2018
PFD Reports
Reports: 419
Areas: 64
69% response rate (above 63% average).
Lakhminder Kaur
Historic (No Identified Response)
2018-0029
24 Jan 2018
Black Country
Black Country NHS Trust
Lodge Road Surgery
Concerns summary (AI summary)
Concerns arose regarding unmanaged long-term zopiclone addiction and the immediate cessation of the drug, which was done to prevent serious self-harm.
Antony Coughtrey
Historic (No Identified Response)
2018-0014
15 Jan 2018
Milton Keynes
HM Inspectorate of Probation
Concerns summary (AI summary)
The Probation Service failed to conduct an internal investigation or Serious Incident Review after a prisoner's death on licence and had a procedural failure in referring licence breaches back to the Parole Board.
Patrick Moran
Historic (No Identified Response)
2018-0006
5 Jan 2018
London Inner (North)
Royal Free Hospital
Concerns summary (AI summary)
An insulin overdose occurred due to the common practice of using incorrect syringes, exacerbated by the removal of diabetes from mandatory training and the lack of a system to review compliance with safety alerts.
Marcus Hamilton
Historic (No Identified Response)
2018-0005
5 Jan 2018
Manchester (South)
Greater Manchester Mental Health NHS Fo…
Concerns summary (AI summary)
The mental health service's rigid 28-day prescription policy for maintenance medication left a patient vulnerable during extended travel, providing unreliable advice about obtaining drugs illicitly abroad.
Kristina Cross
Historic (No Identified Response)
2018-0001
2 Jan 2018
Lancashire & Blackburn with Darwen
Department for Health
Ministerial Correspondence and Public E…
Concerns summary (AI summary)
Delayed surgical fixation of a traumatically fractured femur, caused by initial and subsequent misdiagnoses, led to post-operative complications and significantly contributed to the patient's death.