top of page

Inquests (PFDs)

Date
Reference
Deceased
Coroner Area
Sent to
Investigation
Circumstances
Sent to
Categories
Also sent to
1 December 2021
2022-0052
Kaja Spiewak
West Sussex
Railway related deaths | Child Death (from 2015) | Suicide (from 2015)
Govia Thameslink Railway Ltd and and Network Rail
11 May 2022
2022-0139
Cristofaro Priolo
Inner North London
Care Home Health related deaths
BUPA Care Services and Highgate Care Home
7 March 2022
2022-0078
Joyce Dennis
County of Surrey
Care Home Health related deaths
Roseland Care Home
10 February 2022
2022-0042
Sheila Steggles
Norfolk
Hospital Death (Clinical Procedures and medical management) related deaths |�Mental Health related deaths
Hellesdon Hospital
28 April 2022
2022-0129
Alphonso Shearer
Manchester South
Hospital Death (Clinical Procedures and medical management) related deaths | Community health care
These reports are being sent to: Greater Manchester Health and Social Care Partnership | Trafford Clinical Commissioning Group
3 February 2022
2022-0040
Mark Jones
Manchester South
Hospital Death (Clinical Procedures and medical management) related deaths |�Other related deaths
Department of Health and Social Care
15 February 2022
2022-0048
Jason Lennon
East London
Mental Health related deaths | Hospital Death (Clinical Procedures and medical management) related deaths | Other related deaths
Department of Health and Social Care, East London Foundation NHS Trust and NHS England
02/12/2022
2022-0390
Melsadie Parris
Buckinghamshire Category: Child Death (from 2015) | Other related deaths This report is being sent to: Buckingham Council Children�s Services
Buckingham Council Children�s Services
Child Death (from 2015) | Other related deaths
17 February 2021
2022-0119
Margaret Greenacre
North Northumberland and South Northumberland
Care Home Health related deaths
Baedling Manor Care Home
26 January 2022
2022-0030
Ketheeswaren Kunarathnam
West London
State Custody related deaths | Mental Health related deaths | Suicide (from 2015) | Other related deaths
Home Office
26/09/2022
2022-0380
Lewis Begley
Norfolk Category: Alcohol, drug and medication related deaths This report is being sent to: Norfolk and Suffolk NHS Foundation Trust
Norfolk and Suffolk NHS Foundation Trust
Alcohol, drug and medication related deaths
16 December 2021
2022-0068
David O�Brien
Newcastle upon Tyne and North Tyneside
Care Home Health related deaths
Springfield Health Care Services and Care Quality Commission
1 February 2022
2022-0032
Jake Cahill
Cornwall & the Isles of Scilly
Child Death (from 2015) | Suicide (from 2015) |�Other related deaths
Youth Justice Board for England and Wales
7 April 2022
2022-0109
Laura Smallwood
Cornwall and the Isles of Scilly
Other related deaths
Minister for Crime and Policing
22 February 2022
2022-0058
Van Tuyen
Inner North London
Hospital Death (Clinical Procedures and medical management) related deaths
Department of Health and Social Care | Barts Health NHS Trust | NHS England
7 March 2022
2022-0083
Michael Humphries
County of Surrey
Care Home Health related deaths | Community health care
Tadworth Grove Care Home and Tissue Viability Nurses
27 January 2022
2022-0022
Maria Howell
Essex
Care Home Health related deaths
Holmes Care Group Limited
24 January 2022
2022-0020
Idris Habib
Mid Kent and Medway
State Custody related deaths |�Mental Health related deaths
HMP Swaleside
11/11/2022
2022-0370
Derek Shaw
Mid Kent and Medway Category: Emergency services related deaths (2019 onwards) This report is being sent to: Department of Health and Social Care
Department of Health and Social Care
Emergency services related deaths (2019 onwards)
23 March 2022
2022-0093
Robert Murray
East Sussex
Care Home Health related deaths | Emergency services related deaths (2019 onwards)
Association of Ambulance Chief Executives and Nursing and Midwifery Council
16/06/2022
2022-0180
Lee Caruana
Birmingham and Solihull
Emergency services related deaths (2019 onwards)
Birmingham Integrated Care Board and NHS England and Department of Health and Social Care
21/06/22
2022-0192
Kate Hyatt
West Yorkshire (Western)
Mental Health related deaths | Suicide (from 2015)
Hands of Light Academy
17/07/2022
2022-0213
Kathleen Stewart
Manchester South Category: Emergency services related deaths (2019 onwards) This report is being sent to: Tameside and Glossop Integrated Care NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
