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Inadequate Triage and Missed Opportunities for Assessment at Hospital: Woman’s death caused by severe pain hours after hospital discharge

<!-- wp:paragraph --> <p><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/">Leila Benyounes</a> represented the family of a 63-year-old lady who suffered an acute cardiac arrhythmia due to severe pain hours after she had been discharged from hospital in May 2022.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The deceased, a former fitness instructor with a medical history of osteoarthritis to her right hip, had awoken with extreme pain to her right hip and required Entonox and intravenous morphine prior to transfer to hospital by ambulance.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>It was held at the inquest that the triage within the emergency department was inadequate, did not include a pain score or pull through significant information onto the hospital records, including the opiate analgesia prescribed by the paramedics. It was also held that there was an under-triage of the deceased’s condition, and it was appropriate for the deceased to be admitted for a mobility assessment prior to discharge which did not occur.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>It was found that the death was due to a cardiac arrhythmia caused by acute adrenaline excess, as a result of the severe pain the deceased was experiencing to her right hip.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>A narrative conclusion was recorded at the inquest in which it was held that there was an inadequate triage and missed opportunities for assessment at hospital.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila was instructed by Victoria Wanless at <a href="https://www.beechampeacock.co.uk/">Beacham Peacock Solicitors</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>Leila Benyounes is Head of the Inquests Team at Parklane Plowden Chambers and is ranked as Band 1 by Legal 500 for Inquests and Inquiries. Leila has been appointed to the Attorney General’s Treasury Counsel Panel A since 2010. Leila is appointed as Assistant Coroner for Gateshead and South Tyneside. Leila regularly represents interested persons in a wide range of inquests including Article 2 jury inquests and complex medical matters.  Her full profile can be accessed <a href="https://www.parklaneplowden.co.uk/barristers/leila-benyounes">here</a>.</em></p> <!-- /wp:paragraph -->

Doctor Knows Best- Supreme Court clarifies “Professional Practice Test”

