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Coroner’s reportPrevention of future deaths · 2025-0077

“(brief summary of matters of concern) To consider the development and publication of a…”

Dated 7 Feb 2025, from the coroner for Cambridgeshire and Peterborough. Sent to 3 organisations or people.

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 4 Apr 2025.

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 dated7 Feb 2025
  2. Deadline4 Apr 2025
  3. Published on judiciary.uk12 Feb 2025
  4. Today27 Oct 2026

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Responses from each recipient

Responses from each recipient
Sent toResponse
National Institute for Health and Care ExcellenceNamed in the report as “National Institute for Health and Care Excellence (NICE)”Response publishedPublished on judiciary.uk in February 2025.
British Society for Haematology (BSH)Response publishedPublished on judiciary.uk in February 2025.
NHS EnglandResponse publishedPublished on judiciary.uk in February 2025.

The coroner’s concerns

(brief summary of matters of concern) To consider the development and publication of a national guidelines and standard operating procedure for the carrying out of Bone Marrow Aspirate (BMA) and trephine biopsy to include recommended methodology. To consider the development of a data base to record these procedures and their outcomes.

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, 2025-0077
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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