Staffordshire and Stoke on Trent
Coroner Area
Reports: 68
Earliest: Feb 2014
Latest: 3 Feb 2026
74% response rate (above 62% average).
Roy Walklet
Historic (No Identified Response)
2023-0240
15 May 2023
Royal Stoke University Hospital
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
Hospital policy prevented a crucial gastroscopy until a ward bed was available. A consultant was also unaware of patient allocation because the patient remained in A&E, delaying critical review.
Diana Reay
Historic (No Identified Response)
2021-0309
15 Sep 2021
Royal Stoke University Hospital
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
Multiple doctors misread scans, mistaking a fluid-filled cyst for a full bladder, which resulted in unnecessary and repeated catheterisations of the patient.
Harold Blackshaw
Historic (No Identified Response)
2021-0292
2 Sep 2021
NHS England
Haywood Hospital
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
The rehabilitation ward lacks an effective admission process to assess patient needs and implement necessary fall prevention measures for high-risk elderly patients.
Michele Duckworth
Historic (No Identified Response)
2021-0051
12 Feb 2021
Royal Stoke University Hospital
Alcohol, drug and medication related deaths
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
The patient was incorrectly prescribed Tazocin, an antibiotic against trust guidelines due to prior ESBL colonization, an error that was repeatedly missed during medical reviews.
Steven Cooke
Historic (No Identified Response)
2020-0302
30 Dec 2020
NHS England
Community health care and emergency services related deaths
Mental Health related deaths
Suicide (from 2015)
Concerns summary
There is no national guidance for mental health professionals to engage with patients' families, hindering the collection of a full medical picture.
Sheila Graham
Historic (No Identified Response)
2018-0355
16 Nov 2018
Midlands Partnership NHS Trust
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
Prolonged social isolation for a patient with C. difficile negatively impacted her well-being, compounded by inadequate nutritional information recording and assessment.
Norman Beard
Historic (No Identified Response)
2016-0438
7 Oct 2016
Care First Homes
Care Home Health related deaths
Concerns summary
Poor management, staff shortages, and lack of policies contributed to neglected pressure ulcers and significant weight loss. Delayed specialist referrals and ignored medical advice compounded the patient's deteriorating condition.
Nadim Butt
Historic (No Identified Response)
2016-0137
7 Apr 2016
University Hospital of North Midlands
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
The hospital failed to conduct a serious untoward incident review or root cause analysis, limiting critical examination of decisions. Additionally, a necessary consultant-led out-of-hours rota for post-surgery patients was not yet implemented.
John Moreton
Historic (No Identified Response)
2015-0430
9 Nov 2015
Highways Agency
Road (Highways Safety) related deaths
Concerns summary
A pedestrian stile leads directly onto a busy dual carriageway with a national speed limit, and there are no warning signs for pedestrians or motorists regarding this dangerous crossing point.
Florence Lowe
Historic (No Identified Response)
2015-0415
29 Oct 2015
Staffordshire County Council
Road (Highways Safety) related deaths
Concerns summary
A 60mph speed limit on a road with residential properties and busy amenities is inappropriate, and a major roundabout lacks a pedestrian crossing. Other local roads have adopted lower limits for safety.
John Bartle
Historic (No Identified Response)
2015-0232
18 Jun 2015
REDACTED
Hospital Death (Clinical Procedures and medical management) related deaths
Concerns summary
Concerns were raised about a perceived lack of staff over a bank holiday leading to delayed interventions, alongside poor nutritional support, inadequate pain control, and poor communication from nursing staff.
Harold Henshall
Historic (No Identified Response)
2014-0217
12 May 2014
Staffordshire County Council
Road (Highways Safety) related deaths
Concerns summary
Inadequate street lighting and crossing facilities on Church Street, especially near St Edwards Church, increased the risk to elderly pedestrians crossing the road.
Neil Blood
Historic (No Identified Response)
2014-0183
4 Feb 2014
Shimano Inc
Department for Transport
Other related deaths
Product related deaths
Concerns summary
A lack of regulatory oversight, risk assessment, and consumer warnings for pedal cycle cleats and shoes raises concerns about potential dangers to users.