Emergency services related deaths (2019 onwards)
16/11/2022
2022-0367
Susan Skillen
Liverpool and Wirral Category: Other related deaths | Alcohol, drug and medication related deaths This report is being sent to: NHS England and NHS Improvement
NHS England and NHS Improvement
Other related deaths | Alcohol, drug and medication related deaths
09/11/2022
2022-0362
Maria Whale
South Wales Central Category: Wales prevention of future deaths reports (2019 onwards) | Emergency services related deaths (2019 onwards) This report is being sent to: Cardiff and Vale University Health Board NHS Trust and Welsh Ambulance Service Trust
Cardiff and Vale University Health Board NHS Trust and Welsh Ambulance Service Trust
Wales prevention of future deaths reports (2019 onwards) | Emergency services related deaths (2019 onwards)
14/11/2022
2022-0361
Ghulam Mohammad
East London Category: Hospital Death (Clinical Procedures and medical management) related deaths This report is being sent to: Department of Health and Social Care and The Royal London Hospital
Department of Health and Social Care and The Royal London Hospital
Hospital Death (Clinical Procedures and medical management) related deaths
08/11/2022
2022-0357
Roy Travers
Inner North London Category: Hospital Death (Clinical Procedures and medical management) related deaths This report is being sent to: Whittington Health NHS Trust
Whittington Health NHS Trust
Hospital Death (Clinical Procedures and medical management) related deaths
03/11/2022
2022-0352
Raneem Oudeh and Khaola Saleem
Birmingham and Solihull Category: Emergency services related deaths (2019 onwards) | Other related deaths This report is being sent to: West Midlands Police | The Home Office
West Midlands Police | The Home Office
Emergency services related deaths (2019 onwards) | Other related deaths
04/11/2022
2022-0349
Graham Flindle
Manchester South Category: Other related deaths This report is being sent to: The Greater Manchester Health and Social Care Partnership
The Greater Manchester Health and Social Care Partnership
Other related deaths
04/11/2022
2022-0347
Lynn Moss
Manchester South Category: Other related deaths This report is being sent to: Department of Health and Social Care
Department of Health and Social Care
Other related deaths
04/11/2022
2022-0351
Philip Day
Manchester South Category: Hospital Death (Clinical Procedures and medical management) related deaths This report is being sent to: Department for Health and Social Care
Department for Health and Social Care
Hospital Death (Clinical Procedures and medical management) related deaths
13/09/2022
2022-0341
Peter Pearson
Worcestershire Category: Care Home Health related deaths This report is being sent to: Corbett House Nursing Home | Care Quality Commission | Worcestershire County Council
Corbett House Nursing Home | Care Quality Commission | Worcestershire County Council
Care Home Health related deaths
7 March 2022
2022-0072
Jack Ritchie
South Yorkshire West
Suicide (from 2015) | Community health care | Other related deaths
Department for Education | Department of Health and Social Care | Department for Culture Media & Sport
12/07/22
2022-0159
Louise Allen
East London
Mental Health related deaths | Suicide (from 2015)
North East London NHS Foundation Trust and The Clinical Commissioning Group
4 March 2022
2022-0070
Sarah-Louise Doyle
Liverpool and Wirral
Hospital Death (Clinical Procedures and medical management) related deaths |�Mental Health related deaths
Mersey Care NHS Foundation Trust
13 May 2022
2022-0143
Deceased names: Michael Draper and Rafal Wojdyl
Manchester West
Road (Highways Safety) related deaths
Salford City Council
22 February 2022
2022-0060
Christopher Osland
North East Kent
Hospital Death (Clinical Procedures and medical management) related deaths |�Product related deaths
East Kent Hospitals University NHS Foundation Trust
25 April 2022
2022-0122
Millie-Rae Needham
South Yorkshire (West District)
Hospital Death (Clinical Procedures and medical management) related deaths |�Child Death (from 2015)
Sheffield Teaching Hospitals NHS Foundation Trust
01/06/22
2022-0163
Samuel Gomm
South Wales Central
Mental Health related deaths | Suicide (from 2015)
Powys Teaching Health Board and Powys County Council
22/06/2022
2022-0188
Derek Holmes
Manchester South
