Source · Prevention of Future Deaths
Liam Oldsworth
Ref: 2017-0301
Date: 20 Oct 2017
Coroner: Paul Cooper
Area: Lincolnshire
Responses identified: 0 / 1
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The serious incident analysis report was significantly delayed in being received by the coroner's office, hindering timely review and learning.
Date
20 Oct 2017
56-day deadline
23 Jan 2018 est.
Responses identified
0 of 1
Coroner's concerns
The serious incident analysis report was significantly delayed in being received by the coroner's office, hindering timely review and learning.
View full coroner's concerns
_ The Serious Incident Analysis report dated 18/3/2015 has only within the last week been received by this office_ Attached are recommendations and shared learning:
Report sections
Investigation and inquest
On 19/08/2014 commenced an investigation into the death of Liam Oldsworth, aged 22 Months. The investigation is currently on going: At post mortem the medical cause of death was reported as 1a Aspiration Pneumonia Long standing Hypoxic Ischaemic Brain Injury and West Syndrome_
Circumstances of the death
The child was bought into the Pilgrim Hospital, Fishtoft; Boston with a high temperature, 41.9 and difficulty in breathing: No infection found. Patient treated for Septicaemia and meningitis with antibiotics, condition deteriorated despite all medical support
Action should be taken
In my opinion bearing in mind this report is now over 2 years old but was only delivered to this office in the last week all these recommendations should now have been acted upon and implemented and if not why not and timescale for compliance. Please confirm_
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Report details
- Reference
- 2017-0301
- Date of report
- 20 October 2017
- Coroner
- Paul Cooper
- Coroner area
- Lincolnshire
Responses identified
Responses identified
0 of 1
1 response not yet linked
Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 23 Jan 2018 (estimated).
Sent to
- United Lincolnshire Hospital