Prevention of Future Deaths report: David Wilson (12 June 2023)

Summary

David Wilson was admitted to Pinderfields Hospital on 27 December 2022 and subsequently underwent a CT scan which indicated an inflammation in the distal section of his colon. To identify the cause of this he underwent a flexible sigmoidoscopy, during which there was a colonic perforation which resulted in his death the following day.

Content

In his report, the Coroner raises significant concerns about the consent process followed in the case of Mr Wilson and whether he was able to make a truly informed decision when undergoing this procedure. He noted matters of concern as follows:

• The Consent Form signed by Mr Wilson was a standard pre-printed form. It did not attempt to provide any statistical rating for the risks identified, which would have enabled Mr Wilson to evaluate the risks.
• No attempt was made to interpret or tailor the risk inherent in the procedure in the light of Mr Wilson's extensive medical history and co-morbidities.
• The Consent Form did not refer to the risk of death. The Coroner states that due to this, Mr Wilson was not in a position to make a truly informed procedure to undergo the sigmoidoscopy.
• The Consent Form did not identify the clinicians involved in discussing the decision with him apart from one individual, the latter having obtained the patients signature when he was under the influence of morphine sedation.

Related Reading

• Julie Smith, Informed Consent: what is it? (21 December 2020)
• NHS Resolution, Nadine’s story: Informed consent (the Montgomery case) (6 August 2020)