Repeated warnings
Each one is a single concern, raised with the same organisation in two or more coroners' reports at least six months apart. Nemotron Super judged every match to be the same or a closely related hazard, and both quotes are checked word for word against the reports.
All chains
Organisation type
Theme
Relation
Reports
More filters
Minimum confidence
At least
18 chains, most recent report first. The order is by date only; there is no ranking of organisations.
- 3 reports · 1 coronerIdentical hazardConfidence 0.95 · high
- Adhesions leading to small bowel obstruction
NHS England · National body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · high - Insufficient patient observation leading to inpatient falls
University Hospitals Birmingham NHS Foundation Trust · NHS body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · high - 2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report
- Governance failure in incident identification and poor quality of clinical notes
Barts Health NHS Trust · NHS body
3 reports · 1 coronerIdentical hazardConfidence 0.90 · highNo published response to an earlier report - 2 reports · 1 coronerIdentical hazardConfidence 0.96 · high
- Patients not informed of surgical risks in Turkey
Department of Health and Social Care · National body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · high - 2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report
- Unrecognised oesophageal intubation and unconfirmed tracheal tube placement
NHS England · National body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · high - Delayed sepsis recognition and treatment
Blackpool Teaching Hospitals NHS Foundation Trust · NHS body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report - Recurring hazard (see the quoted concerns)
Medicines and Healthcare products Regulatory Agency · National body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report - Inadequate clinical records hinder investigations
Department of Health and Social Care · National body
3 reports · 1 coronerIdentical hazardConfidence 0.90 · high - 2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report
- Continuing medication for VTE risk after discharge
National Institute for Health and Care Excellence · National body
2 reports · 2 coronersIdentical hazardConfidence 0.90 · highNo published response to an earlier report - Lack of continuity of care due to excessive care team members
Norfolk and Suffolk NHS Foundation Trust · NHS body
2 reports · 1 coronerIdentical hazardConfidence 0.92 · high - Missed breech presentation due to lack of routine prenatal scanning
Department of Health and Social Care · National body
2 reports · 2 coronersIdentical hazardConfidence 0.92 · highNo published response to an earlier report - 2 reports · 2 coronersIdentical hazardConfidence 0.90 · high
- 2 reports · 1 coronerIdentical hazardConfidence 0.95 · high