Community health care and emergency services related deaths | Other related deaths |
Tameside and Glossop Integrated Care NHS Foundation Trust
01/07/22
2022-0203
Daniel Xavier
East London
Hospital Death (Clinical Procedures and medical management) related deaths
Barts Health and Department of Health and Social Care
17/06/2022
2022-0182
Victoria Cartwright
Manchester West
Alcohol, drug and medication related deaths | Mental Health related deaths
Wigan Discharge Team
19/04/22
2022-0170
Volodymyr Korol
Surrey
Mental Health related deaths | Community Health Care | Emergency Services related deaths
Whitepost healthcare Group
15/06/2022
2022-0178
Paul Welch
Cornwall and Isles of Scilly
Other related deaths
Cornwall Council and Mylor Parish Council and Sailors Creek CIC
09/06/2022
2022-0172
Shirley Moloney
East London
Mental Health related deaths
Department of Health and Social Care and The National Quality Board
09/08/2022
2022-0249
Mathew Moore
Dorset Category: Suicide (from 2015) | Alcohol, drug and medication related deaths This report is being sent to: Swanage Medical Practice
Swanage Medical Practice
Suicide (from 2015) | Alcohol, drug and medication related deaths
23/06/22
2022-0193
Khalid Yousef
Birmingham and Solihull
Mental Health related deaths | Other related deaths
NHS England, Birmingham and Solihull Mental Health, Home Office and West Midlands Police
13/05/22
2022-0162
Rita Britten
West Yorkshire Western
Hospital Death (Clinical Procedures and medical management) related deaths
NHS England and Resuscitation Council
04/08/2022
2022-0239
James Curry
Manchester South Category: Hospital Death (Clinical Procedures and medical management) related deaths This report is being sent to: Tameside and Glossop Integrated Care NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
Hospital Death (Clinical Procedures and medical management) related deaths
30/05/22
2022-0160
Mark Sumnall
Derby and Derbyshire
Hospital Death (Clinical Procedures and medical management) related deaths
Derbyshire County Council and NHS Derby & Derbyshire Clinical Commissioning Group
13/07/2022
2022-0209
Daniel Clements
West Yorkshire Western Category: Mental Health related deaths | Suicide (from 2015) This report is being sent to: Department of Health and Social Care | South West Yorkshire Partnership NHS Foundation Trust
Department of Health and Social Care | South West Yorkshire Partnership NHS Foundation Trust
Mental Health related deaths | Suicide (from 2015)
09/06/22
2022-0168
Jennifer Dyer
East Sussex
Road (Highways Safety) related deaths
East Sussex County Council
17/06/2022
2022-0183
Amanda Hesketh
Manchester South
Alcohol, drug and medication related deaths
Donneybrook Medical Centre | Department of Health and Social Care
25/07/2022
2022-0229
Stephen Coombes
Suffolk Category: Road (Highways Safety) related deaths This report is being sent to: Suffolk Highways | Kier Highways Ltd
Suffolk Highways | Kier Highways Ltd
Road (Highways Safety) related deaths
12 May 2022
2022-0152
Pauline Keen
North East Kent
Hospital Death (Clinical Procedures and medical management) related deaths | Mental Health related deaths | Other related deaths
Kent and Medway NHS Social Care Partnership Trust and Kent County Council � Adult Social Care
19/07/2022
2022-0219
Beryl Simcock
Nottinghamshire and Nottingham Category: Care Home Health related deaths This report is being sent to: Radcliffe Manor House Care Home
Radcliffe Manor House Care Home
Care Home Health related deaths
12 May 2022
2022-0140
Sergio Dunkley
Sefton, St Helens and Knowsley
Hospital Death (Clinical Procedures and medical management) related deaths | Mental Health related deaths | Suicide (from 2015)
NHS England and Care Quality Commission
25/05/22
2022-0158
Ian Cockfield
East London
Hospital Death (Clinical Procedures and medical management) related deaths
Department of Health and Social Care and East London Foundation NHS Trust
13 May 2022
2022-0142
Spencer Barr
Birmingham and Solihull
Hospital Death (Clinical Procedures and medical management) related deaths | Mental Health related deaths | Alcohol, drug and medication related deaths | Other related deaths
Probation Service � Young Adults Central Team, Birmingham Women�s and Children�s NHS Foundation Trust, Change Grow Live and Forward Thinking Birmingam
08/06/2022
2022-0173
Ian Taylor
Inner South London
Police related deaths
Independent Officer for Police Conduct and Metropolitan Police Service
