Hospital Death (Clinical Procedures and medical management) related deaths
Dated 24 Feb 2025, from the coroner for Surrey. Sent to 10 organisations or people.
A coroner wrote this report after an inquest, to warn the organisations below about a risk of further deaths.
The 56-day response deadline
Deadline passedReplies were due by 21 Apr 2025. A reply may have been sent and not yet published.
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.
- Report dated24 Feb 2025
- Deadline21 Apr 2025
- Published on judiciary.uk26 Feb 2025
- Today23 Oct 2026
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Responses from each recipient
| Sent to | Response |
|---|---|
| NHS England | Response publishedPublished on judiciary.uk in February 2025. |
| Department of Health and Social Care | Response publishedPublished on judiciary.uk in February 2025. |
| Care Quality Commission | Response publishedPublished on judiciary.uk in February 2025. |
| General Medical Council | Response publishedPublished on judiciary.uk in February 2025. |
| Royal College of Anaesthetists | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 21 Apr 2025. A reply may have been sent and not yet published. |
| Association of Anaesthetists of GB and Ireland | Deadline passedNo response published on judiciary.uk so far. The 56-day deadline was 21 Apr 2025. A reply may have been sent and not yet published. |
| Difficult Airway Society | Response publishedPublished on judiciary.uk in February 2025. |
| Royal College of Emergency Medicine | Response publishedPublished on judiciary.uk in February 2025. |
| Royal College of Physicians | Response publishedPublished on judiciary.uk in February 2025. |
| Surrey and Sussex Healthcare NHS TrustNamed in the report as “Surrey and Sussex Healthcare NHS Foundation Trust” | Response publishedPublished on judiciary.uk in February 2025. |
The coroner’s concerns
Read the coroner’s concerns in the full report on judiciary.uk.
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, 2025-0107
- Added to Minute Book
- 8 Oct 2026
- Reuse
- We show short extracts and link to the original. We don’t host the full report.
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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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