Regulation 28: Prevention of Future Deaths report – Najeeb Katende

Summary

Coroners have a statutory duty to issue a Prevention of Further Deaths report to any person or organisation where, in the opinion of the coroner, action should be taken to prevent future deaths. 

This coroners report relates to the death of 15 year-old Najeeb Katende and the delay in defibrillation due to the equipment being set to manual mode and not detecting his shockable rhythm.

The coroner found that the delay in defibrillating Najeeb significantly reduced his chances of survival.