Ambulance firm that carried Peggy Copeman not set to add defibrillators

Peggy Copeman, on her daughter Maxine's wedding day. 

Peggy Copeman on her daughter Maxine's wedding day - Credit: Maxine Fulcher

Bosses of the private ambulance firm that carried Peggy Copeman on the day of her death say a raft of changes have been made since the incident - but that its vehicles will not be fitted with defibrillators. 

A cardiological expert told an inquest that Mrs Copeman, from New Buckenham, could have been saved by a defibrillator on December 16 2019 while in a private ambulance driving back to Norfolk from Taunton.

Managers at Cygnet Healthcare and Premier Rescue Ambulance Service (PRAS) were asked by Jacqueline Lake, senior coroner for Norfolk, about changes to policies and procedures following Mrs Copeman's death on the fourth day of her inquest. 

The crew from Premier Rescue Ambulance Service (PRS) had pulled into the hard shoulder of the M11 near Junction 9 in Essex after concerns Mrs Copeman was unresponsive, "snoring" and had mucus coming out of her nose - signs of respiratory or cardiac distress said Dr Khan.

On Thursday, a statement from Dr Khalid Khan, cardiology expert said in his view PRAS staff had failed to recognise the 81-year-old was in respiratory or cardiac distress and she had "effectively died whilst sitting between them". 

He added in his view the staff members did not act promptly in calling emergency services in a "reasonable or timely matter".

Dr Khan said the type of cardiac arrest Mrs Copeman suffered could have been treated if defibrillation was administered speedily - but no defibrillator was on board. He said Mrs Copeman had entered aysytole, the most serious form of cardiac arrest. 

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Allen Tapfumaneyi, compliance manager of PRAS, addressed questions from Mrs Lake around training for staff, awareness of first aid kits and changes to its booking procedures. 

Staff involved in the transportation of Mrs Copeman did not have any medical training, with one member trained in CPR, and another shadowing. 

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He told the court all staff have since been given training in basic life support including drivers and that a system was in place to prompt staff when training was running out.

In addition, changes to its transportation policies included patients must be able to walk independently and would carry out transfers in the South West region.

Mrs Lake asked if the service had given consideration to putting in defibrillator in their vans.

But Mr Tapfumaneyi said: "No, we are considered as a non-emergency patient support. We haven't put any defibrillators in the vans." 

Gemma Daley, counsel for Mrs Copeman's family, told Mr Tapfumaneyi that the service did not contact the family following the incident.

He said: "I would like to apologise to the family for such an omission for not contacting them following such a tragic event. We will ensure in the future to have contact with the family and work with them." 

Dr Arokia Antonysamy, the regional managing director for Cygnet Health, said changes had been made to its referral pathways,  its transportation policies, care plans, and had increased staff recruitment.

Dr Antonysamy said changes to its discharge policy meant patients were given examinations to ensure fitness to travel on the day of departure "regardless of how far the journey" was.

She added fluid balance chart are maintained at all times during their stay in the ward.    

Referring medical teams are also asked to provide complete additional details in relation to a patients physical health.

Susan Graham, service director from Norfolk and Suffolk Foundation Trust, will give evidence on Friday. 

The court heard all out of area referrals units are asked to provide written consent from patient's families or next of kin - though Dr Antonysamy said the hospital could not always refuse if this information was not give given the urgency of a patient needing mental health treatment.

Earlier in the day, the court heard the timeline of ambulances being deployed to Mrs Copeman following a 999 call at 2.27pm. 

The court heard crews were sent to the scene after a 999 operator was told "Peggy Copeman had passed away" in response to questions about her breathing.

The first unit arrived at 2.37pm followed by an ambulance crew a minute later. 

Paramedic Michael Moran, from East of England Ambulance Service, had received reports Mrs Copeman was in cardiac arrest and joined colleagues in attempted resuscitation. 

The court heard a decision was taken to stop the resuscitation attempt as it was deemed to be futile and Mrs Copeman died at 2.59pm.

The inquest is expected to conclude on Friday. 

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