Ernest Smith
14 Mar 2024 · Coroner Sonia Hayes · Essex
The coroner's concerns
1. delayed medical review of leg bruising
“Medical review requested on 10 March by nurses due to concerns about the acute development of bilateral bruising on Mr [name redacted] legs. This request was chased by nurses on 11 March and was not conducted until the evening of 12 March.”
2. delayed antibiotic treatment for infected haematoma
“Antibiotics for the infected haematoma were not commenced until 3 April.”
3. non‑adherence to sepsis protocol after sepsis highlighted
“Sepsis was highlighted by the Trust surgical team on 3 April and the Sepsis Protocol was not followed.”