<!-- wp:paragraph --> <p>On 12<sup>th</sup> July 2023, the Supreme Court handed down its judgment in <em><u><a href="https://www.bailii.org/uk/cases/UKSC/2023/26.html">McCulloch and Others v Forth Valley Health Board [2023] UKSC 26,</a></u></em> the first Supreme Court decision on the issue of informed consent since <em><u><a href="https://www.bailii.org/uk/cases/UKSC/2015/11.html">Montgomery v Lanarkshire Health Board [2015] UKSC 11</a></u></em>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Five Justices unanimously dismissed the appeal holding that the “professional practice test” is the correct legal test for doctors when providing treatment options to a patient. Treatment options need to be supported by a responsible body of medical opinion, and should include all “reasonable” treatment options, but not all “possible” treatment options. The Court affirmed that the narrowing down from “possible” alternative treatments to “reasonable” alternative treatments is an exercise of “clinical judgement” and therefore to be judged subjectively from the perspective of the doctor.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In this fatal accident case, the question was whether the doctor should have advised the patient of a particular treatment option, as it was contended that if such advice had been given, the treatment would have been accepted by the patient, thereby avoiding the patient’s death.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>The Facts</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Mr McCulloch died on 07/04/12 aged 39 years, shortly after admission to hospital having suffered a cardiac arrest at home. The cause of death was recorded as idiopathic pericarditis and pericardial effusion: it was agreed that Mr McCulloch died as a result of cardiac tamponade.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Mr McCulloch had first been admitted to hospital on 23/03/12 with a history of severe pleuritic chest pains, worsening nausea and vomiting. Tests showed abnormalities compatible with a diagnosis of pericarditis. By 24/03/12, after a deterioration, Mr McCulloch was intubated and ventilated in the intensive treatment unit. Following some improvement that day, a decision was made not to transfer Mr McCulloch to a different hospital to facilitate pericardiocentesis, a potential treatment which had been discussed with him.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Dr Labinjoh, an experienced consultant cardiologist, for whose acts and omissions it was contended the respondent was vicariously liable, was first involved in Mr McCulloch’s care on 26/03/12 when she was asked to review an echocardiogram. Dr Labinjoh recorded that Mr McCulloch’s presentation did not fit with a diagnosis of pericarditis and she would discuss with Dr Wood, who was exploring immunocompromise, malignancy.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Mr McCulloch’s condition improved and on 30/03/12 he was discharged home on antibiotics to be reviewed by Dr Wood in four weeks’ time with a repeat echocardiogram and a chest X-ray to be arranged in advance.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The discharge letter recorded the diagnosis as acute viral myo/pericarditis and pleuropneumonitis with secondary bacterial lower respiratory tract infection.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On 01/04/12 Mr McCulloch was re-admitted to hospital by ambulance with central pleuritic chest pain, similar to the previous admission. After treatment with intravenous fluids and antibiotics, Mr McCulloch was transferred to the acute admissions unit on 02/04/12 and a repeat echocardiogram was arranged.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Dr Labinjoh’s second involvement was on 03/04/12. Dr Labinjoh’s evidence, which was accepted in the lower court, was that she was not asked to review Mr McCulloch but to assist in the interpretation of the third echocardiogram. She did not consider that it differed from the first two echocardiograms in a way that gave cause for concern.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Dr Labinjoh visited Mr McCulloch on the acute admissions unit on 03/04/12 to assess whether his clinical presentation was consistent with her interpretation of the echocardiogram. Mr McCulloch denied having any chest pain, palpitations or breathlessness on exertion or lying flat.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Dr Labinjoh recorded “no convincing features of tamponade or pericardial constriction. The effusion is rather small to justify the risk of aspiration… I am not certain where to go for a diagnosis from here”.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Dr Labinjoh’s understanding was that the management plan agreed with Dr Wood was still in place and did not prescribe any medical treatment. Dr Labinjoh did not discuss the risks and benefits of NSAIDS as she did not regard it necessary or appropriate in her professional judgement to prescribe NSAIDS, but did advise Mr McCulloch against pericardiocentesis at that time, a potential treatment which had previously been discussed.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>By 06/04/12 Mr McCulloch’s condition had improved, and the plan was for discharge. Dr Lainbjoh was unable to review Mr McCulloch prior to discharge as she was due to operate elsewhere but indicated in a telephone call that the decision to discharge should be made by the responsible consultant.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Mr McCulloch was discharged on the evening of 06/04/12 remaining on oral antibiotic medication. On 07/04/12 at 14.00 Mr McCulloch suffered a cardiac arrest at home and was taken to hospital where he died at 16.46 after a prolonged period of attempted resuscitation.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>Conclusions from the Lower Courts</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The appellants’ claim failed at first instance before the Lord Ordinary and on appeal to the Inner House.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Lord Ordinary held that whilst the experts agreed that it was standard practice to prescribe NSAIDs to treat pericarditis, this was not a straightforward case of acute pericarditis: the diagnosis remained uncertain, and Mr McCulloch had not complained of pain.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Lord Ordinary rejected the appellants’ argument that the decision in <em>Montgomery</em> meant that Dr Labinjoh was under a duty to discuss with Mr McCulloch the option of using NSAIDs to reduce the size of pericardial effusion and to discuss its risks and benefits where, in her professional judgement, she did not regard it as appropriate to do so.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Lord Ordinary concluded that “no case based on failure to advise of the risks of a recommended course of treatment, or of alternative courses of treatment along the lines of <em>Montgomery, </em>has been made out”.