Recurance · prevention of future deaths reports
Pre-inquest brief
Fragmented transfer information across records
The earlier warning
Edward Cowey · 14 Oct 2020 · Emma Serrano, Derby and Derbyshire
“That patient electronic and paper based transfer information is not kept on one database.”
judiciary.uk/prevention-of-future-death-reports/edward-cowey
What was promised
A published response was found, but no specific action could be extracted with a verified quote.
What recurred
- 18 Oct 2022 · Kenneth Perkins · Sabyta Kaushal · Closely related · confidence 0.90 (high)
The clearest link, quoted from both reports:
Earlier · Edward Cowey · 14 Oct 2020
“That patient electronic and paper based transfer information is not kept on one database.”
Later · Kenneth Perkins · 18 Oct 2022
“There was no clear detailed handover or transfer document which would have detailed his medication, medical history and history of recurrent falls”
What happened next
No web check of the stated actions has been published for this chain.