Prevention of Future Deaths reports · 2015

Ian Emsley

Regulation 28 report to prevent future deaths, written 8 Sep 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report8 Sep 2015
DeceasedIan Emsley
CoronerElizabeth Earland
Coroner areaExeter and Great Devon
CategoryState Custody related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

Text recovered by OCR from a scanned PDF. OCR is imperfect: check anything you rely on against the source PDF. Reproduced verbatim, including the scan's own layout.

ANNEX A

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

NOTE: This form is to be used after an inquest.

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS
THIS REPORT IS BEING SENT TO:

1. HMP Exeter
2. HMP Portland

1 | CORONER

| am Dr Elizabeth Earland, HM Senior Coroner for the coroner area of Exeter and
Greater Devon

2 | CORONER’S LEGAL POWERS

| 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 the 10" February 2015 | commenced an investigation into the death of lan Paul
Emsley, aged 50 years. The investigation concluded at the end of the inquest on the 3"
September 2015. The conclusion of the inquest was Natural Causes. The cause of
death being:

1a— Metastatic Renal Cell Carcinoma

4 | CIRCUMSTANCES OF THE DEATH
PMH - Metastatic renal cancer. Prev IV drug use (on methadone) , alcoho! excess

Diagnosed with terminal renal ca Sept 2013 whilst resident in HMP Dorchester. He was
transferred to HMP YOI Portland on the 26" November 2013. Moved to palliative care
wing HMP Exeter Nov 2014 with life expectancy in terms of weeks. Treatment consisted
of steroids and analgesia. Mid Jan 2015 course of Radiotherapy to try and ease
symptoms. 29/1/15 deterioration more pronounced and by 1/2/15 was unconscious for
majority of the time. Family and Nursing staff were present at approx 1820hrs 1/2/15
when he stopped breathing. Prison Dr attended to confirm death 1930hrs 1/2/15.

Police attended no sus circs.

An Investigation was opened on 10th February 2014.

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 terminally ill patients will suffer more unless action
is taken. In the circumstances it is my statutory duty to report to you.

The MATTERS OF CONCERN are as follows.

During the Inquest into Mr Emsley’s death from Natural Causes in the palliative
care wing at HMP Exeter, the care at HMP Exeter was highly proactive in the last 9
weeks of his life. The care given, in HMP YOI Portland was less so and subject to
a number of resource based constraints in end of life care provision. The result
being that transfer to HMP Exeter could have been much sooner.

The Clinical Reviewer found that overall it might be helpful for healthcare staff to
be given formal guidance or training to assist them in making decisions regarding
the assessment of the requirement of restraints and the assessment and decision
making of release on compassionate grounds at Multi-Disciplinary Team Meetings
involving prison (security) staff and healthcare.

With lack of formal guidance/or training on the subject healthcare staff were
uncomfortable with making decisions on a prisoners risk of re-offending or
escape. As a consequence there is a potential for delay in effecting transfer
and/or compassionate release for prisoners who are terminally ifl, which could
also impact on the family.

When you have had an opportunity to review the current procedures | require a
substantive response within the statuary 56 days.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe you and your
organisation have the power to take such action, please see what | require of you as
listed below:

1a - Assessment of the requirement of restraints
1b - Assessment and decision making on compassionate grounds

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by Monday 2" November 2015. |, 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

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

1. | tti(‘(‘i‘z‘ Or Deceased’s Daughter
2 © Partner
3 a Father

4. The Treasury Solicitors Department
5. The Prisons and Probation Ombudsman

| 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.
ae = c

8” September 2015 Zo = a,

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