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Coroner’s reportPrevention of future deaths · 2014-0038

“The lack of transport heater availability was not explained in the written evidence…”

Dated 27 Jan 2014, from the coroner for Inner North London. Sent to 1 organisation or person.

A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.

Read the full report on judiciary.uk

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The 56-day response deadline

All responses published

Replies were due by 24 Mar 2014.

Organisations that receive a report must reply to the coroner within 56 days, saying what they will do or why they will do nothing. We show whether a response is published on judiciary.uk; a reply may have been sent and not yet published.

  1. Report dated27 Jan 2014
  2. Deadline24 Mar 2014
  3. Published on judiciary.uk27 Jan 2014
  4. Today23 Oct 2026

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Responses from each recipient

The coroner’s concerns

– (1) The lack of transport heater availability was not explained in the written evidence presented by the Trust. I did not judge it appropriate to adjourn the inquest in order to obtain further written or live evidence on this point, as sufficient information was available in order to conclude matters on 24 January 2014. However, it remains a concern that, in similar circumstances, the lack of transport heater could result in future patients becoming hypothermic on transfer, which might result in their death. As such, I am making this report in order that the Trust can respond to this concern.

An extract. Read the full report, including the circumstances of the death, on the Courts and Tribunals Judiciary website.

Source
judiciary.uk, Prevention of Future Deaths reports, 2014-0038
Added to Minute Book
8 Oct 2026
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Contains public sector information licensed under the Open Government Licence v3.0. Source: Courts and Tribunals Judiciary, judiciary.uk. Open Government Licence v3.0

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