Prevention of Future Deaths reports · 2018

Margaret Spencer

Regulation 28 report to prevent future deaths, written 29 Mar 2018. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report29 Mar 2018
DeceasedMargaret Spencer
CoronerZafar Siddique
Coroner areaBlack Country
CategoryHospital Death (Clinical Procedures and medical management) related deaths
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.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Chief Executive, Walsall Healthcare NHS Trust (Manor Hospital) 

1 

CORONER 

I am Zafar Siddique, Senior Coroner, for the coroner area of the Black Country. 

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  the  18  December  2017,  I  commenced  an  investigation  into  the  death  of  Mrs 
Margaret Spencer.  The investigation concluded at the end of the inquest on 22 March 
2018. The conclusion of the inquest was a short narrative conclusion of: 

Died after developing complications arising from a failure to remove a pessary that had 
been  put  in  place  in  2014.    A  failure  to  do  a  timely  follow  up  review  due  to  system 
failures in IT and administrative input errors contributed to a decline in her condition and 
these failures and omissions were contributed to by neglect. 

The cause of death was:   

1a    Acute Kidney Injury 
b   Hospital Acquired Pneumonia 
c    
 ll   Ischaemic Heart Disease, Frailty, Forgotten Vaginal Pessary 

4 

CIRCUMSTANCES OF THE DEATH 

i)  Mrs Spencer  was under the care of the Manor Hospital Gynaecology clinic 
at  Manor  Hospital.    She  had  regular  appointments  and  review  after  being 
diagnosed with a prolapse.  This was treated with a pessary.   

ii)  She last saw and was reviewed by her Consultant on the 23 May 2014 and 

a new pessary given.  

iii)   Due  to  a  change  in  IT  systems  no  follow  up  review  took  place  and  her 
condition  deteriorated  with  her  reporting  frequent  urinary  tract  infections 
during 2017.  

iv)  This  resulted  in  further  hospital  admissions  and  in  November  2017  it  was 

discovered that the pessary had eroded through the bladder.   

v)  Sadly  despite  plans  for  further  surgery  her  condition  continued  to  decline 
and  she  passed  away  on  the  17  December  2017  after  developing 

1 

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 pneumonia and acute kidney injury.  

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.  Evidence  emerged  during  the  inquest  that  there  were  failures  to  properly 
implement sufficient training for staff during the introduction of a new IT system 
(Lorenzo).    This  resulted  in  the  premature  closing  of  her  access  plan  and 
effectively no further review.  This failure to conduct a review led to a number of 
patients including Mrs Spencer being placed at risk of harm. 

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.  

1.  You may wish to consider further reviewing the systems in place to ensure that 
all  relevant  patients  identified  during  the  relevant  period  have  been  identified 
and  further  treatment  offered  as  needed.    In  addition  you  may  wish  to  review 
that this IT system change did not result in any other patients across the Trust 
having their cases closed prematurely. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 28 May 2018. 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; Family. 

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 

 29 March 2018                                                   

Mr Zafar Siddique
Senior Coroner 
Black Country Area 

2 

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