Norman Dorn

Mr Norman Henry Charles Dorn died on the August 2014. An investigation was opened on the 2rd September 2014 and was concluded by way of an inquest on the 3rd March 2015. The causes of death were I(a) Asphyxiation 1(b) Complete Obstruction Of Trachea By Food Particles and in part Il Gastric Mucosal Tear With Severe Bleeding: An open verdict was returned

Norman Dorn was found and was presumed to be dead in an armchair at Porte Rouge Residential Home, Vicarage Road, Torpoint at around 11.30 on 26th August 2014 wilh a sandwich in his hand and with excess food in his mouth. He was last seen alive 10 to 15 minutes before eating a jam sandwich and drinking apple juice He was known to have swallowing problems and had been provided with soft food. There were no staff trained to recognise death and they did not make attempts to remove the food from his mouth or resuscitate him as required by the care home policy. Nor did the GP altend in timely manner when requested or staff from other emergency services. It was not clear whether such actions could have resuscitated him or not.

To review the facts and circumstances of this inquest (disclosure of the statements and reports can be provided) with a view to reinforcing the need to have clear and adequate policies in place to recognise death and out appropriate resuscitation or call professional medical help in a timely fashion: In this case the police considered a possible manslaughter charge against the care home staff.