Charles Williamson · Prevention of Future Deaths report

On 6th June 2019 I commenced an investigation into the death of Charles Williamson.
The investigation concluded on the 25th September 2019 and the conclusion was one of Accidental death. The medical cause of death was 1a) Urinary tract infection on a background of long term catheterisation; 1b) Traumatic brain injury; and 2) Hospital acquired pneumonia

Charles Williamson fell in Portugal suffering a significant traumatic brain injury. He was repatriated to England and admitted to Wythenshawe Hospital. A scan identified an enlargement of the chronic subdural haematoma. A drainage operation was performed at Salford Royal Hospital. He was moved back to Wythenshawe subsequently. A scan on 16th February 2019 showed a recurrence of the chronic subdural haematoma. A further successful drainage procedure was undertaken at Salford Royal Hospital. He was subsequently again returned to Wythenshawe Hospital. On 18th March 2019 further tests concluded with a MR scan showing a likely infection in the brain. He was transferred to Salford Royal Hospital for a craniotomy. He was on antibiotics for 6 weeks initially at Salford Royal Hospital and then at Wythenshawe. He was transferred to the neuro-rehabilitation unit at Trafford on 17th April 2019 he continued to deteriorate with confusion and loss of mobility. He was catheterised as a consequence. He showed signs of an infection which was a urinary tract infection and a pneumonia. He was treated with antibiotics. He continued to decline and died at Tameside General Hospital on 5th June 2019.

The inquest heard that following neurological incidents such as those sustained by Mr Williamson it will often be the case that a key to returning to baseline or closer to baseline is effective and early neuro-rehabilitation. The inquest was told that a shortage of appropriate neuro-rehabilitation beds in Greater Manchester was in some cases preventing early effective neuro-rehabilitation and increasing the risk of complications which could lead to death.