Source · Prevention of Future Deaths
Marjorie Booth
Ref: 2016-0094
Date: 4 Mar 2016
Coroner: John Pollard
Area: Manchester (South)
Responses identified: 0 / 1
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Concerns were raised about an apparent hospital policy not to routinely perform CT scans for suspected fractures, even when the risk of missing a fracture outweighs radiation exposure risk for elderly patients.
Date
4 Mar 2016
56-day deadline
29 Apr 2016
Responses identified
0 of 1
Coroner's concerns
Concerns were raised about an apparent hospital policy not to routinely perform CT scans for suspected fractures, even when the risk of missing a fracture outweighs radiation exposure risk for elderly patients.
View full coroner's concerns
was told that a CT scan is not routinely asked for in these circumstances, even though it is really the only way to be sure that there is no impacted or un-displaced fracture, because of the risk of exposing the patient to additional levels of radiation: The doctor giving this evidence agreed with me that the minimal risk of the radiation (in a patient over 90 years old) did not compare with the considerable risk of missing such fractures: Can the Trust explain why there is apparently a policy not to perform scans in such circumstances and whether in fact this could be amended: X-ray day - giving policy
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:
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:
Report sections
Investigation and inquest
On 21st October 2015 commenced an investigation into the death of Marjorie Booth dob 27 March 1924_ The investigation concluded on the 2nd March 2016 and the conclusion was one of Accidental Death: The medical cause of death was Ia Respiratory and cardiac Failure 1b Hospital acquired pneumonia 1c Acute stroke 11_ Left hip replacement, atrial fibrillation, moderate to severe mitral regurgitation; hypertension.
Circumstances of the death
On the 21st September 2015 she fell at her home address: She tripped over the tail of a coat which she was carrying and fell at the bottom of the stairs She was taken to hospital where she was examined and had an taken of her hip but the staff failed to note that she had an impacted fracture of the hip. She returned to the hospital the following when a CT scan was performed; the fracture was identified and was operated upon: She then sadly declined over the next days and died on the 19t October:
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Report details
- Reference
- 2016-0094
- Date of report
- 4 March 2016
- Coroner
- John Pollard
- Coroner area
- Manchester (South)
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: 29 Apr 2016.
Sent to
- Stockport NHS Foundation Trust