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PPS - trauma > The coroner's office and court > Flashcards

The coroner's office and court Flashcards

1
Q

Who set up the coroner’s court?

A

900 years ago

French

Dis-incentivise the killing of the killing of the french

If anyone was found violently killed = norman

If they were found not to be a norman they would have to py a fine - Mudrum fine

Coroner only established who died

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2
Q

What does the coroner establish now?

A

Who

Why

When

Where

How the person died

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3
Q

What was the role of the coroner in the dark ages?

A

Coroner ordered the killing of witches

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4
Q

What is a role that the coroner did up the the 1970s?

A

Up to the 1970s, coroners could indict a person of murder

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5
Q

Who was the last person to be indited of murder by a coroner?

A

Lord Lucas

Accused of murdering family nanny

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6
Q

What can the coroner do if they suspect murder?

A

Can refer to the crime prosecution service

If believe a crime has been committed

May not accuse someone of murder

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7
Q

What are practical roles of the coroner?

A

Learn lessons to prevent deaths in the future

Refer potential crime to the crown prosecution service for consideration

Scrutinise unexplained deaths

Identify failures of the police and health services

Find the truth and give a voice to the bereaved

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8
Q

What is Rule of Law?

A

Wherever you are geographically, you will be treated the same way

Outcome of a court case will be identical regardless of where in the UK

Ensures consitency by following a process

Rules of evidence is applied to everything that is heard in court which sets out material facts as close as the legal process will come to finding the truth

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9
Q

What is the aim of Rule of Law?

A

To be reproducible regardless of venue

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10
Q

How does Rule of Law make sure it is reproducible?

A

Consistent procedure and rules of evidence to find material facts

Consistent law applied to material facts

Few decisions are discretionary

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11
Q

Which deaths are referred to the coroner?

A

Any death which is

  • a violent or unnatural death
  • cause is unknown
  • within custody or otherwise in state detention
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12
Q

What is an unnatural death

A

Industrial diseases

High courts have widened definition to include where there have been medical failures

Natural death becomes unnatural where there is reasonable cause to suspect failures or neglect has contributed to the death

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13
Q

What finessed the interpretation of unnatural?

A

Touche/ Jamieson cases

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14
Q

Describe the Touche/ Jamieson case

A

Woman went to private hospital in London to deliver twins via Caesarian

Died of stroke caused by eclampsia

Coroners argued that stroke and eclampsia is natural, no jurisdiction to ask for an inquest

High court found that failure. neglect could have lead to the death even though natural cause

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15
Q

What happens if the coroner critises too much or is not critical enough?

A

Lawyers will judicially review the decision if too critical

Family will judicially review the decision if not critical enough

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16
Q

What is the professional background of a coroner?

A

Either

  • a D-skilled doctor
  • lawyer
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17
Q

Where does criticism come from?

A

Expert

Need independent expert - cannot be involved with the victim in any way

18
Q

How does the expert determine whether a crime has been carried out or not?

A

Coroner allows expert to hear all the evidence

Ask them if they thought of any failures the staff made

19
Q

What happens if the expert believes a failure was made?

A

Qualify the failures

20
Q

What is neglect considered as?

A

Really high legal test

If recorded in court, can be recorded to CPS

21
Q

What happens to trials where there were failures of basic care causative of the death?

A

Referred to the CPS (crown prosecution service)

Prosecute the doctor - manslaughter

22
Q

What is the most serious thing that can happen in Coroners court?

A

Trial reffered to the CPS

23
Q

Where is evidence collected from?

A

Gathered by many sources

24
Q

What are examples of evidence collected in court?

A

Witnesses cross-examined and cross-referred

25
Q

What does cross-examining mean?

A

Test if they’re telling the truth

26
Q

What are the disadvantages of cross-examining?

A

Makes the witnesses feel uncomfortable

Makes them feel as they’re on trial

Pressure the cross examination creates is designed to get to the truth - effective

27
Q

The court completely exonerates witnesses

TRUE or FALSE

A

TRUE

28
Q

What does MCCD mean?

A

Medical certificate of cause of death

29
Q

Under what conditions can you not fill the MCCD?

A

Haven’t treated the patient in final illness

Haven’t seen patient 14 days or after after death

No evidence of natural cause of death

30
Q

What are classical errors practictioners make when filling MCCDs?

A

Errors of saying MI because of old age without evidence

Family want to avoid autopsy for emotional or religious reasons so convince practitioner to put natural cause of death on MCCD

31
Q

Why should health professionals not be swayed into changing response on MCCD due to family requests?

A

Bereaved family will come back after the grieving period and accuse doctor

Family will be angry with professional when they realise they do not know why their loved one died

32
Q

History of ischaemic heart disease or narrowing of the arteries is enough to conclude that patient died of coronary artery disease

TRUE or FALSE

A

FALSE

Need evidence

Shipman
Tomlison/Patel

33
Q

What are tips in filling MCCD?

A

Don’t use mode of dying as cardiac arrest - everyone has cardiac arrest when they die

Don’t put organ failure without being supported by 1b

Don’t use short form such as MI or COPD

Only write MI if evidenced

34
Q

What is the only time it is okay to use short hand in MCCD?

A

HIV

35
Q

What does 1b mean?

A

Explains the underlying pathology that caused the organ failure

Example:

Ia. Renal failure
Ib. Necrotising-proliferative nephropathy
Ic. Systemic lupus erythematosus

36
Q

When can you use old age as a cause of death?

A

Over 80

Slow deterioration

No other causes

37
Q

What is an example of a MCCD that uses old age as cause of death?

A

1a - cardiopulmonary degeneration

1b - old age

38
Q

What is the principle when writing the cause of death on the MCCD?

A

Do not put anything that you cannot

  • justify in court
  • on oath
  • being tested by a barrister

Fill the MCCD to the best of your knowledge and belief

39
Q

What if the pathologist is unsure about the cause of death?

A

Do not speculate

Have evidence for what you write

40
Q

What are the 3 possible consequences of an inappropriate MCCD?

A
  1. You get away with it
  2. Bounced back by the Registrar of Deaths which could result in an Inquest
  3. Queried by another family member = inquest
41
Q

When is an inquest from a family member normally ordered?

A

When another family member has convinced the doctor to lie on the medical certificate

42
Q

What is an example of an Inquest being ordered on an inappropriate MCCD?

A

Sood

£100 fine

£1 600 costs

PPS - trauma (4 decks)

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