The Crown Office and Procurator Fiscal Service has announced that a Fatal Accident Inquiry will not be held into the death of Amanda Cox who died at the Royal Infirmary of Edinburgh (RIE) in December 2018. The decision not to proceed to FAI has been taken with the agreement of Ms Cox’s family and takes account of the Serious Adverse Event Review carried out by NHS Lothian and the subsequent actions taken and lessons learned.
Principally these actions relate to the physical environment at RIE since Ms Cox is believed to have become disorientated when she left the Neonatal Unit to make her way back to her ward. NHS Lothian has also shared clinical information to help develop national guidance on the management of headache in Pregnancy and the development of national pathways for the management of women with complex obstetric care needs.
Dr Tracey Gillies, Medical Director, NHS Lothian, said: “The death of Mrs Cox was a deeply tragic occurrence and our sincere condolences remain with her family. We are so sorry that she died in our care.
“NHS Lothian conducted a thorough investigation to help prevent a similar tragedy happening again. The recommendations about the physical area were implemented immediately and clinical recommendations have also been shared with obstetric and neurology services across Scotland to help develop national guidance.
“Following the review, a robust action plan was put in place to improve maternity patient pathways, upgrade signage and wayfinding and extend CCTV surveillance throughout the Royal Infirmary of Edinburgh.”
NHS Lothian’s full statement can be read here.
The Crown Office Media Release can be read here.
