Source · Prevention of Future Deaths
Anita Mandalia
Ref: 2021-0234
Date: 9 Jul 2021
Coroner: Graeme Irvine
Area: East London
Responses identified: 0 / 2
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Date
9 Jul 2021
56-day deadline
2 Sep 2021
Responses identified
0 of 2
Coroner's concerns
The provided text is incomplete and does not contain specific concerns for summarization.
View full coroner's concerns
_ Mrs Mandalia had been prescribed NICE guidance BNF guidance stipulates that this medication ought not to be prescribed for longer than Mrs Mandalia had received that prescription far longer that the recommended period. The GP surgery had not reviewed the appropriateness of that prescription Despite having received instructions within discharge summary from secondary mental health trust in August 2020 that required the surgery to re-refer Mrs Mandalia if concerns arose regarding her mental health, when issues were raised in October and December 2020 to the surgery no referral was made.
3. In June 2020 the surgery introduced measures to mitigate the risk of overdose presented by Mrs Mandalia which required medication to be dispensed in dosette box containing a maximum supply of medications However on 6th January 2021 Mrs Mandalia was prescribed lfor pain which allowed her access to an excess of
3. In June 2020 the surgery introduced measures to mitigate the risk of overdose presented by Mrs Mandalia which required medication to be dispensed in dosette box containing a maximum supply of medications However on 6th January 2021 Mrs Mandalia was prescribed lfor pain which allowed her access to an excess of
Report sections
Investigation and inquest
On 12th February 2021 commenced an investigation into the death of Anita Mandalia aged 58 years. The investigation concluded at the end of the inquest on &th 2021 . The conclusion of the inquest was that Mrs Mandalia died from: 1a Multi Organ System Failure 1b Septic Shock Ic Pneumonia Multiple drug overdose, depression A short form conclusion of accidental death was arrived at
Circumstances of the death
July
Mrs Mandalia took an overdose of prescribed medications whilst at home on 7th February 2021. Despite medical treatment she succumbed to complications of the overdose on 1th February 2021 in hospital:
Mrs Mandalia took an overdose of prescribed medications whilst at home on 7th February 2021. Despite medical treatment she succumbed to complications of the overdose on 1th February 2021 in hospital:
Action should be taken
In my opinion action should be taken to prevent future deaths and believe you [ANDIOR your organisation] have the power to take such action.
Similar PFD reports
Related inquiry recommendations
Report details
- Reference
- 2021-0234
- Date of report
- 9 July 2021
- Coroner
- Graeme Irvine
- Coroner area
- East London
Responses identified
Responses identified
0 of 2
2 responses not yet linked
Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 2 Sep 2021.
Sent to
- Newbury Group Practice
- Newbury Park Health Centre