Melanie Lowe
PFD Report
All Responded
Ref: 2016-0404
All 1 response received
· Deadline: 16 Apr 2017
Sent To
Response Status
Responses
1 of 1
56-Day Deadline
16 Apr 2017
All responses received
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Coroner's Concerns
_ (1) The trust's action plan is very basic, lacking specific detail. Some elements are blank and there is an absence of supporting evidence: A far more rigorous action plan is required in an effort to prevent future deaths such as Melanie's Cont.
Responses
Action Should Be Taken
In my opinion action should be taken to prevent future deaths and believe you and your organisation have the power to take such action. YouR RESPONSE You are under a to respond to this report within 56 of the date of this report;, namely by 16th January 2017 . |, the coroner, may extend the period. Your response must contain details of action taken or proposed to be taken, setting out the timetable for action: Otherwise you must explain why no action is proposed:
Report Sections
Investigation and Inquest
On 2 March 2016 commenced an investigation into the death of Melanie Ellen Lowe: The investigation concluded at the end of the inquest on 9 November 2016. The conclusion of the inquest was that Melanie Ellen Lowe killed herself: The jury added a narrative conclusion Melanie's risk of self harm/suicide was not properly and adequately assessed and reviewed. Adequate and appropriate precautions were not taken t0 manage her risk of self harm/suicide
Circumstances of the Death
Melanie Lowe, a 41 year old lady had suffered from somatization disorder over a long period of time and was sectioned under s2 MHA in the Derwent Centre Harlow. On the morning of 2 March she was found unresponsive in her room and she was found to have a wad of tissues obstructing her airway: She died in Princess Alexandra Hospital Harlow later that day: Both the trust's own Serious Incident Investigation report and the independent psychiatric report provided by an independent psychiatrist instructed by the court were highly critical of the care provided to Melanie in the time leading up to her death
Copies Sent To
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.