Emma Langley
18 Nov 2019 · Coroner James Bennett · Birmimgham and Solihull
A similar concern from this report was raised again 1 time later. See the linked reports.
The coroner's concerns
1. patient not admitted to hospital
“The deceased/her family were keen for her to be admitted to hospital. The paramedic asked the deceased's partner to sign the 'non-conveyance' statement on his EPR tablet after summarising a 1 hour 45 minute attendance. The rejection of medical advice was diluted by other details. The deceased's partner stated he did not appreciate what he was signing. He was distressed and emotional and the room had been busy with family members, the paramedics and his ill partner.”
2. inadequate communication of medical advice
“In my judgment, the facts of this case demonstrate the current system of signing a screen on a tablet after a generic summary, does not adequately amplify to a patient/their family (who might be distressed and emotional) they are rejecting medical advice to be admitted to hospital.”
Linked reports
Closely relatedConfidence 0.90 · high
This report
“The paramedic asked the deceased's partner to sign the 'non-conveyance' statement on his EPR tablet after summarising a 1 hour 45 minute attendance.”
Later report
“(2) The EPR did not record that the deceased had been advised to go to hospital nor that she understood any such advice and she was not asked to sign a disclaimer;”
Responses
2019-0384-Response-by-West-Midlands-Ambulance-Service-NHS-Trust.pdf ↗· West Midlands Ambulance Service
Stated action
“We are currently in the process of changing the software on our electronic patient report to include a statement that will be visible on the screen where patients, family or carers will see and read prior to signing. This statement clearly sets out that they are signing to acknowledge the refusal for treatment and/or transport to hospital and/or referral for further care against the advice of the attending ambulance clinicians. It also goes on to state that the risks of this has been explained”