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The Independent
06-02-2025
- Health
- The Independent
Doctor describes delay in giving sick baby antibiotics, inquest hears
Antibiotics prescribed for a premature baby suffering with a respiratory illness were not given until after he suffered the first of two cardiac arrests, an inquest heard. Ben Condon, who was two months old, died at Bristol Children's Hospital in April 2015. He was being treated in the paediatric intensive care unit for acute respiratory distress syndrome (ARDS) and metapneumovirus (hMPV) – similar to the common cold in adults. Avon Coroner's Court heard that on April 17 Ben's condition deteriorated and he suffered two cardiac arrests before dying. It later emerged that before his death, Ben had also developed a pseudomonas bacterial infection. The University Hospitals Bristol and Weston NHS Foundation Trust, which runs the children's hospital, later admitted their failure to give Ben timely antibiotics contributed to his death. Dr Jessica Spaull, who was a junior doctor on the unit, said she had been concerned about Ben that morning and had discussed this with his parents, Allyn and Jenny Condon. She told the inquest she had a conversation with a consultant after the mid-morning ward round to give Ben antibiotics. 'I cannot recall any details of what I said but I recall the conclusion was that it would be reasonable to start Ben on antibiotics,' she said. 'I recall I was in the process of doing that (writing up the prescription) when another of my allocated patients… when their endocrinal tube was accidentally removed. 'I recall I went over to that bed in an emergency, and I recall that I was involved reintubating that patient. 'That meant I had not completed that prescription at that point.' The inquest has heard that Ben, from Weston-super-Mare, North Somerset, suffered the first of two cardiac arrests that afternoon and died later that evening. Dr Spaull told the hearing that later that day while completing a handover with the medical staff working the evening shift, she realised the antibiotics had not been administered. 'I recall looking at the drug chart and realising that the antibiotic prescribed earlier hadn't been given,' she said. 'I mentioned this to one of the bedside nurses who had attempted help with the resuscitation. 'I recall mentioning to one of the other junior doctors.' Jennifer MacLeod, representing the Condon family, asked Dr Spaull whether there was a 'general consensus' among doctors that Ben's respiratory illness was caused by a virus, rather than a bacterial infection. Dr Spaull replied: 'I think this is a really tricky question to answer for me just because, as a junior doctor on paediatric intensive care unit then, I still don't have the expertise to have formulated ideas about ARDS causality because of my lack of experience in that area.' Ms MacLeod asked whether there was a 'level of complacency' about how poorly Ben was. Dr Spaull said this question was hard for her to answer as at the time she was a junior doctor only five weeks into her first placement on a paediatric intensive care unit. 'For me, I had heard Ben's parents were worried, and I was worried about Ben's oxygenation in particular that morning,' she said. 'I think I would have judged how worried to be based on the experienced team's assessment. 'I do not think I can comment on the specific question.' She added: 'I think that while I was not experienced in ARDS, I was able to make an assessment of a patient in intensive care as that was what I had been doing for the past five weeks, but also on a neo-natal intensive care unit prior to that. 'I recall having dialogue about my patients that I was concerned was. 'I think I would have made an assessment, which would have been appropriate for a junior doctor on the unit to make, and I think I would have discussed that assessment with a consultant in an open dialogue because they were present. 'In terms of specifics I can't recall those conversations.' The inquest continues.
