Kathryn Barrow

PFD Report Historic (No Identified Response) Ref: 2019-0308
Date of Report 19 September 2019
Coroner Chris Morris
Response Deadline est. 31 December 2019
Coroner's Concerns (AI summary)
GPs prescribed Diazepam without verifying consultant advice or checking for illicit access, and the practice had not reviewed its prescribing approach for this medication.
View full coroner's concerns
In the circumstances it is my statutory to report to you: _ Having claimed this has been advised by her Consultant Psychiatrist; Mrs Barrow has obtained short course prescriptions for Diazepam from the surgery apparently without the Mary end long due duty The further documentation received from mental health services to confirm this, Or without further checks being made by the GP; From the evidence heard at court; doctors at the practice prescribing Diazepam to Mrs Barrow do not appear to have sought to ascertain whether or not she may have access to this medicine illicitly;
3. court heard evidence that the practice has not recently undertaken review of its approach to prescribing Diazepam:
Sent To
  • Heaton Moor Medical Group
Response Status
Linked responses 0 of 1
56-Day Deadline 31 Dec 2019
About PFD responses

Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.

Source: Courts and Tribunals Judiciary

Report Sections
Investigation and Inquest
On 3r July 2019, opened an inquest into the death of Kathryn Barrow, who was found dead on 7th March 2019, aged 59 vears. The investigation concluded at the of the inquest which heard on 23rd August 2019 The evidence heard in court did not therefore confirm by what means Kathryn Barrow came by her death: At the end of the inquest, therefore recorded an Open conclusion:
Circumstances of the Death
Kathryn Barrow was found dead at her home on 7th March 2019. She had a history of mental illness, and had received care and treatment for bipolar affective disorder both by mental health specialist services and doctors at the practice_ Mrs Barrow was prescribed a variety of medication, which she supplemented with illicit drugs A post mortem examination did not establish a medical cause for Mrs Barrow' $ death Toxicological tests suggested Mrs Barrow had used Diazepam, Cannabis and Olanzapine in the period leading up to her death: Whilst such tests did not identify any evidence of overdose, their results must be regarded with circumspection to the effects of decomposition: An investigation by Greater Manchester Police concluded there were no suspicious circumstances surrounding Mrs Barrow' $ death.
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:
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.