PFD report

Cady James Stewart · Prevention of Future Deaths report

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Issued 21 Dec 2018•Manchester South

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

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Concerns
1

Raised in this report

Recipients
1

Named on the report

Responses found
0

Of 1 recipient

Stated actions
0

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

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Concerns and recipient responses

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Concerns raised1

  1. Failure to remove palliative opiate medication from a bereaved person’s possession
    Part of recurring concern: Failure to secure and control medicationPart of recurring concern: Inadequate control of access to means of self-harm
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

No linked response statements

No respondent-stated action or position is clearly linked to these concerns.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Failure to remove palliative opiate medication from a bereaved person’s possession

Wider context from the report

“1. The inquest heard that Cady Stewart’s mother had died a few months before from terminal cancer. Whilst her mother was on palliative care she had been prescribed a significant amount of opiate drugs. After her death the medication was not removed by the nursing team and remained in Cady Stewart’s possession. It remained in her possession even though she attempted to take her life immediately after her mother’s death. She used that in combination with medication prescribed to her to take her life. ”

Is this part of a recurring concern?

Yes — Failure to secure and control medication; Inadequate control of access to means of self-harm.

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Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026