Prevention of Future Deaths reports · 2025

David Jones

Regulation 28 report to prevent future deaths, reference 2025-0514, written 14 Oct 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report14 Oct 2025
Reference2025-0514
DeceasedDavid Jones
CoronerNathanael Hartley
Coroner areaNottingham and Nottinghamshire
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedNottingham University 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

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

1.  Chief  Executive  of  Nottingham  University  Hospitals  NHS  Trust  (“the

Trust”).

1

CORONER

I  am  Nathanael  Hartley,  Assistant  Coroner  for  the  coroner  area  of  Nottingham  and
Nottinghamshire.

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 12 August 2024 an inquest was opened into the death of David Charles Noel Jones,
aged  65.  The  inquest  concluded  on  2  September  2025.  I  made  a  narrative
determination at inquest that he died as a result of an aortic dissection.

4

CIRCUMSTANCES OF THE DEATH

Mr Jones had attended hospital following an episode of dizziness. He was reviewed in
the Emergency Department and noted to have low blood pressure and a low pulse rate.
He was monitored within Resus before being stepped down to Majors whilst awaiting
admission  to  ward  B3  for  monitoring  of  his  blood  pressure  and  kidney  function.  Mr
Jones had an incident of chest pain and sweatiness whilst mobilising when he was in
Majors. That was not brought to the attention of a senior doctor and did not result in a
further  clinical  assessment  and  consideration  of  further  investigations  within  resus.
Those  likely  further  investigations  may  well  have  revealed  the  presence  of  an  aortic
dissection. Mr Jones remained as an inpatient in hospital until the following day when
he was discharged and sadly died later that day from the effects of the aortic dissection.

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 could occur unless action is taken. In the
circumstances it is my statutory duty to report to you.

This is not the first inquest involving the Trust where there have been concerns about
an undiagnosed aortic dissection. I am personally aware of another recent inquest in
which  evidence  was  provided  to  assure  the  coroner  that  relevant  learning  has  been
disseminated  across  the  appropriate  departments  at  the  Trust,  and  processes
amended to try to prevent recurrence. I am also aware of evidence given to my coroner

1

 colleagues  about  the  Trust’s  educational  programme,  particularly  for  the  emergency
department team.

The MATTERS OF CONCERN are as follows.  –

1.  Whilst reviews were carried out through the Morbidity and Mortality process for
two of the departments involved in Mr Jones’ care, one has not been carried
out by the Emergency Department, despite concerns raised at inquest by the
witness  from  that  team.  I  am  concerned  that  potential  learning,  which  may
make a difference to future patients presenting with atypical aortic dissections,
has  not  been  identified  or  passed  on  to  clinicians  within  the  emergency
department and any other relevant departments.

2.  Despite  Mr  Jones’  clinical  picture  changing  whilst  in  the  emergency
department, the middle grade doctor reviewing Mr Jones did not alert a senior
doctor of the change. I am concerned that training in relation to atypical aortic
dissections brought to my attention in evidence at this and a previous inquest,
and to my coroner colleague’s attention in inquests they conducted, may not
have been ineffective. I am concerned about recurrence for other patients who
present  atypically,  and  that  the  patients  who  experience  similar  significant
developments  whilst  in  hospital  may  remain  unreviewed  by  those  with  the
appropriate  skill  and  seniority,  and  a  risk  of  death  from  undiagnosed  aortic
dissections may follow.

6

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and I believe you 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 9 December, 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.

8

COPIES and PUBLICATION

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

1.  Mr Jones’ family.

I  have  also  sent  a  copy  to  the  Chair  of  the  NHS  Nottingham  and  Nottinghamshire
Integrated Care Board, for their information.

9

Dated: 14 October 2025

Nathanael Hartley
HM Assistant Coroner
For Nottingham and Nottinghamshire

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 Nottingham University Hospitals NHS Trust (PDF)
9 December 2025

STRICTLY CONFIDENTIAL
Miss Mairin Casey
HM Coroner for Nottingham and Nottinghamshire
The Council House
Nottingham
NG1 2DT

Medical Directors Office
3rd Floor, Trust Headquarters
City Campus
Hucknall Road
Nottingham
NG5 1PB

www.nuh.nhs.uk

Dear Miss Casey

Please find enclosed Nottingham University Hospitals NHS Trust’s (NUH) response to the
Regulation 28 Prevention of Future Deaths Notice issued by Assistant Coroner, Nathaniel
Hartley, on 2 September 2025, following inquest into the death of the late Mr David Charles
Noel Jones.

This response describes a program of work at NUH with workstreams supporting the
improvement of early diagnosis of Acute Aortic Dissection.

Here we summarise the completed, ongoing and planned future work within NUH to improve
the early detection of Acute Aortic Dissection; the Acute Aortic Dissection Improvement
project. This work will be undertaken by an Acute  Aortic Dissection Improvement Group led
by the Cardiac Surgery team, with support from colleagues in the Emergency Department,
Acute Medicine, Stroke, Radiology, Patient Safety team and the Medical Director’s Office,
and involves other teams such as Stroke and Radiology etc as required.

The Acute Aortic Dissection Diagnosis improvement work is in liaison with the colleagues
from across the East Midlands Aortic Network to ensure inclusion of best practice and
learning from other regional centres across the network and National Programmes.

We would like to extend our apologies and condolences to the family and friends of the late
David Charles Noel Jones and hope this response provides assurance of our commitment to
improving patient safety and experience.

Yours sincerely

Medical Director and Responsible Officer

Enc

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