Inquest into the death of NHS worker concludes Covid-19 was unlikely to be work related
At an inquest last week, the Senior Coroner for South Wales Central concluded that an NHS worker who died from Covid-19 was unlikely to have caught the virus at work.
Mr Alan Macalalad died on 20 May 2020, aged 44, after going into cardiac arrest at the Royal Glamorgan Hospital, Llantrisant. He worked as a theatre assistant for Cardiff and Vale health board. He had Type-2 diabetes and needed surgery in 2019 due to pneumonia and collapsed lungs. He raised concerns with his manager and his GP about Covid-19 given his medical history and he was moved to a role with no patient contact. His wife, a nurse was sent home from work with Covid symptoms on 5 May 2020 and Mr Macalalad was required to self-isolate. He went on to develop symptoms and on 20 May 2020 he was admitted to the Royal Glamorgan hospital. Sadly, he developed a blocked blood vessel in his lungs and suffered a cardiac arrest.
The circumstances in which a coroner will investigate a Covid-19 death
Anyone may refer a death to a coroner but, in the context of workplace deaths, most referrals are made under the Medical Certificate Cause of Death procedure or under under RIDDOR. There must be a report to the coroner if the medical practitioner completing the Medical Certificate of Cause of Death “suspects that the person’s death was due to… an injury or disease attributable to any employment held during the person’s lifetime.” Regulation 6(2) of RIDDOR requires a report to be made to the HSE where “any person dies as a result of occupational exposure to a biological agent’ which includes the virus which causes Covid-19 disease. There are therefore some instances in which a Covid-19 death may be reportable to the coroner where the virus may have been contracted in the workplace.
However, a coroner will not investigate all deaths and has a duty to investigate only where s/he has reason to suspect that the death was violent or unnatural or where the cause of death is unknown, or the deceased died while in state detention. In the context of Covid-19 deaths, inquests are likely to take place on the basis that the death was unnatural, or the cause of death is unknown.
The vast majority of deaths from Covid-19 are due to the natural progression of a naturally occurring disease and so will not be investigated by a coroner. A natural cause of death may be rendered unnatural for the purposes of an inquest where some human error contributed to the death. The Chief Coroner has issued guidance on Covid-19 deaths and possible exposure in the workplace which states that if the medical cause of death is Covid-19 and there is no reason to suspect that any culpable human failure contributed to the death, there will usually be no requirement for an investigation to be opened. The words “reason to suspect” have a low threshold and lower even than a prima facie case is sufficient. The guidance states it is a matter for the coroner’s judgement in each case whether the facts and evidence in the particular case provide “reason to suspect” that the death was unnatural.
Scope of the investigation and who is required to participate
The purpose of an inquest is not to attribute blame for the death but to establish who died and when, how and where the death occurred.
A participant in an investigation is called a Properly Interested Person. The family of the deceased is automatically given this status. In a workplace incident, the employer will be an interested person since it will have “sufficient interest” in the inquest.
Even if the Coroner is under a duty to investigate a Covid-19 death and holds an inquest, there is likely to be much uncertainty about where the virus was contracted in the particular case. Given that the virus spreads rapidly, can be spread by symptom-less carriers and has a variable incubation period, being able to pinpoint the precise source of the infection is likely to be extremely difficult in most cases.
The general test for causation of the death is whether, on the balance of probability, the conduct in question more than minimally, negligibly or trivially contributed to the death. At the inquest into Mr Macalalad’s death, the Coroner concluded that Mr Macalalad died of natural causes and that, on the balance of probabilities, it was unlikely that the cause of his Covid-19 infection occurred at work.
For further information in relation to inquests into workplace deaths and employer liability claims, please contact our Corporate Claims team.
 Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013
 Guidance No 37 as amended