6 May 2022
2022-0132
Trevor Reynolds
North Wales (East and Central)
Hospital Death (Clinical Procedures and medical management) related deaths
Betsi Cadwaladr University Health Board
3 May 2022
2022-0130
Kate Hedges
Manchester South
Railway related deaths �| Mental Health related deaths �| Hospital Death (Clinical Procedures and medical management) related deaths
Greater Manchester Mental Health NHS Foundation Trust | Department of Health and Social Care
18 May 2022
2022-0148
Matthew Evans
Surrey
Community health care | Mental Health related deaths | Suicide (from 2015) | Alcohol, drug and medication related deaths
NHS England, Department of Health, Care Quality Commission, General Medical Council, Surrey Clinical Commissioning Group, GP and Farnham Park GP Practice
19 May 2022
2022-0150
Hassan Zubair
East London
Railway related deaths
Network Rail
18/08/2022
2022-0259
Chelsea Mooney
South Yorkshire Western Category: Community health care and emergency services related deaths | Mental Health related deaths This report is being sent to: Cygnet Health Care | NHS England
Cygnet Health Care | NHS England
Community health care and emergency services related deaths | Mental Health related deaths
26 April 2022
2022-0123
Ashleigh Timms
East London
Emergency services related deaths (2019 onwards) |�Other related deaths
Sequence Care Group | London Fire Brigade | National Fire Chiefs� Council | British Standards Institution
21 March 2022
2022-0088
Zoltan Torok
Berkshire
Road (Highways Safety) related deaths
Highways England
14 January 2022
2022-0010
Brian Wareham
Gwent
Wales prevention of future deaths reports (2019 onwards) | Community health care | Hospital Death (Clinical Procedures and medical management) related deaths
Aneurin Bevan University Health Board and Richmond Clinic
4 February 2022
2022-0038
Joy Burgess
Greater Manchester South
Mental Health related deaths | Suicide (from 2015) | Hospital Death (Clinical Procedures and medical management) related deaths | Other related deaths
Department of Health and Social Care
28 February 2022
2022-0063
Martha Mills
Inner North London
Child Death (from 2015) |�Hospital Death (Clinical Procedures and medical management) related deaths
King�s College Hospital NHS Foundation Trust
31 December 2021
2021-0435
Jos Tartese-Joy
Greater Manchester South
Hospital Death (Clinical Procedures and medical management) related deaths |�Child Death (from 2015)
Department of Health and Social Care
18 March 2022
2022-0089
Emiliano Sala
Dorset
Other related deaths
Department for Transport | Department for Culture, Media and Sport | British Chambers of Commerce | Institute of Directors | Executives� Association of Great Britain | Confederation of British Industry | Non-Executive Directors��Association | British Horseracing Authority | England and Wales Cricket Board | Professional Footballers� Association | Premier League | English Football League | Football Association�| UK Athletics | UK Sport | Lawn Tennis Association | Jockey Club | Rugby Football Union | Rugby Football League | Motorsport UK
13/11/2022
2022-0360
Lee Brown
East London Category: Police related deaths | State Custody related deaths This report is being sent to: Department for Foreign, Commonwealth and Development Affairs
Department for Foreign, Commonwealth and Development Affairs
Police related deaths | State Custody related deaths
5 January 2022
2022-0002
James Emmerson
Bedfordshire and Luton
Mental Health related deaths | Hospital Death (Clinical Procedures and medical management) related deaths | Other related deaths | Community health care
Association of Directors of Adult Social Services | Royal College of Psychiatrists |�Department of Health and Social Care | East London NHS Foundation Trust | Health and Housing � Central Bedfordshire
7 March 2022
2022-0079
Melanie Elms
County of Surrey
Mental Health related deaths �| Hospital Death (Clinical Procedures and medical management) related deaths | Railway related deaths
Surrey and Borders Partnership NHS Foundation Trust
17 December 2021
2021-0425
Ziggy Mitchell-Stagg
Inner North London
Hospital Death (Clinical Procedures and medical management) related deaths |�Child Death (from 2015)
Homerton University Hospital NHS Trust
04/11/2022
2022-0350
Ellen MacFarlane
