Inquest into the death of a dementia sufferer in a Care Home. During the afternoon of 7 October the deceased told staff he had pain in his chest. He had a poor diet and had previously been treated for indigestion. He was assessed by non-medical staff and, after drinking water, his pain subsided. Later that night he was found in a hot bath having died from a heart attack.
The Coroner recorded death due to natural causes contributed to by systemic neglect, he recommended that medical treatment should be sought whenever chest pain is reported