Prevention of Future Deaths reports · 2025

Evie Muir

Regulation 28 report to prevent future deaths, reference 2025-0600, written 26 Nov 2025. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report26 Nov 2025
Reference2025-0600
DeceasedEvie Muir
CoronerStephen Simblet
Coroner areaEssex
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Organisation namedMid and South Essex 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 FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Mid and South Essex NHS Foundation Trust, Broomfield Hospital, Court Road, 

Broomfield, Essex.  

1 

CORONER 

I am STEPHEN SIMBLET KC assistant coroner, for the coroner area of Essex. 

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 21/03/2025,   I commenced an investigation into the death of Evie Gladys Muir, who died 
aged 17. The investigation concluded at the end of the inquest on 26/11/2025. The conclusion 
of the inquest was death by natural causes. The medical cause of her death was coronary artery 
vasculitis. 

4 

CIRCUMSTANCES OF THE DEATH 

The deceased died aged 17 of a heart attack suffered less than 2 weeks after her admission to 
hospital where she had a week- long stay for treatment for cardiac problems. She suffered with 
a rheumatological condition axial spondylarthritis for which she was receiving adalimumab 
medication. She was known to be HLA B27 positive. The deceased was discharged from 
hospital on 6th February having been provided with various medications. On 19th February, she 
collapsed with a cardiac arrest from which she could not successfully recover.  

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. 

The MATTERS OF CONCERN are as follows.  –  

(1)  That hospital reviews into unusual cardiac deaths such as this one are not more 
widely shared with other clinicians involved with a patient’s care, and other 
disciplines, such as, in this case, rheumatology specialists. This means that the full 
clinical picture of how a patient died may not be sufficiently widely understood.  

(2)  patients with cardiac problems known to be HLA B27 positive or 
otherwise known to present rheumatological conditions being 

1 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 adequately assessed for the risks which those rheumatological 
problems might present, include vasculitis.  

.   

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 25th January 2026. 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 : 

(i) 
(ii) 

(iii) 

 and 

, parents of the deceased; 

  to the LOCAL SAFEGUARDING BOARD (where the deceased was under 
18)].  

, Child Death Review Team Lead. 

I have also sent it to the Department of Health who may find it useful or of interest. 

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 

26th November 2025                     

Stephen Simblet KC 
Assistant Coroner 

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 Mid and South Essex NHS Foundation Trust (PDF)
H.M Assistant Coroner 
Mr Stephen Simblet KC 
SEAX House 
Victoria Road South 
Chelmsford 
Essex 
CM1 1QH 

23 January 2026 

Dear Mr Simblet KC 

Regulation 28 Report to Prevent Future Deaths – Miss Evie Gladys Muir 

I write further to your Regulation 28 Report to Prevent Future Deaths dated 26 November 
2025, relating to the Inquest of Miss Evie Muir. 

We have considered your concerns and now set out our formal response to each matter 
using your numbering as follows. 

Matters of Concern 

1.  That hospital reviews into unusual cardiac deaths such as this one are not more 
widely  shared  with  other  clinicians  involved  with  a  patient’s  care,  and  other 
disciplines,  such as,  in  this  case,  rheumatology  specialists.  This  means  that 
the  full  clinical  picture  of  how  a  patient  died  may  not  be  sufficiently  widely 
understood.  

Many medical specialist societies and national bodies have produced guidance on how 
to conduct morbidity and mortality (M&M) meetings, and these can be a valuable source 
of  learning  for  the  clinical  teams  and  the  wider  organisation.  At  Mid  and  South  Essex 
NHS  Foundation  Trust,  the  Cardiothoracic  Centre  (CTC)  M&M  meeting  is  conducted 
broadly in line with available guidance including an assessment of whether the death was 
potentially  avoidable.  Learning  points  are  shared  widely  with  the  CTC  team  but  are 
currently  not  included  in  the  Trust-wide  mortality  review  meetings  which  would  allow 
dissemination to a much wider group of clinicians.  

We  are  currently  undertaking  a  quality  improvement  programme  to  improve  our 
processes  for  learning  from  deaths  in  line  with  our  new  operating  model  and  clinical 
governance structure. The new process will allow sharing of learning between teams and 
across hospital sites. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 We do consider that it would have been beneficial for a joint review of Miss Muir’s care 
by both the Cardiology and Rheumatology teams. 

The  Rheumatology  team  have  confirmed  that  they  will  in  future  invite  Cardiology 
colleagues  to  their  departmental meetings  to  improve education of  coronary vasculitis 
and  myopericarditis.  I  understand  that  the  Rheumatology  team  are  working  hard  to 
improve awareness and management of cases such as Miss Muir’s. 

2.  Patients  with  cardiac  problems  known  to  be  HLA  B27  positive  or  otherwise 
known to  present  rheumatological  conditions  being  adequately  assessed for 
the  risks  which  those  rheumatological  problems  might  present,  include 
vasculitis. 

My  clinical  colleagues  advise  me  that  the  coexistence  of  Ankylosing  spondylitis  with 
systemic vasculitis that specifically targets the coronary arteries is exceptionally rare and 
primarily documented in isolated case reports. 

We have therefore agreed a wider learning exercise to raise awareness of cases such 
as this is required. Our Rheumatology team have confirmed that they will present Miss 
Muir’s case at the Essex Rheumatology meeting, which is a regional meeting. They will 
also  continue 
increase  awareness  among  allied  rheumatology  health  care 
professionals. 

to 

We plan to complete a full review of our Learning From Death’s process this year with 
the aim of ensuring that it is robust and effective. As part of this work, we will be looking 
at the effectiveness of M&M meetings and identifying opportunities to elevate their use, 
with a focus on opportunities for cross-speciality learning.  

If I can assist further with these matters, please do not hesitate to contact me. 

Yours sincerely 

Chief Executive 
Mid and South Essex NHS Foundation Trust

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