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recurance

Philip Powell

30 Nov 2017 · Coroner Zafar Siddique · Black Country

The coroner's concerns

  1. 1. delay in ordering Debrisoft

    “Evidence emerged during the inquest that there were delays in ordering Debrisoft which would have helped in managing the wound”
  2. 2. poor communication and poor systems in ordering Debrisoft

    “evidence of poor communication and poor systems in place in ordering Debrisoft with confusion about the process and overall responsibility”

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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