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Inner House, having agreed with this approach to the legal test, upheld the decision of the Lord Ordinary.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>Supreme Court</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The two principal issues which arose on this appeal were:</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>1. What legal test should be applied to the assessment as to whether an alternative treatment is reasonable and requires to be discussed with the patient?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>2. Did the Inner House and Lord Ordinary err in law in holding that a doctor’s decision on whether an alternative treatment was reasonable and required to be discussed with the patient is determined by the application of the professional practice test?<em></em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The appellants contended that the assessment of whether an alternative is reasonable is to be undertaken by the circumstances, objectives and values of the individual patient, and therefore objectively, whereas the respondent contended that this was to be assessed by reference to the “professional practice test” and therefore subjectively from the perspective of the doctor.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>The Supreme Court held that the correct legal test to be applied to the question of what constitutes a reasonable alternative treatment is the “professional practice test” found in </strong><strong><em><u>Hunter v Hanley [1955] SC 200</u></em></strong><strong><em> </em></strong><strong>and </strong><strong><em><u>Bolam v Friern Hospital Management Committee [1957] 1 WLR 582. </u></em></strong><strong>&nbsp;</strong></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Court held that as Dr Labinjoh took the view that prescribing NSAIDs was not a reasonable alternative treatment because Mr McCulloch had no relevant pain and there was no clear diagnosis of pericarditis and, because that view was supported by a responsible body of medical opinion, there was no breach of the duty of care to inform required by <em>Montgomery.</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Numerous reasons were cited by the Court in support of the application of the professional practice test including consistency with <em>Montgomery, </em>consistency with medical professional expertise and guidance (the BMA and GMC were interveners in the appeal), avoiding conflict in a doctor’s role, avoiding bombarding the patient with information and, ultimately, avoiding uncertainty.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Court further considered a hypothetical example where there are ten possible treatment options and there is a responsible body of medical opinion that would regard each of the ten as possible treatment options. The Court held that the question then is the exercise of the individual doctor’s clinical judgement, supported by a responsible body of medical opinion, if it is determined that only four of those options are reasonable. The doctor is not negligent by failing to inform the patient about the other six even though they are possible alternative treatments.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>As set out at paragraph 57 “the narrowing down from possible alternative treatments to reasonable alternative treatments is an exercise of clinical judgement to which the professional practice test should be applied”.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The duty of reasonable care would then require the doctor to inform the patient not only of the treatment option that the doctor is recommending but also of the other three reasonable treatment alternative options (plus no treatment if that is a reasonable alternative option) indicating their respective advantages and disadvantages and the material risks involved in such treatment options.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>The Court held overall that in line with the distinction drawn in </strong><strong><em>Montgomery</em></strong><strong> between the exercise of professional skill and judgement and the court-imposed duty of care to inform, the determination of what are reasonable alternative treatments clearly falls within the former and ought not to be undermined by a legal test that overrides professional judgement. In other words, deciding what are the reasonable alternative treatments is an exercise of professional skill and judgement.</strong></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Conversely, it was held that if the professional practice did not apply in determining reasonable alternative treatments, one consequence would be an unfortunate conflict in the exercise of a doctor’s role: by requiring a doctor to inform a patient about an alternative medical treatment which the doctor exercising professional skill and judgement, and supported by a responsible body of medical opinion, would not consider to be a reasonable medical opinion.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>Comment</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This case provides a significant clarification of a doctor’s obligation to obtain informed consent for treatment, applying the “professional practice test” as defined in <em>Bolam</em> and qualified in <em>Bolitho.</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But, if a doctor’s duty is to inform a patient about material risks to enable a patient to make an informed choice as confirmed in <em>Montgomery,</em> does this decision not dilute the protection of a patient’s autonomy by giving doctors the power to limit the provision of information to patients and rule out available treatment options? &nbsp;</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On the other hand, is it realistic to require doctors to inform patients of any possible treatment without recourse to the exercise of their professional skill and judgement, with the added protection of the support by a responsible body of medical opinion?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>If the decision in <em>Montgomery </em>“reflected a move away from medical paternalism protecting a patient’s autonomy and right to self-determination”, does this decision in <em>McCulloch</em> not go one step forward by endorsing patient choice, but go two steps back by narrowing that choice?</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>Leila is a barrister at Parklane Plowden Chambers and a specialist in the field of Clinical Negligence. She is ranked as a leading junior in Legal 500 and Chambers and Partners for Clinical Negligence. Leila’s full profile can be accessed <a href="https://www.parklaneplowden.co.uk/barristers/leila-benyounes">here</a></em></p> <!-- /wp:paragraph -->

