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recurance

Oriel Vasey

4 Mar 2026 · Coroner Abigial Combes · Sunderland

The coroner's concerns

  1. 1. use of outdated form leading to erroneous allergy information

    “This form remains in place unchanged, and the process for handling this form, which belongs to the ICB, remains unchanged which means that this same error could occur again.”
  2. 2. inclusion of clinical allergy details in financial form

    “If this form is intended purely for financial decision making, it is unclear why there is a requirement for a specific section on allergies. That has led, in this case, to sub optimal care being provided to [the deceased] because treating medics had incorrect information on [the deceased]'s clinical record.”

Responses

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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

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