Manchester South Category: Care Home Health related deaths | Emergency services related deaths (2019 onwards) This report is being sent to: Department for Health and Social Care
Department for Health and Social Care
Care Home Health related deaths | Emergency services related deaths (2019 onwards)
3 February 2022
2022-0028
Harry Simmons
Plymouth, Torbay and South Devon
Road (Highways Safety) related deaths
Plymouth City Council
5 April 2022
2022-0099
Beatrice Dawkins
Hampshire, Portsmouth and Southampton
Hospital Death (Clinical Procedures and medical management) related deaths |�Alcohol, drug and medication related deaths
Portsmouth Hospitals NHS Trust
22 February 2022
2022-0053
Jane Shilton
Leicester City and South Leicestershire
Care Home Health related deaths | Mental Health related deaths |�Alcohol, drug and medication related deaths
Hamilton Community Homes Ltd
4 March 2022
2022-0069
Edward Akroyd
West Yorkshire Western
Child Death (from 2015) |�Hospital Death (Clinical Procedures and medical management) related deaths
Calderdale and Huddersfield Foundation Trust
22 January 2022
2022-0018
Thomas Moffett
Lancashire and Blackburn with Darwen
State Custody related deaths
HMP Preston | HMPPS
15 November 2019
2019-0390
Francesca Sio
London (South)
Hospital Death (Clinical Procedures and medical management) related deaths
Greenbrook Healthcare | Bromley Clinical Commissioning Group
19 September 2019
2019-0305
Caspian Thorn
Manchester (South)
Child Death (from 2015); Hospital Death (Clinical Procedures and medical management) related deaths
HSIB
31 July 2019
2019-0284
Nigel Abbott
Birmingham and Solihull
Community health care related deaths; Emergency services related deaths (2019 onwards); Mental Health related deaths
Birmingham City Council; Birmingham and Solihull Mental Health NHS Trust; West Midlands Police; NHS Birmingham and Solihull Clinical Commissioning Group; NHS England; Department of Health and Social Care
8 March 2021
2021-0066
Joan Rutter
Blackpool and Fylde
Care Home Health related deaths
Riverside Rest Home
05/11/2019
2019-0380
Neville McNair
East Sussex
Hospital Death (Clinical Procedures and medical management) related deaths; State Custody related deaths
NHS England and NHS Improvement; HM Prison and Probation Service
16 September 2019
2019-0297
Taejelle Francois
West Yorkshire (West)
Child Death (from 2015); Hospital Death (Clinical Procedures and medical management) related deaths
Calderdale and Huddersfield NHS Trust
13 September 2019
2019-0296
Lucia Stear
Liverpool and Wirral
Child Death (from 2015); Other related deaths
Department of Housing, Communities & Local Government
30 October 2019
2019-0372
Robert Ginn
London Inner (North)
tate Custody related deaths
Care UK; HMP Pentonville
31 July 2019
2019-0286
Gladys Borgogno
Stoke-on-Trent & North Staffordshire
Hospital Death (Clinical Procedures and medical management) related deaths
University Hospital of North Midlands
10 December 2019
2019-0421
Brenda Drew
Dorset
Alcohol, drug and medication related deaths
Royal Pharmaceutical Society
22 July 2019
2019-0287
Richard Carlon
Birmingham and Solihull
Alcohol, drug and medication related deaths; Mental Health related deaths; Suicide (from 2015)
Birmingham City Council; West Midlands Police; Birmingham and Solihull Mental Health NHS Trust
29 November 2019
2019-0412
Connor Davies
South Wales Central
Hospital Death (Clinical Procedures and medical management) related deaths; Suicide (from 2015); Wales prevention of future deaths reports (2019 onwards)
Cwm Taf Health Board
12 August 2019
2019-0273
Karen Burns
Birmingham and Solihull
Emergency services related deaths (2019 onwards); Suicide (from 2015)
West Midlands Police; Home Office
2 March 2021
2021-0056
Martin Sullivan
Manchester South
Emergency services related deaths (2019 onwards)
NHS England and NHS Stockport Clinical Commissioning Group
27 August 2019
2019-0262
Kay Martin
Sunderland
Other related deaths
Home Office
18 February 2021
2021-0046
Kevin Clarke
London Inner South
Police related deaths | Emergency services related deaths (2019 onwards)
Metropolitan Police Service and London Ambulance Service
7 November 2019
2019-0365
Charlotte Jacobs
Manchester City
Hospital Death (Clinical Procedures and medical management) related deaths
Manchester University NHS Foundation Trust
7 August 2019
2019-0276
Carl Klimaytys
Brighton and Hove
Railway related deaths
Govia Thameslink Railways; Network Rail
bottom of page