Parklane Plowden Podcast &#8211; Understanding coroner inquests and the role of lawyers

<!-- wp:paragraph --> <p>Listen to Parklane Plowden’s latest podcast: <a><em>Understanding coroner inquests and the role of lawyers</em>.</a></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Head of our Inquests and Inquiries Team and Assistant Coroner for Gateshead and South Tyneside, <a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/">Leila Benyounes </a>is joined by the Deputy Chief Coroner for England and Wales and Senior Coroner for the City of Sunderland, Derek Winter DL, to discuss the role of the coroner service and the inquest process.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The two also discuss the role of lawyers in coroner courts and how effective legal representation can support different participants throughout the inquest process. &nbsp;&nbsp;</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Helpful resources and further reading:</p> <!-- /wp:paragraph --> <!-- wp:list {"ordered":true,"type":"1"} --> <ol type="1"><!-- wp:list-item --> <li><a href="https://www.judiciary.uk/courts-and-tribunals/coroners-courts/office-chief-coroner/">Office of the Chief Coroner</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.gov.uk/government/publications/guide-to-coroner-services-and-coroner-investigations-a-short-guide">Guide to coroner services for bereaved people</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.gov.uk/government/statistics/coroners-statistics-2021/coroners-statistics-2021-england-and-wales#:~:text=In%202021%2C%2055%25%20of%20deaths,mortem%2C%20no%20change%20on%202020.&amp;text=In%20the%20majority%20(79%25),a%20post%2Dmortem%20was%20held.">The latest coroner statistics for England and Wales</a> (2021)</li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.sra.org.uk/solicitors/resources/practising-coroners-court/">Solicitors Regulation Authority Coroner inquest toolkit</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.barstandardsboard.org.uk/for-barristers/resources-for-the-bar/resources-for-practising-in-the-coroners-courts.html">Bar Standards Board Coroner Inquest toolkit</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/courts-and-tribunals/coroners-courts/coroners-legislation-guidance-and-advice/coroners-guidance/">Chief Coroner Guidance and Law Sheets</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/wp-content/uploads/2022/09/GUIDANCE-No-44-DISCLOSURE-final.pdf">Disclosure requirements for coroner inquests</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no-33-suspension-adjournment-and-resumption-of-investigations-and-inquests1/">Resumption guidance</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no-41-use-of-pen-portrait-material1/">Pen Portrait material guidance</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/wp-content/uploads/2016/02/law-sheets-no-2-galbraith-plus.pdf">Galbraith Plus</a></li> <!-- /wp:list-item --> <!-- wp:list-item --> <li><a href="https://www.judiciary.uk/courts-and-tribunals/coroners-courts/reports-to-prevent-future-deaths/">Prevention of Future Deaths</a></li> <!-- /wp:list-item --></ol> <!-- /wp:list -->

