Source · Prevention of Future Deaths

Kymberley Holden

Ref: 2017-0105 Date: 4 Apr 2017 Coroner: Elizabeth Didcock Area: Nottinghamshire Responses identified: 0 / 2 View PDF

Persistent unsafe prescribing of controlled drugs and inadequate understanding of reporting serious incidents, compounded by poorly coordinated management for neurological patients, pose ongoing risks.

Date 4 Apr 2017
56-day deadline 11 Jul 2017 est.
Responses identified 0 of 2
Community health care and emergency services related deaths

Coroner's concerns

AI summary
Persistent unsafe prescribing of controlled drugs and inadequate understanding of reporting serious incidents, compounded by poorly coordinated management for neurological patients, pose ongoing risks.
View full coroner's concerns
In the circumstances it is therefore my statutory duty to report to you Essentially the serious outstanding The continuing risk of unsafe prescribing of controlled drugs by the Ivy Grove Surgery, and the limited understanding of the duty to report serious prescribing incidents_
2. The continuing risk of poorly coordinated management and prescribing in neurological patients under the care of both DCHS and the Derby Hospital drug and

During the Hearing; heard evidence in relation t0 these matters, and the oral evidence and documents went some way to addressing the concerns raised:

Report sections

Investigation and inquest
On the 28th February 2015, commenced an investigation into the death of Kymberley Holden; aged 27 years. The investigation concluded at the end of the inquest on the 23rd March 2017. The conclusion of the inquest was a Narrative as follows: On the 26th November 2014 Kymberley Holden died from Oxycodone toxicity. This had been prescribed for pain arising from her neurological condition: The dose prescribed for her; was significantly higher than intended, and contributed to her death.
Circumstances of the death
Kymberley had a chronic neurological condition, that of Devics Disease, similar to Multiple Sclerosis She was under the care of the Neurology team at Derby Hospitals NHS Trust. She suffered with chronic pain. Her GP prescribed a dose of a strong Opiate, Oxycodone, for pain, at a concentration that was 10 times the intended dose An alert on the prescribing screen, advising that the medication was a concentrated solution was overridden. The suggestion to prescribe this medication, which was used rarely in general practice, came from a Specialist Nurse working for a different Health Trust; that of Derbyshire Community Health Services. This nurse did not discuss her suggestion of Oxycodone with the Hospital team, who were advising on all other medications Further detail of my findings in relation to these issues is included in the written judgment in this case, which is attached to this document:
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.
Inquest conclusion
On the 26th November 2014 Kymberley Holden died from Oxycodone toxicity. This had been prescribed for pain arising from her neurological condition: The dose prescribed for her; was significantly higher than intended, and contributed to her death.

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Report details

Reference
2017-0105
Date of report
4 April 2017
Coroner
Elizabeth Didcock
Coroner area
Nottinghamshire

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: 11 Jul 2017 (estimated).

Sent to

Derbyshire Community Health Services
Ivy Grove Surgery

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