Source · Prevention of Future Deaths

Amanda Richardson

Ref: 2024-0484 Date: 9 Sep 2024 Coroner: Kevin McLoughlin Area: West Yorkshire (East) Responses identified: 1 / 2 View PDF

Systemic failures in medication review led to a patient receiving double the maximum dose for six months. Additionally, inadequate security and search procedures in a mental health hospital allowed illicit drugs to be present.

Date 9 Sep 2024
56-day deadline 4 Nov 2024 est.
Responses identified 1 of 2
Alcohol, drug and medication related deaths State Custody related deaths

Coroner's concerns

AI summary
Systemic failures in medication review led to a patient receiving double the maximum dose for six months. Additionally, inadequate security and search procedures in a mental health hospital allowed illicit drugs to be present.
View full coroner's concerns
the the

1 The evidence taken at inquest revealed that Ms Richardson had been prescribed for a period of about six months at double the stipulated maximum dose. The pathologist expressed the view that the high" level oft ffound in her blood on [toxicology analysis could possibly account for her death onTS OwShe had also taken death was attributed to the toxicity of both the and in combination: 2 It was admitted that the prescription of at the rate of mglday was double the Imglday stipulated maximum (withoul addltional monitoring being undertaken) and was made in error _ This situation went unnoticed for some six months, until her death There was no effective system of review in the hospital in this period The pharmacist appears to have dispensed the drug without querying the high dose. The nurses who administered the drugs did not question it: The MDT meetings which took place did not check the dose or reflect upon its potential interaction with the several other medications prescribed. Overall, there was no effective resilience in the hospital's systems to safeguard against drugs bring prescribed or administered in error_
3. On 19.4.23_ Ms Richardson was permitted unescorted leave in the community under S.17 MHA 1983. She did not return: She did, however, voluntarily reappear at the hospital the following day , albeit under the influence of illicit drugs and alcohol: Evidence was given that nurses reported having searched Ms Richardson on her return, but no adequate written record was made to confirm the nature or duration of the search, nor by whom it was conducted, in breach of hospital policies Ms Richardson died some 9 days later. Despite the seriousness of the 19.4.23 incident; no searches were carried out in her room or the hospital grounds in the period following her return: The toxicology and pathological evidence indicated that she had taken heroin shortly before her death_ Her room was not searched even after her death, as assumptions were wrongly made that her death was due to a cardiac event;
5. Some time after hear death, Ms Richardson's clothing and belongings were returned to an aunt: She searched through them and found various plastic "wraps" which were taken to the police and subsequently tested and confirmed as containing and The inference is that these were present in her bedroom at the time 0f her deain
6. The inquest was unable to establish how or when Ms Richardson obtained illicit illegal drugs_ Concerns were expressed as to the adequacy of the security arrangements in this lOw secure mental health hospital as at April 2023. 7 . In fairness to the hospital, it should be acknowledged that an Internal Serious Incident Review has taken place. Evidence was taken from the Group Deputy Chief Executive in relation to the [overhaul of security systems, pharmacy review procedures, staff training and record keeping which has taken place since Ms Richardson's death.

Responses

1 respondent
InMind Private Sector
6 Nov 2024 PDF
Action Taken

Inmind Healthcare states that they completed a Serious Incident Report and implemented an action plan of recommendations, with details of steps and actions implemented and embedded by Inmind following this incident detailed at length within a witness statement and in oral evidence at the inquest. (AI summary)

View full response
Dear Sir Inquest Touching the Death of Amanda Richardson We write in response to the Regulation 28 Report dated 9 September 2024 following the inquest touching the death of Amanda Richardson. Following Amanda's sad death, Inmind Healthcare completed a Serious Incident Report which shared with the CQC and Commissioners prior to the Inquest. The Serious Incident Report included an action plan of recommendations arising from the findings of the report. The details of the steps and actions implemented and embedded by Inmind following this incident were detailed at length within a witness statement of and in oral evidence of and Hospital Director at the inquest. The evidence included both changes to practice arising directly from this case and further improvements to service due to further organisational change. We do not intend to repeat in detail their evidence and consider that given the assurances before the Court at the inquest demonstrate that Inmind had learned lessons from this case and implemented change to prevent future deaths. We note that the Coroner has not specified any particular concerns arising from that evidence or identified a circumstance giving rise to risk of future deaths. On clarifying this with Coroner he states that he

considers his duty to make a prevention of future death report was triggered because of the seriousness of the case and that he felt a public record should be made of these concerns but did list concerns (as required with reference to paragraph 22 of the Chief Coroner's Guidance]. Further the Coroner stated that he has made a report notwithstanding the "assurances" given by Inmind Healthcare Inmind Healthcare remain committed to learning and improving service but given the assurances given to the Coroner at the Inquest, Inmind Healthcare consider that actions have been taken to fully address the issues identified by the Serious Incident Report and to prevent future deaths in similar circumstances.

Report sections

Investigation and inquest
On 31 May 2023 commenced an investigation into the death of Amanda Richardson; aged 40 The investigation concluded at the end of the Inquest on 30 August 2024. The conclusion of the Inquest was a narrative conclusion, in which the medical cause of death was: 1a and Toxicity.
Circumstances of the death
Amanda Richardson, aged 40, had been transferred from prison to a low secure mental health hospital called Waterloo Manor Independent Hospital in Leeds, under provisions of a Hospital Order made under the Mental Health Act 1983_ She was prescribed the drug amongst other medication. On Saturday 29 April 2023, Ms Richardson was pronounced dead by a paramedic after her lifeless body was found on the floor of her bedroom Toxicology Analyses subsequently revealed Jat a very high level well within the range encountered in fatalities, along with It transpired she had in error been prescribed at double the stipulated maximum dose_
Action should be taken
In my opinion action should be taken to prevent future deaths and believe your organisation has the power to take such action:

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Report details

Reference
2024-0484
Date of report
9 September 2024
Coroner
Kevin McLoughlin
Coroner area
West Yorkshire (East)

Responses identified

Responses identified 1 of 2
1 response not yet linked

Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 4 Nov 2024 (estimated).

Sent to

In Mind Healthcare Group Ltd
Waterloo Manor Hospital

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