VENUE CHANGE: INQUESTS GRANDSTAND EVENT | 12 January 2023

<!-- wp:paragraph --> <p><strong>VENUE CHANGE:</strong> Our Inquests Grandstand event will be held at <strong>The County Hotel, Newcastle in the Mozart Suite</strong>. The hotel is located next to the train station.&nbsp;</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We are delighted to invite you to our&nbsp;Inquests Grandstand Event featuring guest speaker Deputy Chief Coroner, Derek Winter.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This event provides seminars covering a range of topics and updates led by Parklane Plowden Chambers' team of Inquests specialists. A downloadable delegate pack will be made available to attendees prior to the event. The pack will include a case law update&nbsp;provided by&nbsp;<a href="https://www.parklaneplowden.co.uk/barristers/megan-crowther">Megan Crowther</a>&nbsp;and&nbsp;<a href="https://www.parklaneplowden.co.uk/our-barristers/sophie-watson/">Sophie Watson</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Our&nbsp;barristers have substantial experience of representing a broad range of interested persons at inquests and public inquiries. They have a proven track record of handling complex and high-profile cases concerning deaths arising in a variety of circumstances and settings. From deaths in custody, to those arising in care homes and other institutions, the wealth of expertise available to bereaved families and corporate bodies is second to none.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>This event is being delivered alongside the newly founded PLP Foundation,&nbsp;created to support local charities and social causes. We invite attendees to make&nbsp;voluntary donations, which&nbsp;will be donated to&nbsp;<a href="https://children-ne.org.uk/">Children North East</a>&nbsp;and the&nbsp;<a href="https://charliewaller.org/">Charlie Waller Trust</a>&nbsp;on behalf of the PLP Foundation.</strong></p> <!-- /wp:paragraph --> <!-- wp:heading --> <h2><strong>Programme</strong></h2> <!-- /wp:heading --> <!-- wp:columns --> <div class="wp-block-columns"><!-- wp:column {"width":"100%"} --> <div class="wp-block-column" style="flex-basis:100%"><!-- wp:table --> <figure class="wp-block-table"><table><tbody><tr><td>13:30</td><td>Arrival and Registration</td></tr><tr><td>13:45</td><td>Welcome and Introduction<br>By&nbsp;<strong><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a></strong>.</td></tr><tr><td>14:00</td><td><strong>Recent Changes in the Coronial Service</strong><br>By<strong>&nbsp;Derek Winter</strong>, Deputy Chief Coroner and Senior Coroner for Sunderland</td></tr><tr><td>15:00</td><td><strong>Article 2 and Inquests</strong><br>By&nbsp;<strong><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a></strong>&nbsp;and&nbsp;<strong><a href="https://www.parklaneplowden.co.uk/our-barristers/richard-copnall/" target="_blank" rel="noreferrer noopener">Richard Copnall</a></strong>.</td></tr><tr><td>16:00</td><td>Tea Break</td></tr><tr><td>16:15</td><td><strong>Inquest Top Tips: a practical guide to getting the most out of an inquest</strong><br>By&nbsp;<strong><a href="https://www.parklaneplowden.co.uk/our-barristers/bronia-hartley/" target="_blank" rel="noreferrer noopener">Bronia Hartley</a></strong>.</td></tr><tr><td>16:45</td><td><strong>Inquest Costs and Funding</strong><br>By&nbsp;<strong><a href="https://www.parklaneplowden.co.uk/our-barristers/tom-semple/" target="_blank" rel="noreferrer noopener">Tom Semple</a></strong>.</td></tr><tr><td>17:15</td><td>Questions/Closing Remarks&nbsp;</td></tr><tr><td>17:30</td><td><strong>Social&nbsp;(Vermont Hotel Rooftop Terrace - Original Venue)</strong></td></tr></tbody></table></figure> <!-- /wp:table --></div> <!-- /wp:column --></div> <!-- /wp:columns --> <!-- wp:paragraph --> <p><strong><a href="http://lexlinks.parklaneplowden.co.uk/doForm.aspx?a=0xF15D4A97E0E04123&amp;d=0x49EB4C9596DBE1A5^0xBDC0B87423493533|0x40F3E49C83A12815^0xAF1BA1DD83354AE1|0xF1B146662D144B75^0x8A1CDD2DB76555E3|0x9CB58EF48012E032^0x26D74C775CFD45BA|0xA14B30AADF25AF0D^0x4538EA01547C6D9520542FC6B6F63C93|0x43D48F22BB6859DF^0x26D74C775CFD45BA|0xD52134AC788FF0FE^0xAF1BA1DD83354AE1|&amp;isMergeFormLink=1&amp;incD=0x7C0176C586DD3A52^0xE640AFC48EFC9ABD|0x49EB4C9596DBE1A5^0xBDC0B87423493533|0x4AA4940AA96EF179^0x9A2C7E2C08C59784|0x1F76935CAA54AE0A^0x8289A37C6AE6BA965FBB7D45CB30F41358BB1960BCA350AB3F9175DEBD522801CC95BA496219A306|0x4E70367B326D3F87^0xBDC0B87423493533|0x7789D30FD723DAF4^0x8289A37C6AE6BA968636BD27E2361040|0xC00B32B3252A1623F7126F7C46654076^0x8289A37C6AE6BA968636BD27E2361040|0xEC3640B4180F8F16^0xCD63CDE545792BF615C3BA126AB3CBB5|0x40F3E49C83A12815^0x57B15974B603D5F0|0xF1B146662D144B75^0x8A1CDD2DB76555E3|0xEA5DE7CEE9203CB2^0x883E06AF35488E45583E8FA52B9B9BAF|0xA14B30AADF25AF0D^0x17922B9099DE2B55F699159D61C256AC3D73B6DA6C8A152AEC4E595D0F1DD548F35DDB6A3E862FE0|0xA548B87FA4C989317DE335C01C7EE1CE^0xF36C7F1BB4B6A5EC000DF390350624DD451E7BAEDAE95E3CC6BA3B169DC85692|0xD52134AC788FF0FE^0xF1A21711D6384BCE|">Register for the Inquests Grandstand Event</a> - please select in person or online </strong></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Find out more about our Inquests and Inquiries team on this&nbsp;<a href="https://www.parklaneplowden.co.uk/expertise/inquests-inquiries-barristers/" target="_blank" rel="noreferrer noopener">page</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>For further enquiries please email&nbsp;<a href="mailto:events@parklaneplowden.co.uk" target="_blank" rel="noreferrer noopener">events@parklaneplowden.co.uk</a>&nbsp;</p> <!-- /wp:paragraph -->

