Peter Carter
Scotland — FAI
Custody
4 recommendations
Determination
| Reference | ALO-B40-23 |
| Published | 1 January 2024 |
| Sheriff | Sheriff Neil Bowie |
| Sheriffdom | Tayside Central and Fife |
| Date of death | 11 June 2019 |
| Location | Forth Valley Royal Hospital (prisoner at HMP Glenochil) |
| Cause of death | Post-surgical complications; blood test oversight failures |
Recommendations 4
Addressed to:
NHS Forth Valley
NHS Forth Valley to review clinical oversight of blood test results within laboratories; establish parameters for increased clinical oversight; system for flagging abnormal results; review discharge process for patients returning to prison
No mandatory response mechanism — unlike PFD reports (England & Wales), recipients are not required to respond.
About FAIs
Fatal Accident Inquiries are held under the 2016 Act before a sheriff. They are mandatory for deaths in custody and at work. The sheriff may make recommendations under s.26(1)(b) but there is no enforcement mechanism.