Source · Prevention of Future Deaths
Ida Toole
Ref: 2017-0146
Date: 2 May 2017
Coroner: Thomas Osborne
Area: Milton Keynes
Responses identified: 0 / 1
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A high falls risk patient was denied a sensor mat based on mental capacity, demonstrating a policy requiring urgent review for potentially neglecting safety needs.
Date
2 May 2017
56-day deadline
27 Jun 2017
Responses identified
0 of 1
Coroner's concerns
A high falls risk patient was denied a sensor mat based on mental capacity, demonstrating a policy requiring urgent review for potentially neglecting safety needs.
View full coroner's concerns
_ During the course of the evidence was told that Mrs Toole did not have a sensor mat alongside her bed despite having been assessed as a high risk Of falling: The reason for this, was told, was due to the fact that Mrs Toole had mental capacity. The policy for the provision of sensor mats to high risk residents should be urgently reviewed_
Report sections
Investigation and inquest
On 16/01/2017 | commenced an investigation into the death of Ida Jean Toole, ages 82 The investigation concluded at the end of the inquest on 2nd May 2017 The conclusion of the inquest was that she died as the result of an accident.
Circumstances of the death
Mrs Toole suffered an unwitnessed fall at Water Hall Care Centre on the 1Oth January 2017 and suffered a head injury She died at Milton Keynes Hospital on the 14th January 2017 Her cause of death was given as 1a) Pneumonia
2) Acute on Chronic Subdural Haemorrhage
2) Acute on Chronic Subdural Haemorrhage
Action should be taken
In my opinion action should be taken to prevent future deaths and believe you have the power to take such action
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Report details
- Reference
- 2017-0146
- Date of report
- 2 May 2017
- Coroner
- Thomas Osborne
- Coroner area
- Milton Keynes
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: 27 Jun 2017.
Sent to
- Excel Care