Leila Benyounes acts for family in tragic child death inquest

<!-- wp:paragraph --> <p><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a> represented the family in the inquest touching the death of Esma Guzel at Hull Coroners Court.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Esma was a 5-year-old girl who tragically died due to a segment of her bowel becoming strangulated in a congenital diaphragmatic hernia (CDH) on 10<sup>th</sup> May 2019.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On 9<sup>th</sup> May 2019 Esma presented to her GP. The GP gave a working diagnosis of a tummy bug/gastroenteritis. Safety netting advice in the form of contacting NHS 111 was given should Esma’s condition worsen.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Esma deteriorated and a call was made to the NHS 111 service where the family were advised to take Esma to an out of hours GP some distance from hospital which provided paediatric services.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Upon arrival at the out of hours GP, Esma went into cardiac arrest and sadly, following transfer to hospital, clinicians were unable to resuscitate her.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The inquest was heard over 7 days in two parts. The first of which began in March 2021 dealing with the Record of Inquest and the second in April 2022 dealing with whether there was a need for a Regulation 28 Prevention of Future Deaths Report.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>At the first hearing, Assistant Coroner Dr Dominic Bell, found in his conclusion, that on the balance of probabilities, Esma would have survived the critical illness if she had been admitted to hospital following her GP assessment by whatever means and by whatever route.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Throughout both hearings the family raised concerns that the NHS 111 algorithm used to triage patients needed to change to properly recognise a deteriorating paediatric patient, the degree of parental concern, and the need to refer them to secondary care after a previous attendance at primary care.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On 1<sup>st</sup> June 2022, following the second hearing, the Coroner issued a Regulation 28 Prevention of Future Deaths Report which largely adopted the family’s concerns.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The report was addressed to the Royal College of Paediatrics and Child Heath, the Royal College of General Practitioners and NHS Pathways and NHS Digital Health.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Coroner acknowledged that the NHS 111 algorithm had been modified. However, he remained concerned that the algorithm still did not have a detailed assessment of the degree of parental concern of a paediatric patient, no recognition of a previous review by a GP, no recognition of the timing of events and no option for referral to paediatric services.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The Regulation 28 response is required by 27<sup>th</sup> July 2022.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila was instructed by <a href="https://www.hudgellsolicitors.co.uk/" target="_blank" rel="noreferrer noopener">Hudgells Solicitors</a> and the inquest was reported in the following press reports. The Family has worked with the charity CDH UK which provides care to patients and their families and raise awareness of CDH.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Read online media coverage:</p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li><a href="https://www.hulldailymail.co.uk/news/hull-east-yorkshire-news/parents-heartbreaking-tribute-loving-little-6851564" target="_blank" rel="noreferrer noopener">Parents' heartbreaking tribute to loving little girl who died in dad's arms</a>, <em>Hull Live</em>.</li></ul> <!-- /wp:list --> <!-- wp:list --> <ul><li><a href="https://www.mirror.co.uk/news/uk-news/girl-5-died-way-doctors-26524727" target="_blank" rel="noreferrer noopener">Girl, 5, dies on way to doctors after being sent home from school with 'tummy bug'</a>, <em>Mirror</em>.</li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila is Joint Head of the Inquests Team&nbsp;at Parklane Plowden Chambers. Ranked as a leading junior in Legal 500 and Chambers and Partners in Inquests and Inquiries and Clinical Negligence, Leila is also appointed as an Assistant Coroner and a Recorder and has been on the Attorney General’s Treasury Counsel Panel A since 2010. Leila regularly represents interested persons in a wide range of inquests. <br>Her full profile can be accessed <a href="https://www.parklaneplowden.co.uk/barristers/leila-benyounes" target="_blank" rel="noreferrer noopener">here</a></p> <!-- /wp:paragraph -->

Jury finds prisoner charged with murder received satisfactory care from prison service before his death

