The inquest into the death of Mr M concluded in December 2019, with the jury finding that he died of natural causes contributed to by neglect. Mr M received care and support services from Imagine, Act and Succeed (IAS) and this was a placement made in partnership with his local Council. In 2017, he was sadly found collapsed in his apartment following an epileptic fit.
Mr M had been living in the apartment since 2016 and was unable to leave without staff support due to his needs. Mr M had previously suffered from ‘petit mal seizures’, which were moments of absence which lasted a few seconds, however, in October 2016 he suffered three ‘grand mal seizures’, which cause a loss of consciousness and violent muscle contractions. His GP prescribed a higher dose of medication and the neurologist request to be informed of any further seizures to consider further changes to medication.
Mr M suffered two further grand mal seizures prior to January 2017, however, staff at IAS did not inform the neurologist for a review.
Mr M’s risk of having a seizure was monitored by a range of equipment and technology. As part of this, the use of an epilepsy ‘Smart Watch’ was introduced, which was designed to alert support workers to seizure activity. As part of the inquest proceedings, a manager at Empatica, who designed the watch, told the jury that both the watch and the connecting iPod were out of charge on the night Mr M died. The jury heard that there was no formal training, written guidelines or risk assessments put in place for staff by IAS in relation to the watch.
Mr M’s neurologist told that jury that on the balance of probabilities that the detection of a seizure would have likely prevented death.
The jury concluded that Mr M’s death was probably contributed by:
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Inadequate charging of his Epilepsy watch and iPod by his support worker the day prior to his death;
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The absence of any formal training in respect of the watch and its safe and effective use;
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The absence of any formal assistance technology guidelines in the context of Mr M’s specific needs;
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The absence of a checklist which requires the support worker to charge and check the watch and iPod and record that this had been done.
The jury found that the following possibly contributed to Mr M’s death:
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The withdrawal of Waking-Night care;
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The failure of the care provider staff and the GP practice to notify the neurologist of the fourth and/or fifth grand mal seizures.
Farleys pursued a civil claim on behalf of Mr M’s parents against IAS. A Letter of Claim was forwarded to the company, setting out allegations that there had been a breach of duty in the care owed to him by IAS and they had been negligent. It was further alleged that there was a breach of Mr M’s Article 2 Right to Life. Liability was shortly accepted and following negotiations, Farleys secured damages for both Mr M’s parents. The settlement figure also included costs of the inquest proceedings.
More information about this inquest can be found here and here.
To speak to a member of Farleys’ inquests team, please call 0333 331 4269 or contact us by email.