Thomas William Pearson · Prevention of Future Deaths report

On 16/02/2016 I commenced an investigation into the death of Thomas William Pearson, 64 . The investigation concluded at the end of the inquest on 24 June 2016. I recorded a narrative conclusion that Mr Thomas William Pearson died at Doncaster Royal Infirmary on 11th February 2016 from a combination of a lung disease, which was attributable to his work as an underground coal miner and to his cigarette smoking, and of rheumatoid arthritis. I recorded the medical cause of Mr Pearson's death as 1(a) Chronic obstructive pulmonary disease (chronic bronchitis) and rheumatoid arthritis

Mr Pearson was a retired coal miner who had been a heavy smoker. He suffered from, inter alia, chronic obstructive pulmonary disease and rheumatoid arthritis.

In 2015/2016 he suffered a number of bouts of pneumonia and, on a number of occasions, was admitted to Doncaster Royal Infirmary.

On 22nd January 2016 Mr Pearson was admitted with debilitating breathlessness. He received treatment but died, at Doncaster Royal Infirmary, on 11th February 2016.

(1) Mr Pearson suffered from chronic obstructive pulmonary disease and rheumatoid arthritis. He had worked underground as a coal miner for approximately 26 years and had been a heavy smoker.

(2) For approximately 4 years (up to January 2016) Mr Pearson was using an inhaler containing seretide, one of the component elements of which is fluticasone.

(3) In the latter months of his life Mr Pearson suffered a number of bouts of pneumonia.

(4) Dr T Rogers (Consultant Respiratory Physician), who gave evidence at the inquest, confirmed that fluticasone causes a reduction in the body's defence mechanisms and, as a result, carries with it an increased risk (estimated at 1.7 fold) increase in the risk of the patient developing pneumonia.

(5) For a proportion of patients, the increased risk of developing pneumonia may be justified by the benefits that the use of fluticasone brings. However, Dr Rogers also stated that, for the majority of patients, namely those without a raised eosinophil count (a group which included Mr Pearson), fluticasone, whilst still carrying an increased risk of the development of pneumonia, would bring no benefits.

(6) In response to an enquiry put to him, Dr Rogers agreed that it would be helpful for the use of inhaled steroids (in particular fluticasone) to be reviewed.