Death of toddlers on same day at hospital was not foreseeable, inquiry told

An fatal accident inquiry into the deaths of two toddlers at the Royal Hospital for Children (RHC) in Glasgow heard independent reports found neither death could have been predicted, an inquiry has heard.

Cailyn Newman died a month before she would have turned two on December 6 2016.

Her death, in the emergency department at 8.42pm, happened less than eight hours after 22-month-old Sonny Campbell died.

Both toddlers had been previously admitted to the hospital before being discharged, the fatal accident inquiry at Glasgow Sheriff Court was told.

Sonny, who was a twin and lived in Carntyne, in Glasgow’s east end, had been admitted to hospital on December 5, after a GP at Lightburn Medical Centre told his mother, Amy Reilly, to take him to the hospital, following a four-day bout of vomiting.

The GP had first seen Sonny on December 2 and warned Ms Reilly to expect that his twin would likely be infected, noted the child was “pale and irritable” and suspected he had gastritis and respiratory tract infection (RTI).

Ms Reilly and her mother, Isobel Reilly, took Sonny to the RHC, where he was admitted at about 5.38pm and triaged as Category 4 by paediatrician Dr Aoife Ryan, but was not seen by a more senior consultant before being discharged, according to joint minutes read to the inquiry by advocate depute Isabella Ennis KC.

However, the following day, Sonny’s mother returned from running errands while his grandmother cared for him, around 11.20am, and noticed he was “pale and yellow” and “taking short intakes of breath”, and Isobel Reilly began giving him CPR, the court heard.

An ambulance arrived at about 11.53am and the family arrived at the RHC by 12.15pm, however, paramedics described Sonny’s condition as “unresponsive” with “poor respiratory effort” while in the ambulance his heart rate dropped to 39 beats per minute despite chest compressions and an oxygen mask.

He was taken to the resuscitation unit but was described as having “blue lips” and was intubated but no pulse could be found and 38 minutes after, he was pronounced dead with his parents present.

A post-mortem examination found bronchial pneumonia and streptococcus G, and gave the cause of death as acute haemorrhagic leukoencephalitis – described as “very rare and usually fatal”, the court heard.

A significant clinical incident review “found no fault in the care provided to Sonny”, and a separate review deemed that Cailyn’s death could “was not foreseeable or easily preventable”, the court heard.

Giving evidence, Isobel Reilly said: “I felt they just wanted us to go as it was so busy. I said, ‘what if he’s like that tomorrow’ and she said, ‘bring him in’.”

Under cross-examination from the family’s lawyer, Mark Allison, Isobel Reilly told the court that on December 5, she and her daughter “emphasised” the colour of his skin due to concerns about his liver and kidneys, but were told it was probably “sallow” skin tone.

Isobel Reilly alleged that Dr Ryan said, “I’ll ask the boss” around three times, adding: “She said the boss said if he hadn’t been sick, then we could leave.”

However, she said her grandson was sick in reception, and the family helped to clean up before taking Sonny home.

She alleged they were not given advice about what to do if symptoms worsened; if Sonny continued to vomit; or if he did not wet his nappy as often as usual, however, Dr Ryan insisted that she would have “volunteered worsening advice to any family”, the court heard.

During cross-examination by Helen Watts KC, representing NHS Greater Glasgow and Clyde (NHS GGC), Dr Ryan denied using the phrase, “I’ll ask the boss” and said she would “volunteer worsening advice”, and apologised for a “perception of advice” about returning the next day.

Ms Ennis said: “Is there anything on reflection that you wish to change or correct?”

Dr Ryan said: “No, I don’t think so.”

She apologised for the family for Sonny’s “tragic and untimely death”.

The court heard agreed evidence that Cailyn, who lived in Renfrew, was taken to hospital on December 2 regarding cold-like symptoms and her mother, Dawn Anderson, reported she had been “sleepy and lethargic”, and she was admitted on a total of four occasions.

A GP called an ambulance to take the child to the Royal Alexandra Hospital in Paisley, however, paramedics diverted to the RHC where Cailyn arrived at 6.04pm, and was noted as being “bright and active”, the court heard.

The toddler was suspected to have an upper RTI infection and her parents were described as being “anxious” but Cailyn was discharged at 7.30pm.

In the next few days, her condition did not change, and on December 5 Cailyn was taken back to RHC by her parents and discharged, however, in the car she was sick, described as “dark green” vomit, and the family returned and were put in triage 5 before being discharged, the court heard.

On December 6, Cailyn’s parents brought her back to RHC at about 6.34pm as she had vomited and developed a rash, and was assessed as being Category 1.

Her recent history – including being readmitted twice on December 5 and again on December 2 – was shared with medics, and the child was described as “pale and placid” with “mottled skin on her legs and arms” and suffering “cardiovascular deterioration”, the court heard.

Cailyn was given resuscitation for 40 minutes but she died at 8.42pm.

Cause of death was given as Streptococcus pneumonia and severe necrotising bronchial pneumonia.

The hearing continues in front of Sheriff Cameron.