The Penningtons Manches clinical negligence team has settled a claim on behalf of the parents of a three month old baby girl who died as a result of delays encountered in the accident and emergency (A&E) department at St George’s Hospital.
Following their daughter’s birth at 27 weeks, she was treated for necrotising enterocolitis at St Helier Hospital. At three months old, she underwent surgery for the removal of a stricture and also a hernia repair at St George’s Hospital. Three weeks later she was discharged.
She returned to St Helier Hospital six days later for a routine appointment. The paediatric doctor who examined her noted her abdomen to be swollen but, as her observations were stable, her parents were advised to attend A&E if they became concerned. On their return home, her parents noted her abdomen to be more distended and she began vomiting violently. They took her to A&E at St George’s Hospital.
They arrived at A&E at 23:19 and she was triaged in her car seat. Her parents explained that she appeared unwell and was struggling to breathe. They also explained that she had been discharged from hospital a week earlier. They were asked to book her in at reception, which they did, and she was then taken to the paediatric area to wait to be reviewed.
She was not categorised as an urgent case. She was reviewed by a paediatric nurse at around 00:05. She was noted to have a heart rate of 32 bpm and had a hard distended abdomen.
The nurse called for assistance and she was transferred to a ward. On arrival she was found not to be breathing. There were difficulties in achieving venous access and intubation. Efforts were made to resuscitate but she died at 01:50.
The post mortem subsequently confirmed the causes of death as ileal obstruction, peritoneal adhesion, necrotising enterocolitis stricture and extreme prematurity.
Having carried out investigations and obtained expert evidence, Penningtons Manches made a claim against the Trust for its delay in diagnosing and treating the ileal obstruction.
The Trust admitted there was a failure to identify the seriousness of the baby’s condition immediately on arrival on A&E at St George’s. It admitted that this led to a delay of around 35 minutes before she was seen by a paediatric nurse. It also admitted that, had she been seen by the paediatric neonatal staff at St George’s 35 minutes earlier, on the balance of probabilities, this would have prevented her arrest in A&E. However, the Trust denied that her death would have been avoided had the delay not occurred.
Following service of proceedings, settlement discussions commenced and the case was settled.