Family receive apology and compensation
Northwick Park Hospital in north-west London has apologised for shortcomings in treatment and provided compensation to a bereaved family following the death of their son from sepsis.
Posted on 04 June 2020
The London North West University Healthcare NHS Trust, which manages the hospital, finally admitted liability for the young boy’s death years after an inquest had identified multiple missed opportunities in his case. The coroner who carried out the inquest also raised important concerns that the boy’s parents were not listened to and advised that parental concerns should not be dismissed without adequate investigation.
The Trust admitted liability only after further expert evidence was produced by law firm Leigh Day, who were instructed on behalf of the family, which confirmed that earlier treatment could have saved his life.
The young boy, whom we will call P, became unwell one evening with a high fever. He was taken by his parents to Northwick Park Hospital, where he was diagnosed with a throat infection and prescribed antibiotics.
Unfortunately, P continued to feel unwell and, after a few days, he had worsened to the point of vomiting, with whole body aches, swollen eyes, and tachycardia (a high pulse rate). His parents took him back to Northwick Park Hospital, where he was diagnosed with mesenteric adenitis, a generally mild condition which usually clears without requiring treatment, and a continuing throat infection.
Despite the diagnosis, P was admitted into the hospital, where he continued to be unwell, with cold hands and feet, profuse sweating, and a refusal to drink fluids.
Later that night, P was complaining of pains all over his body and his mother, who had stayed by his side, continued to worry about his continued pain and cold sweats and he was eventually given an extra blanket.
The next morning, the nursing staff found that P had deteriorated further and was drowsy, with a high heart rate, low blood pressure, low temperature, and acidic blood gases. A consultant paediatrician was called due to concerns over potential sepsis. Urgent treatment was given, rousing P for a time, and a plan was made to transfer P to the intensive care unit.
Only at this point was it realised that P was likely suffering from septic shock and needed to be transferred to Great Ormond Street Hospital for specialist paediatric intensive care.
P was taken to theatre to be intubated in preparation for the transfer but tragically a few minutes after he was intubated he suffered a cardiac arrest and died.
A post-mortem was carried about which detected Influenza A in the nose and lungs.
The coroner was informed and commissioned an independent report from a paediatric intensive care expert, who found that there were multiple missed opportunities to identify the severity of P’s condition and initiate aggressive, targeted treatment. Unfortunately, by the time the severity of P’s condition was recognised, he was in an extremely vulnerable state and unable to tolerate intubation.
The coroner issued a Regulation 28 Report to Prevent Future Deaths to the Department of Health, highlighting concerns that the Paediatric Early Warning Scores (PEWS), used in P’s care, “do not reflect the current research into child illness” and “may tend to act to distract the doctors away from the fact that despite a low PEWS score a child might be seriously ill.”
Despite the coroner’s comments, the Trust initially denied liability for P’s death, claiming that nothing could reasonably have been done to save his life, even if the severity of his condition had been appreciated earlier. The medical negligence team at Leigh Day carried out further investigations on behalf of the family, and additional expert evidence was produced to demonstrate that, on balance, P’s life could have been saved with an earlier recognition that he was triggering for sepsis and the instigation of appropriate treatment.
After a number of years, the Trust finally admitted liability for P’s death, apologising to his parents for the mistakes that were made, and a settlement for the family was reached.
Sarah Campbell, medical negligence solicitor from law firm Leigh Day, said:
“Sadly, we hear all too often that parents are not being listened to. This is a death which probably would not have occurred had the medical staff looking after P overnight only listened to his mother’s concerns and used their clinical judgment instead of relying on the tick box exercise of filling in the PEWS chart and assuming that because his scores were low he wasn’t in any danger.”
Michael Roberts, solicitor who assisted Sarah with this case, said:
“I sincerely hope the shortcomings identified by the legal process have led to changes which will ensure that nobody in future will have to go through what P and his family have suffered.”
Leigh Day worked on the case with barrister Katie Gollop QC of Serjeants Inn Chambers.
Sarah Campbell practises exclusively in the area of claimant clinical negligence work.
Michael Roberts is a senior associate solicitor in the medical negligence department.