James Bateley · Prevention of Future Deaths report

On 13th June 2014 I commenced an investigation into the death of James Bateley, born on 24th November 2014, being 88 years of age. An Inquest was opened on 13th June 2014 and was concluded on 10th March 2014

Mr Bateley was admitted to Worthing Hospital on 30th May 2014 as he was medically unwell. Severe pressure sores with necrosis of tissue on buttocks and scrotal area were documented. A safeguarding alert was raised due to the severity of these pressure sores. Mr Bateley died on 6th June 2014. A post mortem examination was carried out and the pathologist gave as the cause of death:-
1a. Bronchopneumonia & Sepsis
1b. Necrotising Fasciitis
1c. Pressure Wound
2. Ischaemic Heart disease

During the inquest the evidence revealed matters giving rise for concern. In my opinion there is a risk that future deaths will occur unless action is taken. In the circumstances it is my statutory duty to make this report to you.

The MATTERS OF CONCERN are:-
During the evidence it became apparent that neither the nursing home, where Mr Bateley was living, nor the Community Nurses, who had been called in to assist in treating Mr Bateley’s pressure sores had ready access to the necessary dressings. There was evidence given that these dressings are not readily available to nursing homes or the Community Nurses who regularly have to treat this type of ailment. The dressings have to be ordered through the GP and we were told that it could take up to 14 days for them to arrive. In Mr Bateley’s case staff had to borrow and make use other resident’s dressings. Sadly Mr Bateley was taken into hospital before his dressings arrived. Whilst the absence of these dressing was unlikely to have contributed directly to Mr Bateley’s death there is concern for others in the future who cannot rely on others to borrow dressing from.