Alexander Braund

Identity and status

Coronial concern

The coroner found through an audit record that words in a SystmOne entry had been deleted and others added later, without an amendment timestamp being apparent on the printed/editable Word patient summary examined at inquest. The safety concern therefore depended on the representation available to reviewers, not merely on whether an audit event existed somewhere in the system.

Respondent account

TPP stated that the live system's audit trail retained amendment metadata and prior text. That response narrows the issue to divergence between the in-system audit representation and the exported summary used in the investigation; it does not erase the coroner's concern about the view examined.

Reviewer-coded mechanism

The review codes the case as provenance hidden by a routine or exported representation. These are reviewer classifications:

• PROV: amendment history and prior content were not equally apparent across representations.
• VIS: the ordinary summary implied that all text existed at the original time.
• GOV: safe use depends on which view is supplied for review, investigation and disclosure.

Limitations

This is one investigated record. It does not establish the prevalence of the behaviour, the behaviour of every export format or current SystmOne behaviour. The live audit trail retained history according to the respondent; the case must not be summarised as absence of any audit trail.

Defence applicability

Operational, clinical, printed, exported and investigation views may be used by different Defence actors. The case informs REQ-008 provenance and amendment clarity and its comparison test, AST-008. It does not establish current DMICP or CORTISONE export behaviour.

Source documents

• SRC-003: Alexander Braund PFD, Judiciary
• SRC-017: TPP response

Last verified

14 July 2026. Primary Judiciary page and official TPP response checked; live-audit and exported-summary statements remain separated in CLM-003.