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Alvin Black

30 Apr 2021 · Coroner Sean Horstead · Cambridgeshire and Peterborough
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The coroner's concerns

  1. 1. poor hygiene in health care centre leading to infection risk

    “Extensive evidence was heard concerning the poor state of cleanliness of the Health Care Centre at the Prison”

  2. 2. failure to administer appropriate anticoagulation therapy

    “missed opportunity for consideration of whether or not anti-coagulation therapy should have been provided to Mr [name redacted]”

Responses

No published response was found on judiciary.uk.

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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person. Methodology and responsible use · Report an error

Alvin Black · Recurance