John Cleave: Prevention of future deaths report

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Date of report: 26/05/2026

Ref: 2026-0301

Deceased name: John Cleave 

Coroner name: Stephen Covell

Coroner Area: Devon, Plymouth and Torbay

This report is being sent to: NHS Devon | NHS Cornwall |
Isles of Scilly Integrated Care Boards 

REGULATION 28: REPORT TO FUTURE DEATHS
1CORONER 
I am Stephen Covell, Assistant Coroner for the coroner area of Devon, Plymouth and Torbay.
2DATE OF REPORT
26 May 2026
3CORONER’S LEGAL POWERS 
I make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013. 
4THIS REPORT IS BEING SENT TO 
1. [REDACTED] Interim Cluster Chief Executive Officer NHS Devon and NHS Cornwall and Isles of Scilly Integrated Care Boards 

You are under a duty to respond to this report within 56 days of the date of this report, namely by 21 July 2026. I, the coroner, may extend the period if an appropriate application is made. 
5YOUR RESPONSE 
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. 

I have a duty to send a copy of your response to the Chief Coroner.
In accordance with the Chief Coroner’s Publication Policy, you should send me any  representations regarding publication of your response. These representations should be made at the same time as the response is provided. I will pass any representations received to the Chief Coroner for a decision. 

Please note any links to webpages included in the response will not be  checked for sensitive information prior to publication, as the information is already online

The names of those who do not respond to PFD reports are regularly published on the Chief Coroner’s webpages Non-responses to Prevention of Future Death (PFD) reports – Courts and Tribunals Judiciary. 
6SUMMARY OF CORONER’S CONCERN
There appears to be no 24 hour Consultant Radiologist cover across Devon’s hospitals to review and report on complex x-rays or scans requiring consultant level expertise. 
7ACTION SHOULD BE TAKEN 
In my opinion unless action is taken to address the above concerns then there is a significant risk of future deaths and I believe that you have the power to take such action. 
8INVESTIGATION AND INQUEST
On 8 January 2024 an investigation was commenced into the death of John Thomas Cleave aged 70 years old. 

The medical cause of death was;
1a Aspiration Pneumonia  
  b Fall and Cervical Spine Fracture
2 Ankolosing Spondylitis  
    
In answer to the how, when and where questions I recorded;
John Thomas Cleave died at 1800 on 29 December 2023 at Torbay Hospital as a result of  complications from a cervical spine fracture sustained in an unwitnessed fall whilst the  Deceased was at his allotment at around 1700 the previous day against a background of  ankolosing spondylitis. The management of the Deceased’s treatment at hospital was  compromised by the radiological report of a CT-Scan failing to identify a high suspicion of a  haemothorax and the Deceased’s care not being led and directed by a clinician with  appropriate experience for the complexity of the case. Care should have been transferred to the nearest major trauma centre at Derriford Hospital in Plymouth.  

Conclusion
Accidental Death
9CIRCUMSTANCES OF DEATH
At about 1700 on 28 December 2023 John Thomas Cleave sustained a fracture to his cervical  spine and a probable haemothorax as a result of an unwitnessed fall on his allotment. The  Deceased’s injuries and subsequent treatment were complicated significantly by the fact that  he suffered from the spinal condition ankolosing spondylitis and had previously undergone  spinal fusions and suffered a cervical fracture.  

The Deceased was admitted to Torbay hospital Torquay at around 1930 and underwent a CT- Scan at around 2200. An initial view of the scan by the clinicians in the Emergency Department identified an unstable fracture of the cervical spine and a suspected haemothorax. A plan was made for the nearest major trauma centre in Plymouth to be contacted with a view  to transferring the Deceased’s care. Before the major trauma centre was contacted, at around  2300 the scan was reported by a registrar grade radiologist, who discounted any 
haemothorax. At the time of submitting the report there was no consultant radiologist on call to review the report. A consultant radiologist has recently reviewed the scan and indicated that it  should have been reported as identifying a high suspicion of haemothorax.  

It is likely that the report wrongly discounting the haemothorax influenced the treatment plan for the Deceased and contributed to his not being transferred appropriately to the major trauma centre for treatment.  

The next day, the Deceased’s care had been transferred to the Trauma and Orthopaedic   Team, albeit his remaining in the emergency department . At approximately 1300 the  Deceased was seen to vomit, aspirate and go into cardiac arrest. Whilst he was successfully  resuscitated, his condition deteriorated and he died at 1800 on 29 December 2023 at Torbay  Hospital.  

In the light of the injuries which the Deceased suffered on a background of a complex medical  history involving his spine and chest, he should have been transferred to the major trauma  centre at Plymouth as soon as the extent of his injuries and his previous medical history, became known. 
10CORONER’S CONCERNS 
During the course of the inquest I heard evidence giving rise to concern. In my opinion there is a risk that future deaths could occur unless action is taken. In the circumstances it is my  statutory duty to report to you. 
The MATTERS OF CONCERN are as follows:
During the course of the inquest, evidence was given to me that a level of complexity due to  the Deceased’s medical history, his injuries and an  apparent artifact in the CT-Scan caused by metalwork in the Deceased’s spine from previous fusions required the expertise of a  consultant radiologist. I was informed that there was (and is still) no out of hours consultant  radiologist cover for hospitals in Exeter, Plymouth and Torbay. 

I am concerned that there will be from time to time a need for scans and x-rays to be  considered and interpreted at consultant radiologist level to facilitate urgent treatment and there is at present a gap in such cover which puts patients at risk.  
11COPIES AND PUBLICATION OF THIS REPORT
I have a duty to send a copy of my report to every Interested Person who in my opinion should receive it. 
I also may send a copy of the report to any other person who I believe may find it useful or of interest. 
I can confirm I have sent the report to:
1.The Deceased’s Family 
2.Torbay and South Devon Healthcare NHS Foundation Trust
I also have a duty to send a copy of the report to the Chief Coroner.
You may make representations to me, the coroner, about the publication of the contents of this report in line with Chief Coroner’s PFD Publication Policy (2026). Any representations will be  sent to the Chief Coroner alongside the report. Please refer to box 4 above for additional  information relating to the publication of reports and responses. 
12Stephen Covell – Assistant Coroner