Coroner s court for GP trainees DR LAURA BARNFIELD 16/5/17 Introduction Cases Role of the Coroner Inquests Preparing a statement Preparing for the day Lessons to be learnt 1
Cases (1) A case was recently discussed by one of the local GP OOH providers. A death had occurred in a patient currently receiving chemotherapy who developed a high fever. There was a delay in that patient receiving prompt medical treatment. As a result a statement was released by the clinical director stating that all patients receiving chemotherapy with a temperature >38C should be referred immediately to A&E Reasons to refer the cause of death is unknown the deceased was not seen by the certifying doctor either after death or within 14 days before death the death was violent or unnatural or was suspicious the death may be due to an accident (whenever it occurred) the death may be due to self-neglect or neglect by others the death may be due to an industrial disease or related to the deceased's employment the death may be due to an abortion the death occurred during an operation or before recovery from the effects of anaesthetic the death may be suicide the death occurred during or shortly after detention in police or prison custody 2
Role of the coroner Investigate deaths where the cause is unknown, thought to be unnatural or warrant enquiry for another reason Responsible for bodies lying within their jurisdiction Aim to disrupt families funeral plans as little as possible but investigate as fully as needed Not about blame Involved in around 1 in 10 deaths Inquests An inquest is a public judicial inquiry to find the answers to a limited but important set of questions: Who the deceased was When they died Where they died How they came by their death The coroner can refer a case to the Crown Prosecution Service or it can be picked up by the civil courts NOT TO APPORTION BLAME 3
Verdicts The coroner can bring the following verdicts: Natural causes Accident or misadventure Suicide Narrative, which enables the coroner to set out the circumstances by which the death came about Unlawful killing Miscellaneous (drug dependence/industrial) Neglect Open, meaning that there is insufficient evidence to decide how the death came about the case is left open in case further evidence appears Balance of probabilities vs beyond reasonable doubt Writing a statement Factual Explain medical terms Opening and closing statements I am Dr Laura Clare Barnfield and I am a General Practice Speciality Trainee 3 (GPST3) doctor at Dr Kirby and Partners, Crompton Health Centre, 501 Crompton Way, Bolton BL1 8UP. I have been in this post since August 2014 and am due to qualify as a General Practitioner in August 2015. My qualifications at present are MBChB DRCOG DGM and my GMC number is 7074019. As a GPST3 I see my own patients in the surgery but there are senior doctors on site for me to approach for advice if needed. My trainer is Dr XX. This statement is prepared both from the medical records and my own recollection of events. Closing statement I believe the contents of this statement to be true. Prepared on DATE. 4
Preparing for an inquest Visit court Ask a trainer to attend with you Request copies of post mortem, toxicology, relevant statements and consider questions that are likely to be asked Contact MDDUS/hospital legal team Consider need to inform Coroner of any dates you cannot attend On the day Bring a copy of your statement and the medical notes Dress smartly Swear an oath Speak to the family and the Coroner Stay for the whole session Attendance fee 5
Lessons learnt Report under Regulation 28 (Coroners (Inquests) Regulations 2013) 56 days for organisation to reply Report published online on Ministry of Justice website Prevention of future deaths Special cases chemotherapy, c difficile Questions? 6
Resources MPS www.medicalprotection.org/uk Manchester City Council www.manchester.gov.uk Ministry of Justice www.justice.gov.uk 7