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Tracy McCarthy

Evidence boundary. This page is a structured project extraction from the linked primary Prevention of Future Deaths source. It is not the report text. Do not infer cause, prevalence or product-wide performance beyond the source and the explicit qualification below.

Open the primary Judiciary source · Source register: SRC-072 · Return to all included reports · Open the case–mechanism/evidence map

Report metadata

Field Value
PFD reference 2024-0280
Registered primary source SRC-072
Report date 2024-05-21
Coroner area Inner North London
Clinical setting Primary care/prescribing
Care transition Hospital overdose information to repeat prescribing
Primary workflow group Medication and prescribing
Primary browsing context Primary and community care
Predominant information boundary Between care settings

The workflow, browsing-context and predominant-boundary fields are retained navigation aids. They are not additional coronial findings, and a single primary value cannot express every aspect of a multi-setting or multi-mechanism report.

Care-pathway classification

This classification distinguishes where safety-relevant information or work arose, where action was expected and where the digital or information workflow failed. It is a project coding of the source, not a coronial statement. “Origin” does not mean the organisation caused the harm.

Dimension Project classification
Settings and pathway participants Secondary acute or outpatient care, Primary care
Information or work-item origin Secondary acute or outpatient care
Origin care context(s) Secondary care
Expected action destination Primary care
Destination care context(s) Primary care
Directional pathway Secondary acute or outpatient care → Primary care
Care-setting span Multiple care settings
Sector boundary Health services only
Failure point Receiving or action service
Classification confidence high

Classification note: Hospital overdose information reached the practice, but the primary-care record did not convert it into a visible risk flag, medication review or preserved supply rationale.

Classification confidence applies only to this care-pathway coding. It is separate from extraction confidence, source authority and causal certainty.

Evidence status and qualification

Field Status
Extraction confidence high
Verification status Primary source linked; high-confidence extraction
Response evidence status Response evidence noted
Registered response sources SRC-102
Non-exclusive mechanism codes VIS, ALERT, LOOP, PROV, HF, GOV

Qualification recorded in the dataset: Drug-related death; report identifies unsafe prescribing and absent flags but does not state that software design itself caused death; practice response identifies EMIS and proposed a coded risk-management care-plan register

“Response evidence noted” means only that the row qualification refers to response/respondent evidence or records a recipient's post-report position. The linked IDs enumerate the official response attachments registered for this row; they do not imply that every response supports every part of the qualification, and they do not establish implementation. “Not assessed” makes no claim about whether a response exists.

Structured project extraction

These fields are analytical summaries, not quotations.

Project summary of the coroner's concern

Acknowledged overdose and dependence risks were not recorded in a way that would alert any practitioner

Requested action

GP practice to act

Digital safety characterisation

Dimension Project extraction
System or record type Practice prescribing/records software; response identifies EMIS
Digital function Medication risk alerting and complex-care summary
Failure mode Known dependence, overdose and prescribing risk were not placed in the record as a flag or alert, and amitriptyline prescribing continued with a 28-day supply
Human-factors issue Clinicians unfamiliar with the patient depended on individual colleagues' memory and could not readily see the rationale for daily supply
Workflow issue Hospital information did not trigger an owned medication review; safety depended on informal continuity with particular doctors
Information issue Relevant risk existed in longitudinal notes but was not summarised or made salient

Downstream Defence trace

No canonical candidate Defence requirement currently cites this report. This does not imply that the mechanism is irrelevant; any mapping must be added and qualified in the controlled requirements register.

The included-case dataset preserves early legacy_military_relevance and legacy_derived_requirement fields for audit history. They are not published here as requirements and must not override the canonical REQ register. New report rows do not need to populate them.