Sarah Fernyhough · Prevention of Future Deaths report

On 22 may 2019 I commenced an investigation into the death of Sarah Fernyhough a 30 year old young woman who died on 22 May 2019 at ████████ Abels Road Halstead. The investigation concluded at the end of the inquest on 10 February 2020.

The conclusion of the inquest was expressed as a Narrative viz:- The deceased died at her home address in the early hours of 22 May 2019. She had taken an overdose of venlafaxine, amisulpride and hydroxyzine as well as cocaine, cannabis and alcohol. At 23.53am on 21 May 2019 she called the ambulance service but on attendance of fire and ambulance crews at 3.04am on 22 May she could not be resuscitated. There was a delay in the attendance and failings in the procedures in place for the categorisation of calls. It is not certain whether, if paramedics had arrived sooner, she would have survived. The evidence does not indicate on the balance of probabilities that the deceased intended to take her own life.

See above

The medical cause of death was 1a) alcohol and multiple drug toxicity

1. The deceased’s call was described as an “abandoned call” and thereafter automatically categorised as category 3 A review of this practice is required.

2. A review is required as to whether it is appropriate for all reported medical conditions to be categorised no higher than category 3
3. In the situation leading up to Ms Fernyhough’s death, the duty EOC who had authority to upgrade the categorisation of the call did not listen to the recording of the “abandoned” call and was not provided with full details of any medical information given. Measures could be put in place to ensure that the duty EOC or other person who has authority to upgrade the categorisation of calls is asked to listen to the recording of the “abandoned” call or provided with full details of any medical information given.

1.