Karena WICKINGS · Prevention of Future Deaths report

On 16 February 2023 I commenced an investigation into the death of Karena WICKINGS.
The investigation concluded at the end of the inquest . The conclusion of the inquest was

Death from complications arising from an essential surgical procedure.

1a Pulmonary Embolism

1b

1c

II

Karena Wickings - aged 58 died in her home in Brampton, Cumbria on 5th February 2023. She had been admitted to hospital two months previously for laparoscopic surgery to remove a screening detected colonic cancer. She had a prolonged admission due to multiple postoperative complications requiring further surgeries. Throughout her admission she was given anticoagulant prophylaxis in the form of enoxaparin. Her clinical condition was improving and it seemed as if the cancer had been fully removed but at the time of discharge her mobility remained significantly restricted. Anticoagulant prophylaxis stopped when she left the hospital and it is unclear if ongoing indication was considered. It is more likely than not that the lack of ongoing prophylaxis led to the formation of thrombosis in her left leg and her death due to pulmonary embolism.

(1) The surgical mortality review conducted after Karena's does not seem to have considered the role that anticoagulation may have played. I understand trust guidelines suggest it continues until 5-7 days or until the patient regains full mobility. I was told many surgeons will extend this to 28 days. Karena was past the 28 day period but still had significant restriction at the time of discharge. A few years ago I heard a very similar case which occurred at a different health trust. The purpose of this report is to suggest that discharge planning might have a prompt to consider possible ongoing anticoagulant prophylaxis in patients who leave the hospital but have not yet regained full mobility.

(2)

(3)