Dorothy Delaney

both Clopidogrel and Rivoroxaban together. Evidence was given at the inquest that advice is not sought on an individual basis for patients at Alexander House Health Centre who are prescribed both Clopidogrel and Rivoroxaban as they rely on advice previously sought in respect of other patients in similar circumstances.

1. 1 therefore have concerns that there are patients under the care of

Alexander House Health Centre who are being prescribed both anticoagulation therapy and antiplatelet medication at the same time, which increases the risk of a haemorrhage occurring, in circumstances where specialist advice has not been sought, taking into account the individual patient’s previous medical history and circumstances.

1. I therefore request EEE review the treatment of all patients in his

practice who are being treated with Clopidogrel, or any other antiplatelet medication at the same time as Rivoroxaban, or any other anticoagulation medication, having regard to the NICE guidelines in

relation to oral anticoagulation.

ACTION SHOULD BE TAKEN

In my opinion urgent action should be taken to prevent future deaths and I believe you and/or your organisation have the power to take such action,

YOUR RESPONSE

You are under a duty to respond to this report within 56 days of the date of this report, 18" November 2015. I, the coroner, may extend the period.

Your response must contain details of action taken or proposed to be taken, setting out the timetable for action. Otherwise you must explain why no action is proposed.

COPIES and PUBLICATION

I have sent a copy of my report to the Chief Coroner and to the following Interested Persons:

o _—i« Dorothy Delaney’s son on behalf of the family (2) Wigan Borough Clinical Commissioning Group, Wigan Life Centre, College Avenue, Wigan, WNi 1NJ

Tam also under a duty to send the Chief Coroner a copy of your response.

The Chief Coroner may publish either or both in a complete or redacted or summary form. He may send a copy of this report to any person who he believes may find it useful or of interest. You may make representations to me, the coroner, at the time of your response, about the release or the publication of your response by the Chief Coroner.

Dated Signed 23 September 2015 Rachael C Griffin