Boy, three, who died after developing sepsis may not have suffered fatal cardiac arrest when he did if he was readmitted earlier, inquest told

Daily Mail​

13 hours ago

A toddler who died after developing sepsis may not have suffered his fatal cardiac arrest when he did if he was readmitted to hospital earlier, an inquest has been told.
Theo Tuikubulau, three, had been gradually getting sicker with a high temperature, flu-like symptoms and breathing difficulties and was struggling to eat or drink in the lead up to his tragic death.
His mother Kayleigh Kenneford called 111 shortly before 11pm on July 7, 2022 and the operator graded the case as a category two - the second most urgent level of call.
He had already been admitted and discharged from Plymouth's Derriford Hospital the previous day with a suspected upper respiratory infection.
An ambulance arrived at their home near Plymouth shortly before 12.30am and Theo reached the hospital just after 1am.
He was treated in the emergency department's resuscitation area and suffered the cardiac arrest at 1.35am before dying a short time later, Devon Coroner's Court heard.
And Professor Damian Roland, a paediatric consultant in emergency medicine, told the inquest that Theo likely would not have died when he did had he been rushed back to hospital at 11pm that night.
Giving evidence as an expert witness on the hospital care Theo received, Prof Roland was asked by coroner Louise Wiltshire: 'Is it likely on balance of probabilities that Theo would have died when he did if appropriate care and treatment was administered at 11pm?'
He Roland replied: 'I think had he arrived earlier, I think it is possible that he would not have suffered the cardiac arrest at that point.'
Ms Wiltshire said: 'That's the key consideration for an inquest, whether somebody would have died when they did if a different treatment was given.
'On balance of probabilities, if Theo had arrived in hospital at 11pm would he have died when he did?'
Prof Roland replied: 'No.'
He was asked about what could have happened had Theo been readmitted by midnight if the 111 call had been graded as a category one emergency.
'I think some earlier treatment would have especially delayed the collapse,' Prof Roland said.
The witness did not agree with the notion that an earlier intervention would have prevented the toddler's death altogether.
'Even if antibiotics had been given at that stage, I think the cascade may have already started and it would have been very difficult to change the outcome,' he added.
'I can't say on the balance of probability that intervention by 11pm would have made a critical difference.
'If you give me six or 12 hours, I think I would say on the balance of probability, yes, something could have been done.
'I can't say on the balance of probabilities that in that time period we could have made a huge difference.'
Prof Roland said from the evidence it was difficult to be certain of Theo's condition at the time his mother spoke with the nurse, but there was evidence at the time of the 111 call.
Reiterating this, the witness said the toddler's original discharge from the hospital in the early hours of July 7 was not 'unreasonable'.
Ms Kenneford was sent home with details of a phone number she should ring if she was concerned about Theo over the next 72 hours.
She called that number at around 10pm on July 7 and spoke with a nurse but previously told the court she felt 'fobbed off'.
Asked about this call, Prof Roland said: 'I think if you've got a constellation of things which are not improving, I think a standard would have been to review in that particular situation.'
An hour later, Theo's mother phoned 111, and the witness said that having listened to that call he could hear Theo's breathing in the background and described it as 'grunting' which was a 'red flag'.
Prof Roland described sepsis as an 'inappropriate response' to an infection, and it was critical the patient received life-saving treatment immediately.
'Once that inflammatory cascade has started, it can be difficult, sometimes impossible to stop,' he said.
'I am very clear about the fact that the night before (July 6), we were not in a cascade situation.
'I don't think that there was sepsis then. Knowing when the intervention could have been made is very difficult.'
Theo died from sepsis caused by an 'invasive' Strep A infection.
The inquest before a jury at County Hall in Exeter continues.