Prevention of Future Deaths reports · 2015

Ronald Bonfield

Regulation 28 report to prevent future deaths, written 11 Sep 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report11 Sep 2015
DeceasedRonald Bonfield
CoronerGraeme Hughes
Coroner areaPowys
CategoryCommunity health care · Emergency Services 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. His Honour Judge Peter Thornton QC, Chief Coroner of England and
Wales.
Mr. Mark Drakeford, Minister for Health, National Assembly for Wales.
Mrs. Allison Williams, Chief Executive, Cwm Taf University Health Board
Practice Manager, Practice 1, Keir Hardie Health Park, Aberdare Road,
Merthyr Tydfil. CF48 1BZ

CORONER

| am Mr Graeme Hughes, Assistant Coroner, for the coroner area of Powys, Bridgend
and Glamorgan Valleys

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.

INVESTIGATION and INQUEST

On the 3” October 2014, | commenced an investigation into the death of Mr Ronald
Francis Bonfield. The investigation concluded at the end of the inquest on the 9"
September 2015. The conclusion of the inquest was - ‘The deceased took Warfarin as
an anti-coagulant. On the 29" September 2014 he sustained a head injury whilst at
home when a chair he sat on toppled backwards. He was diagnosed with a subdural
haematoma. He had sustained this injury at a time when he was over anti-coagulated.
His INR levels were not being monitored as required. His untreatable condition
deteriorated and he passed away at Prince Charles Hospital on the 2™ October 2014 at
10pm’.

CIRCUMSTANCES OF THE DEATH

Whilst at home on 29" September 2014, the deceased sustained a head injury when he
struck his head on the handle of a kitchen door. On 1* October 2014 he was admitted
to Prince Charles Hospital. A head injury was diagnosed, but he was not for active
surgical intervention. He deteriorated and died at Prince Charles Hospital on 2

October 2014.

CORONER’S CONCERNS
The matters of concern as follows:-

(1) The practices and procedures implemented by the Practice 1, Keir Hardie Health
Park, GP Surgery following Mr Bonfield’s death (with regard to monitoring the
compliance of the Health Boards District Nurse Teams following delegation to
undertake a patient's INR testing) is not uniform and/or implemented across all of
the Health Boards Level 4 Accredited GP practices.

(2) The practices and procedures implemented by Practice 1, Keir Hardie Health Park
Surgery act as a check and balance to reduce the risk of an
unmonitored/unactioned failure on the part of the District Nurse service to undertake
the task(testing the patients INR level) delegated to them by the GP practice
concerned.

(3) Until such action is taken there remains a risk that a future death(s) could occur in
similar circumstances to Mr Bonfield’s, where delegated INR testing has not been
done leading to un-monitored over anti-coagulation

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 in the area of:

> Ensuring that all level 4 accredited GP practices across the Cwm Taf Health
Board area follow the (monitoring) practices & procedures implemented by the
Practice 1, Keir Hardie Health Park, GP Surgery following Mr Bonfield’s death
YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report,

namely by 6" November, 2015. 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.

COPIES and PUBLICATION

| have sent a copy of my report to the Chief Coroner; Mr. Mark Drakeford, Minister of
Health, National Assembly for Wales; Mrs. Allison Williams, Chief Executive, Cwm Taf
University Health Board; Practice Manager, Practice 1, Keir Hardie Health Park,
Aberdare Road, Merthyr Tydfil. CF48 1BZ

| 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.

41" September 2015

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