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Medical Negligence Inquests In The Wake Of Covid-19

Reasons to choose Wilson Browne

The Chief Coroner has issued three sets of guidance which include the following:-

  1. Guidance for Coroners on Covid-19.
  2. Hearings during the pandemic.
  3. Summary of the Coronavirus at 2020 and the provisions relevant to Coroners.

As a result of Covid-19 inquests that were due to be held are now being postponed.  Anne Pember who is the Coroner for Northamptonshire has postponed all listed inquests between 24th March 2020 to 1st September 2020 to be re-arranged at a later date.  They are to be reviewed after 31st July 2020.

This means sadly that many families who were expecting to have inquests before the Coroner will now have to wait.  This will undoubtedly cause a great deal of upset to those grieving families and unfortunately as a result is likely to cause a backlog and delay in the Coroner’s court for many months.

Some of the guidance from the Chief Corner which is crucial mainly for organisations such as care homes, prisons GP’s, medical practitioners and NHS Trusts is as follows:-

  • Covid-19 is an acceptable direct or underlying cause of death for the purpose of the death certificate.
  • Covid-19 as a cause of death is not a reason on its own to refer a death to a Coroner, given that the same is a naturally occurring disease and is capable of being a natural cause of death.
  • Whilst a notifiable disease this, however does not mean that referral to a Coroner is required.
  • The Coronavirus Act expands the death certificate window from 14 to 28 days and allows a doctor who was not the attending doctor to sign the death certificate.

Reasons when you would require a referral to a Coroner:-

  • Medical professional unable to certify on the balance of probabilities that Covid-19 was the cause of death due to unclear cause of death or individual not seen within requisite time scales.
  • Concerns about delays in care or provision of care prior to death.
  • Failure to provide PPE or otherwise protect employees.
  • Deaths that automatically require an inquest to be held e.g. death in prison or police station.
  • Any other reason under the Notifications of Death Regulations 2019.

It is highly anticipated that there will be delays in the provision of care, an inability to provide care, incorrect diagnosis, lack of PPE and these are likely to result in the largest number of referrals to Coroners which in turn will likely result in an inquest.

Examples that have already featured in the press which may result in an inquest are:-

  • Misdiagnosis of Covid-19 by a General Practitioner due to atypical symptoms.
  • Refusing to accept patients medically fit for discharge back into care home without Covid-19 testing and protection of care home residents during Covid-19 breakout.

In addition to the above other potential scenarios could include:

  • Failure to provide frontline staff with appropriate or defective PPE.
  • Delay in providing treatment due to the need to adhere to safety guidance e.g. ensuring appropriate PPE in situ prior to commencing treatment.
  • Prioritisation of medical resources e.g. ambulance dispatch, assignment of ventilators etc.
  • Deployment of those who fall within vulnerable categories to frontline work e.g. calling retired NHS workers to work in departments where there is a high risk of contracting Covid-19, pregnant women working in the NHS.
  • Experimental Covid 19 treatment

Coroners will have to be alert to the above in the coming months.  It will be important for there to be robust risk assessments in place, policies and importantly contemporaneous detailed records made by all of those treating patients with Covid-19.  Providing that all steps have been taken reasonably and can be supported evidentially the risk of a finding of neglect at inquest should be minimal.

Louise Tyler

Posted:

Louise Tyler

Partner

Louise is the Head of the Medical Negligence Team working in this area of law for 25 years. She is a member of the Law Society Clinical Negligence Panel, the AvMA (Action for Victims of Medical Accidents) Panel and been appointed to the Executive Committee…