Prevention of Future Deaths reports · 2015

Mary Hollands

Regulation 28 report to prevent future deaths, written 21 Dec 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report21 Dec 2015
DeceasedMary Hollands
CoronerNicola Jones
Coroner areaNorth Wales (East and Central)
CategoryHospital Death (Clinical Procedures and medical management) related deaths
Sourcejudiciary.uk record · original PDF
Responses publishednone published

The report

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REGULATION 28: REPORT TO PREVENT FUTURE DEATHS (1)

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS

THIS REPORT IS BEING SENT TO:

BCUHB, Ysbyty Gwynedd, Penrhosgarnedd, Bangor, Gwynedd LL57 2PW

4 | CORONER

| am Nicola Jones, assistant coroner, for the coroner area of North Wales (East and
Central)]

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 29 July 2015 | commenced an investigation into the death of Mrs Mary Myfanwy
Hollands, aged 98. The investigation concluded at the end of the Inquest on 3
December 2015. The conclusion of the Inquest was that Mrs Hollands died from natural
causes. The medical cause of death was I(a) Ischaemic Heart disease , Pneumonia. I!
Old Age, Dementia.

4 | CIRCUMSTANCES OF THE DEATH

(1) Mrs Hollands was a 98 year old lady with dementia. She sustained an
unwitnessed fall at the nursing home where she lived and was transported to
Ysbyty Gwynedd by ambulance. She complained of pain in her left shoulder
and left hip. X rays where taken of the shoulder and hip. Both of these were
examined and the junior doctor who reviewed the x ray of the hip could not see
any bony injury. It was believed that Mrs Hollands was suffering from a UTI and
she was given antibiotics. Mrs Hollands was transferred to the medical team
and was subsequently discharged.

(2

~S

She then deteriorated over the next four weeks and washer less mobile than
before the fall. She was admitted by ambulance to Ysbyty Glan Clwyd on 10
July 2015. As well as treating Mrs Hollands for dehydration and an infection an
xray was taken of her left hip. This revealed a bony injury. Whilst this could not
be dated it was confirmed that the result was the same as the xray taken four
weeks earlier. The bony injury had been missed on the previous occasion at
Ysbyty Glan Clwyd. Mrs Hollands was not strong enough for surgical
intervention and she was discharged with advice that the hip injury be managed
conservatively. Mrs Hollands continued to deteriorate and died on 27 July 2015

It is accepted that the hip injury was very difficult to identify. In these circumstances
there is a safety netting system in place. A radiologist considers the X-ray and does a
report within 48 hours which is sent to the Emergency Department. In Mrs Hollands’
case the Consultant Radiologist reported that there was “a step in the cortex of the
medial It neck raising the possibility of an undisplaced fracture. If there are ongoing

symptoms, then a repeat film with a lateral is recommended.” The paper copy of this
report never arrived in the Emergency Department. By the time the report was signed
off Mrs Hollands had been discharged. The Emergency Department were not alerted to
the possibility of the fracture. Whilst the report was put on the PACS system there was
no prompt for the Emergency Department staff to consider this.

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 system currently in place for radiologist’s reports being passed to the
Emergency Department is not sufficiently reliable or safe so as to provide
effective safety netting for patients.

(2) Under the current system the x ray will be put on the PACS system and
any obvious bony injury will have the words “red dot” typed on the area
of the injury. The Emergency Department doctor must analyse all X-rays
to check for an injury, whether or not marked with “red dot”. This is then
followed with a radiologists report within 48 hours. The report is put on
the PACS system and a paper copy is despatched to the Emergency
Department and attached to the notes. The radiologist will in his report
note any injuries which he has seen. This provides a safety net where an
Emergency Department doctor may have missed a more subtle injury so
that a patient, whom has been discharged can be recalled for future advice
and/or treatment.

(3) There is currently no coding system for radiologists to make those reports
which identify injuries easily identifiable so that the busy Emergency
Department can prioritise the reading of those reports with a view to
recalling patients whose injuries have gone undetected. This is in the
context of some 50000 patients passing through each Emergency
Department each year, an average of one third of whom are x rayed .
Time is currently being wasted in an already busy department ploughing
through reports which do not need to be considered as no injury is
disclosed.

(4) Also the method of passing the paper information to the Emergency
Department is flawed. There are regular occasions when the paper report
does not arrive, as happened in the case of Mrs Hollands, meaning that
some patients are not recalled for necessary advice and treatment, as in
the case of Mrs Hollands. Once the paper report arrives in the
Emergency Department the paper notes have to be located and the Paper
report attached before it can be considered in context. On occasion a
radiologist will come down and discuss a report. There appears to be a
lack of consistency

(5) There needs to be a reliable system for the report of the radiologist to be
delivered to the Emergency Department, prioritising patient’s with
injuries. An optimum system could be devised between senior
Consultant Radiologists and Senior Consultant Emergency doctors. This
needs to be considered for use prior to digitalisation of Emergency
Department notes and incorporated into the anticipated digitalised
system.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisations have the power to take such action.

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,
namely by 15th February 2016 |, 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 s rt to the Chief Coroner and to the following Interested
Persons, Next of Kin)

lam 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.

[DATE] 21S December 2015 [SIGNED BYAASSISTANT CORONER]

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