Prevention of Future Deaths reports · 2015

Thelma Clarkson

Regulation 28 report to prevent future deaths, written 27 Nov 2015. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report27 Nov 2015
DeceasedThelma Clarkson
CoronerDavid Horsley
Coroner areaPortsmouth and South East Hampshire
CategoryHospital Death (Clinical Procedures and medical management) 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.

REGULATION 28: REPORT TO PREVENT FUTURE DEATHS

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

The Enquiry Handling Team

National Institute for Health and Care Excellence
10 Spring Gardens

London SW1A 2BU

1 | CORONER

| am David Clark Horsley, Senior Coroner, for the Coroner area of Portsmouth and
South East Hampshire.

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 25" February 2015 | commenced an investigation into the death of Thelma Doris
Clarkson. The investigation concluded at the end of the inquest on 19"" November 2015.
The conclusion of the inquest was:

Mrs Clarkson's medical cause of death was Acute Subdural Haematoma and |
concluded that her death was due to an Accident. | enclose a copy of my Record of
Inquest.

4 | CIRCUMSTANCES OF THE DEATH

On 10" February 2015 Mrs Clarkson fell in her home. She sustained a number of
injuries, including head injuries. She was taken to Gosport War Memorial Hospital where
her injuries were treated and she was discharged home that afternoon. Following her
return home, her condition deteriorated and she was taken by ambulance that evening
to Southampton General Hospital where examination determined she had sustained an
inoperable head injury from her earlier fall. She died at Southampton General Hospital
on 11" February 2015.

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. —

Prior to her fall, Mrs Clarkson has for some time been prescribed and was taking the
drug Clopidogrel for her long-standing heart disease. The British National Formulary
warns that patients taking Clopidogrel are at risk of increased bleeding from trauma.
However, | was told in evidence at the Inquest that under the NICE Head Injury Pathway
which was in use at the time at Gosport War Memorial Hospital, had Mrs Clarkson been
taking Warfarin she would have been sent to a larger hospital to have a CT scan of her
head but the Pathway did not include Clopidogret as a similar trigger for a CT scan -
notwithstanding the risk of increased bleeding from head trauma. | was also told that,
had Mrs Clarkson been sent from Gosport War Memorial Hospital for a CT scan, there is
a strong possibility it would have revealed the extent of her head injury and her

treatment - and its potential outcome - may have been different. | am therefore
concerned that the NICE should consider whether its Head Injury Pathway should be
amended to include taking Clopidogrel as a trigger for a CT scan in the same way as
Warfarin presently does.

ACTION SHOULD BE TAKEN

In my opinion action should be taken to prevent future deaths and | believe your
organisation 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 224 January 2016. 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 and to the following Interested
Persons:

1- Mrs Clarkson's family

2- Portsmouth Hospitals NHS Trust

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.

27™ November 2015 [SIGNED BY CORONER]

. CH
r David Clr Hors

Related reports

More reports categorised “Hospital Death (Clinical Procedures and medical management) related deaths”

See all →

Track Hospital Death (Clinical Procedures and medical management) related deaths

See every Prevention of Future Deaths report matching Hospital Death (Clinical Procedures and medical management) related deaths, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.