<!-- wp:paragraph --> <p><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a> represented the Ministry of Justice in Article 2 Jury Inquest</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila Benyounes appeared on behalf of the Ministry of Justice, responsible for the Prison Service at HMP Leeds, in an Article 2 jury inquest held in Wakefield. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The inquest touched on the death of a remand prisoner charged with murder at HMP Leeds, Terence Papworth.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Mr Papworth died as a result of self-inflicted injuries on 22<sup>nd</sup> November 2020. The inquest examined the management of Mr Papworth during his 23-week period in custody including the assessment and management of risk of self-harm and suicide and the medical treatment provided in prison.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>On 15<sup>th</sup> June 2022 the jury returned a narrative conclusion finding that Mr Papworth died from suicide and received satisfactory care from the prison service with no criticism of the actions of discipline staff.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Senior Coroner for West Yorkshire (Eastern), Kevin McLoughlin, held that a Regulation 28 Prevention of Future Deaths report was not necessary.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila was instructed by Victoria Harper-Ward, Senior Lawyer in the MOJ and Inquests Team, at the Government Legal Department.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Details of the press reports:</p> <!-- /wp:paragraph --> <!-- wp:list --> <ul><li><a href="https://www.yorkshirepost.co.uk/news/crime/terence-papworth-inquest-prison-service-not-at-fault-for-suicide-of-joiner-accused-of-killing-amy-leanne-stringfellow-in-doncaster-3733239" target="_blank" rel="noreferrer noopener">Terence Papworth inquest: Prison service not at fault for suicide of joiner accused of killing Amy-Leanne Stringfellow in Doncaster</a>, <em>Yorkshire Post</em></li><li><a href="https://www.bbc.co.uk/news/uk-england-leeds-61815046" target="_blank" rel="noreferrer noopener">Terence Papworth: Prison gave hanged inmate 'satisfactory care'</a>, <em>BBC</em></li><li><a href="https://www.bbc.co.uk/news/uk-england-leeds-61803457.amp" target="_blank" rel="noreferrer noopener">Terence Papworth: Murder suspect died days before trial</a>, <em>BBC</em></li></ul> <!-- /wp:list --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila is Joint Head of the Inquests Team&nbsp;at Parklane Plowden Chambers. Ranked as a leading junior in <em>Legal 500</em> and <em>Chambers and Partners</em> in Inquests and Inquiries and Clinical Negligence, Leila is also appointed as an Assistant Coroner and a Recorder and has been on the Attorney General’s Treasury Counsel Panel A since 2010. Leila regularly represents interested persons in a wide range of inquests.<br>Her full profile can be accessed <a href="https://www.parklaneplowden.co.uk/barristers/leila-benyounes" target="_blank" rel="noreferrer noopener">here</a></p> <!-- /wp:paragraph -->

