The death of an elderly woman who died in hospital after wrapping medical equipment around her neck has prompted the Health Department to take action to reduce the risk of self-harm in patients.
Ann Mary Horton died on Tuesday 16 January 2024 at the Jersey General Hospital.
The 77-year-old had been admitted on 11 December 2023 after her chronic obstructive pulmonary disease worsened.
On the evening of 7 January 2024, Mrs Horton wrapped medical equipment around her neck after reporting anxiety.
The inquest found that “the incident was not fully recorded and opportunities to assess and mitigate the risk of subsequent self-harm were missed”.
Mrs Horton was assessed and showed “significant disproportionate temporal atrophy” – a loss of connections between brain cells.
She was also anxious and confused, according to the inquest.
Just before midnight on Monday 15 January 2024, Mrs Horton was found in bed in cardiac arrest with medical equipment wrapped around her neck again.
An inquest into her death ruled that Mrs Horton died from “compression of the neck by a ligature”.
Deputy Viscount Advocate Matt Berry, acting as coroner, found that there was no evidence of third-party involvement in her death.
Following the verdict, Simon West, Medical Director for Health and Care Jersey, said: “Health and Care Jersey offers its deepest sympathies to Mrs Horton’s family.
“When a patient dies unexpectedly within our care we always investigate to see if we can learn from the event to prevent similar incidents in the future.
“A number of actions were taken following this investigation, and we continue to work collectively across health and care services to reduce the risk of harm to self when people are admitted to hospital.”