Nikolas Clarke represents local authority in inquest into death of woman aged 82

20 October 2021

Nikolas Clarke represented the local authority social services' department in an inquest concerning IMT, an 82-year-old woman, who died in May 2020.

IMT used a wheelchair after her leg had been amputated.

From February 2020 , she was being supported at home by a private care agency contracted by the local authority as part of a care package.

Background to the inquest

In January 2020, IMT was admitted to hospital following a fall and found to have a grade 4 sacral pressure ulcer. In February, she discharged herself from hospital despite advice she should go to inpatient rehabilitation.

The local authority put in place a care package for her at home until April when managing without care was trialled. At that time, IMT declined to be assessed for long-term care. She also declined advice to be nursed in bed or to go to hospital when a specialist hoist was unavailable to lift her at home.

On 5 May 2020, her nephew called an ambulance after he found her in considerable pain and drifting in and out of consciousness.

IMT was found to have a contaminated grade 4 sacral pressure sore reaching to muscle and bone, sepsis and other health complications. She was given antibiotics.

However it was determined that she was unlikely to survive. She died a couple of days later.

The coroner’s findings

The coroner found no evidence of causative failings by the local authority and made no report for Preventing Future Deaths.

He gave a short narrative conclusion saying that IMT had declined to follow important advice which would have reduced the risk presented by the grade 4 ulcer that eventually led to her death.

He was satisfied that nothing done created a cause for concern that this was an unnatural death in terms of the delivery of care or neglect. He found the care delivered was of a good standard by the organisations involved.

Everything was done properly and was carefully documented.