Nicholas James Megginson · Prevention of Future Deaths report

On the 28th May 2014 I commenced an investigation into the death of Nicholas James Megginson, aged 45 years. The investigation concluded at the end of an inquest on the 6th August 2014. The conclusion of the inquest was that of a narrative conclusion;

"Nicholas James Megginson died from effects of a pulmonary thromboembolism arising from him fracturing his ankle when he fell on the 5th May 2014. He was considered high risk for developing a thromboembolism by virtue of the fracture and his underlying vascular impairment. Whilst he was prescribed prophylaxis for venous thromboembolism which was administered after his surgery on the 6th May, he was not prescribed anything thereafter"

The medical cause of his death was recorded as:-
1a. Pulmonary Thromboembolism
1b. Deep Venous Thrombosis
1c. Fractured Left Ankle (operated 06/05/2014)

The deceased was found unresponsive by his wife at the home address on the 22nd May 2014. He had previously fractured his left ankle on the 5th May 2014 and had an operation on 6th May before being discharged home on 7th May. A post mortem examination found that he had died from the effects of a pulmonary embolism.

1. The evidence revealed that there was no consistent advice given to patients discharged post-surgery regarding the risks of venous thromboembolism either orally or in writing incorporating advice in relation to concerning clinical signs which may arise to indicate urgent medical treatment is required.