Inquests Grandstand Event | 15 September 2022 🗓 🗺

<!-- wp:heading --> <h2><strong>EVENT POSTPONED </strong></h2> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Parklane Plowden's Inquests Grandstand Event featuring guest speaker Deputy Chief Coroner, Derek Winter, is scheduled on the 15<sup>th</sup> September 2022. This is a hybrid event, so you can register to attend online or in-person at the <a href="https://www.vermont-hotel.com/" target="_blank" rel="noreferrer noopener">Vermont Hotel</a> in Newcastle.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This event provides seminars covering a range of topics and updates led by Parklane Plowden Chambers' team of Inquests specialists. A downloadable delegate pack will be made available to attendees prior to the event. The pack will include a case law update&nbsp;provided by&nbsp;<a href="https://www.parklaneplowden.co.uk/barristers/abigail-telford" target="_blank" rel="noreferrer noopener"><strong>Abigail Telford</strong></a>&nbsp;and&nbsp;<a href="https://www.parklaneplowden.co.uk/barristers/megan-crowther" target="_blank" rel="noreferrer noopener"><strong>Megan Crowther</strong></a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Our&nbsp;barristers have substantial experience of representing a broad range of interested persons at inquests and public inquiries. They have a proven track record of handling complex and high-profile cases concerning deaths arising in a variety of circumstances and settings. From deaths in custody, to those arising in care homes and other institutions, the wealth of expertise available to bereaved families and corporate bodies is second to none.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><em>This event is being delivered alongside the newly founded PLP Foundation,&nbsp;created to support local charities and social causes. We invite attendees to make&nbsp;voluntary donations, which&nbsp;will be donated to&nbsp;<a href="https://children-ne.org.uk/" target="_blank" rel="noreferrer noopener">Children North East</a>&nbsp;and the&nbsp;<a href="https://charliewaller.org/" target="_blank" rel="noreferrer noopener">Charlie Waller Trust</a>&nbsp;on behalf of the PLP Foundation.</em></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Programme</strong></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>13:30 - Arrival and Registration</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>13:45 - Welcome and Introduction <br>By <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a></strong> and <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/georgina-nolan/" target="_blank" rel="noreferrer noopener">Georgina Nolan</a></strong>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>14:00 - 15:00: <strong>Recent Changes in the Coronial Service</strong><br>By<strong> Derek Winter</strong>, Deputy Chief Coroner and Senior Coroner for Sunderland</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>15:00 - 15:45: <strong>Article 2 and Inquests</strong><br>By <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener">Leila Benyounes</a></strong> and <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/richard-copnall/" target="_blank" rel="noreferrer noopener">Richard Copnall</a></strong>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>15:45 Tea Break</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>16:00 - 16:45: <strong>Inquest Top Tips: a practical guide to getting the most out of an inquest</strong><br>By <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/georgina-nolan/" target="_blank" rel="noreferrer noopener">Georgina Nolan</a></strong> and <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/bronia-hartley/" target="_blank" rel="noreferrer noopener">Bronia Hartley</a></strong>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>16:45 - 17:15: <strong>Inquest Costs and Funding</strong><br>By <strong><a href="https://www.parklaneplowden.co.uk/our-barristers/tom-semple/" target="_blank" rel="noreferrer noopener">Tom Semple</a></strong>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>17:15 - Questions/Closing Remarks</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>17:30 - Social</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p></p> <!-- /wp:paragraph --> <!-- wp:heading {"level":5} --> <h5><s><strong>Register for the Inquests Team Grandstand</strong> <strong>Event</strong>, select online or in person.</s></h5> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Find out more about our Inquests and Inquiries team on this <a href="https://www.parklaneplowden.co.uk/expertise/inquests-inquiries-barristers/" target="_blank" rel="noreferrer noopener">page</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>For further enquiries please email&nbsp;<a href="mailto:events@parklaneplowden.co.uk" target="_blank" rel="noreferrer noopener">events@parklaneplowden.co.uk</a>&nbsp;</p> <!-- /wp:paragraph -->

Leila Benyounes has been sworn in as Her Majesty’s Assistant Coroner

<!-- wp:paragraph --> <p>Parklane Plowden are pleased to announce that Joint Head of the Inquests and Inquiries Team, <a href="https://www.parklaneplowden.co.uk/our-barristers/leila-benyounes/" target="_blank" rel="noreferrer noopener"><span style="text-decoration: underline;">Leila Benyounes</span></a> has been sworn in as Her Majesty’s Assistant Coroners.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The swearing in ceremony took place on 27 January 2022 at City Hall in Sunderland and was conducted by the Chief Coroner for England and Wales, His Honour Judge Thomas Teague QC and attended by Deputy Chief Coroners, Derek Winter and Her Honour Judge Alexia Durran. The ceremony marked the official opening of the new Coroner’s Court and offices in Sunderland where Derek Winter is Senior Coroner.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila was appointed as Assistant Coroner for Gateshead and South Tyneside in June 2021. She is appointed to the Attorney General’s Civil Panel A.&nbsp;</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Leila sits on a part-time basis and remain fully able to accept instructions.&nbsp;</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Ranked by <em>Legal 500 </em>and <em>Chambers and Partners</em>, the <a href="https://www.parklaneplowden.co.uk/expertise/inquests-inquiries-barristers/" target="_blank" rel="noreferrer noopener"><span style="text-decoration: underline;">Inquests and Inquiries Team</span></a> at Parklane Plowden has a wealth of experience and expertise representing interested persons. The Team has a proven track record handling complex and high-profile cases with media sensitivity.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Please click <a href="https://www.parklaneplowden.co.uk/expertise/inquests-inquiries-barristers/" target="_blank" rel="noreferrer noopener"><span style="text-decoration: underline;">here</span></a> for further details</p> <!-- /wp:paragraph -->