Philip Hawkins
18 Jul 2023 · Coroner David Pojur · North Wales East and Central
The coroner's concerns
1. delayed entry to hospital and delayed bed allocation
“Entry into Hospital and Delay to bed allocation”
2. lack of written nursing documentation
“There is no written nursing documentation in relation to Mr [name redacted]' care from 21:52 on 19.03.23”
3. lack of nursing attention to personal care and pressure area assessment
“On 18.03.2 at 02:49 there was no space for a nurse to attend to Mr [name redacted]' personal care needs or assess his pressure areas”
4. failure to perform repeat blood tests
“On 19.03.23 at 12:18, Mr [name redacted] needed 'repeat bloods' but this was never done nor highlighted to clinicians”
5. unexplained oxygen administration without documentation
“On 19.03.23 at 00:31 Mr [name redacted] was given oxygen but there are no nursing notes to indicate why or whether this was discussed with a clinician”
6. nil by mouth status not communicated to visitors
“Mr [name redacted] was nil by mouth but this was not made known to visitors who fed him”
Responses
No published response was found on judiciary.uk.