitoring 
through AMAT (Trust audit system) 
of the discharge checklist process 
and feed back up to the quality 
working group  

Date for 
Completion 
15/06/2025 

Progress / Assurance 

Reset week took place 12/05/2025 

y
e
K

AMAT audit commenced of discharge checklist 
1/5/25 

Reg28May25 

 
 
 
 
 
 Action 
Number 

Recommendation / Area 
for Improvement Identified  

Action Agreed 

Lead 

Date for 
Completion 

Progress / Assurance 

y
e
K

Discharge improvement group to be 
re-invigorated with renewed focus 
and clarity with clear outcomes for 
each of the strategic workstreams 
identified. (Group to have oversight 
of themes identified through the 
PSIIRF process) 

Deputy COO, 

15/5/25 

Director of 
Operations 

14/5/25 The Discharge Improvement Group has 
been re-established with a renewed and 
enhanced focus—not only on increasing the 
timeliness of patient discharges from the 
organisation, but also on ensuring that each 
discharge is carried out with the highest 
standards of safety and quality. 

As part of this work, dedicated workstreams 
have been initiated to support the proactive and 
coordinated planning of discharges across both 
simple and complex care pathways. In parallel, a 
thematic review of historical discharge-related 
incidents is underway to identify key learning 
points and inform future priorities. 

The Group comprises multidisciplinary 
representation, including colleagues from within 
the acute trust, our health and social care 
partners, the local authority, and a 
representative from our patient community. This 
collaborative approach is intended to provide 
assurance that discharge processes are being 
strengthened system-wide, with patient safety 
and continuity of care as central principles. 

Reg28May25 

 
 
 
 Action 
Number 
9 

Recommendation / Area 
for Improvement Identified  
All staff who have 
safeguarding training and 
human factors training as 
part of their mandatory 
training requirements 
should meet Trust 
compliance targets for 
such training.  

Action Agreed 

Lead 

Ward staff training to be completed 

Lead PDN for the division to have 
oversight and ensure sessions are 
booked in a timely manner. 

Protected time to be allocated to staff 
for training to be completed. 

All staff who 
have this 
requirement as 
part of their 
mandatory 
training 

Lead PDN for 
medicine 

Date for 
Completion 
01/06/2025 

Progress / Assurance 

y
e
K

Safeguarding Adults level 2 training 88.1% April 
2025 

Safeguarding training 90.59% - meets trust 
compliance target – May 2025 

Human factors training compliance 84%  

Work ongoing 

10 

To consider if the 
introduction of human 
factors training for 
Discharge team staff may 
benefit in decision making 

To discuss with Education lead 
current content of human factors 
training and its benefits for non-
clinical but patient facing staff 
members  

Education lead  

01/07/2025 

Bespoke training package to be designed for 
non-clinical staff to support with Human factors 
training 

Reg28May25
Also filed under 2025-0190: Samuel-Brookes-Prevention-of-Future-Deaths-Report-2025-0190.pdf
JOHN ELLERY 
H.M. SENIOR CORONER 

FOR SHROPSHIRE, 
TELFORD & WREKIN AREA 

H.M. Coroner’s Service 
Guildhall 
Frankwell Quay 
Shrewsbury 
Shropshire SY3 8HB 

Coroner's Office: 

Email: 

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1. 
Pensnett Road, Dudley, West Midlands, DY1 2HQ 

. Chief Executive, Russells Hall Hospital, Dudley Group NHS Foundation Trust, 

  1 

CORONER 

I am John Ellery, H.M. Senior Coroner, for the coroner area of Shropshire, Telford & Wrekin. 

  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 3 May 2024 I commenced an investigation into the death of Samuel Joseph BROOKES    

The investigation concluded at the end of the inquest on 24, 25 March & 9 April 2025  

 The conclusion of the inquest was; The deceased died following neglect to provide him his required 
care.  

  4 

CIRCUMSTANCES OF THE DEATH 

Mr Brookes was discharged home from Russells Hall Hospital, Dudley on the 8 April 2024 where he 
had  been  admitted  following  a  fall  and  long  lie  at  home.  The  hospital  arranged  his  transportation 
without rearranging his required care of two carers, four times a day. Mr Brookes, who was immobile 
and lived alone, was transported to his bed where he could not reach his pendant alarm nor his mobile 
phone, which was in another room. Mr Brookes was left unattended for two weeks until on the 22 April 
2024 his grandson attended and found him unresponsive, wedged between his bed and the bedroom 
wall. An ambulance was called, sadly on arrival paramedics confirmed that Mr Brookes was deceased 
and his death was declared at 11:37 hours. It is not known when Mr Brookes died between the 8 & 22 
April 2024. 

 
 
  
  
  
 
   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) The hospital arranged for Mr Brookes transportation home without rearranging the required care 
as set out in paragraph 4 above. 

(2) There was no record or documentation or process to show or demonstrate that the care had been 
rearranged.  

(3) The transport company were responsible for transportation only and were not required to notify 
either the hospital, or if known, the care company of Mr Brookes’ safe return. It proceeded on the 
basis or assumption that care would have restarted within 4 hours or sooner.  

(4) Mr Brookes did not have his alarm pendant around his neck and nor was his mobile phone 
available (it was in another room). Accordingly when Mr Brookes got into difficulty he could not 
raise the alarm or call for help. 
ACTION SHOULD BE TAKEN 

  6 

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 10 
June 2025. 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. 

2

   8 

COPIES and PUBLICATION 

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

1.  FBC Manby Bowdler LLP, Solicitors representing the family 
2.  Weightmans LLP, Solicitors representing Dudley Group of Hospitals 
3.  Outcome Care and Support 
4.  Cartello Ambulance - Transport Company  

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 

John Ellery 

H.M. Senior Coroner 
Shropshire, Telford & Wrekin 

15 April 2025 

Send to: 

3

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