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Steven Duquemin

21 Jul 2023 · Coroner Alan Wilson · Blackpool & Fylde
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The coroner's concerns

  1. 1. inconsistent care records underestimating choking risk

    “Entries in care records were inconsistent, some indicating [the deceased] was not at risk of choking when he clearly was at such risk, and indeed one member of staff gave credible evidence that she had on one occasion have to use skills learned at some recent training to assist [the deceased] after he overfilled his mouth with food.”

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