John Kay

“The Inquest heard evidence that the management of a patient with 1 a valve such as Mr [name redacted] had is a complex one. It requires regular monitoring and replacement. The evidence was that when he went into a care home that information about how to care for his valve was not shared with the care home. The consequence was that he was not seen or referred for regular replacements of the valve which increased the risk of the valve not functioning correctly and him developing aspiration pneumonia”