Yahoo
06-02-2025
- Health
- Yahoo
Doctor describes delay in giving sick baby antibiotics, inquest hears
Antibiotics prescribed for a premature baby suffering with a respiratory illness were not given until after he suffered the first of two cardiac arrests, an inquest heard. Ben Condon, who was two months old, died at Bristol Children's Hospital in April 2015. He was being treated in the paediatric intensive care unit for acute respiratory distress syndrome (ARDS) and metapneumovirus (hMPV) – similar to the common cold in adults. Avon Coroner's Court heard that on April 17 Ben's condition deteriorated and he suffered two cardiac arrests before dying. It later emerged that before his death, Ben had also developed a pseudomonas bacterial infection. The University Hospitals Bristol and Weston NHS Foundation Trust, which runs the children's hospital, later admitted their failure to give Ben timely antibiotics contributed to his death. Dr Jessica Spaull, who was a junior doctor on the unit, said she had been concerned about Ben that morning and had discussed this with his parents, Allyn and Jenny Condon. She told the inquest she had a conversation with a consultant after the mid-morning ward round to give Ben antibiotics. 'I cannot recall any details of what I said but I recall the conclusion was that it would be reasonable to start Ben on antibiotics,' she said. 'I recall I was in the process of doing that (writing up the prescription) when another of my allocated patients… when their endocrinal tube was accidentally removed. 'I recall I went over to that bed in an emergency, and I recall that I was involved reintubating that patient. 'That meant I had not completed that prescription at that point.' The inquest has heard that Ben, from Weston-super-Mare, North Somerset, suffered the first of two cardiac arrests that afternoon and died later that evening. Dr Spaull told the hearing that later that day while completing a handover with the medical staff working the evening shift, she realised the antibiotics had not been administered. 'I recall looking at the drug chart and realising that the antibiotic prescribed earlier hadn't been given,' she said. 'I mentioned this to one of the bedside nurses who had attempted help with the resuscitation. 'I recall mentioning to one of the other junior doctors.' Jennifer MacLeod, representing the Condon family, asked Dr Spaull whether there was a 'general consensus' among doctors that Ben's respiratory illness was caused by a virus, rather than a bacterial infection. Dr Spaull replied: 'I think this is a really tricky question to answer for me just because, as a junior doctor on paediatric intensive care unit then, I still don't have the expertise to have formulated ideas about ARDS causality because of my lack of experience in that area.' Ms MacLeod asked whether there was a 'level of complacency' about how poorly Ben was. Dr Spaull said this question was hard for her to answer as at the time she was a junior doctor only five weeks into her first placement on a paediatric intensive care unit. 'For me, I had heard Ben's parents were worried, and I was worried about Ben's oxygenation in particular that morning,' she said. 'I think I would have judged how worried to be based on the experienced team's assessment. 'I do not think I can comment on the specific question.' She added: 'I think that while I was not experienced in ARDS, I was able to make an assessment of a patient in intensive care as that was what I had been doing for the past five weeks, but also on a neo-natal intensive care unit prior to that. 'I recall having dialogue about my patients that I was concerned was. 'I think I would have made an assessment, which would have been appropriate for a junior doctor on the unit to make, and I think I would have discussed that assessment with a consultant in an open dialogue because they were present. 'In terms of specifics I can't recall those conversations.' The inquest continues.
The Independent
05-02-2025
- Health
- The Independent
Doctor defends decision not to give antibiotics to baby before death
A doctor treating a premature baby has defended the decision not to administer him with antibiotics the day before he died, an inquest heard. Ben Condon, who was two months old, died at Bristol Children's Hospital in April 2015 after developing a respiratory illness. Dr Suzy Dean was treating Ben at the hospital's paediatric intensive care unit for acute respiratory distress syndrome (ARDS) and metapneumovirus (hMPV) – similar to the common cold in adults. She said that although Ben was being ventilated and was unwell, his condition was stable. Avon Coroner's Court heard that the following day, April 17, Ben's condition deteriorated, and he suffered two cardiac arrests before passing away. It later emerged that before his death Ben had also developed a pseudomonas bacterial infection. The University Hospitals Bristol and Weston NHS Foundation Trust, which runs the children's hospital, admitted their failure to give Ben timely antibiotics contributed to his death. Dr Dean told the inquest that doctors always recognised there was a risk of a baby developing a bacterial infection, but Ben's presentation on April 16 was stable. Assistant Coroner Robert Sowersby asked whether there was a 'missed opportunity' not to test Ben's blood for a bacterial infection on any day between April 12 and 16. 'I find that difficult because looking back on what we know now, I know there was an infection which was unexpected, but I don't believe he showed signs of an infection on April 16,' Dr Dean replied. 'I think it would have been nice to have an extra set of bloods to reassure me. 'I am not saying Ben is fine, because he has gone ARDS, he has got significant ventilation requirements, and he is very much in an ICU setting. 'But there wasn't a paradigm shift in how he was presenting.' Dr Dean explained that Ben's body temperature was fluctuating, but that alone was not an indicator of an infection. 'To be honest. it didn't particularly concern me, rightly or wrongly, and I appreciate the family have a strong view on that,' she told the hearing. 'It is one factor in his care. That in itself doesn't tell me that he is developing an infection.' Dr Dean was quizzed on other signs of infection in a baby, such as rising C-reactive protein levels in the blood and the 'end of bed' observations. Ben's father, Allyn Condon, a former Olympic athlete, has told the inquest that his son was visibly deteriorating in front of him between April 14 and 16. Jennifer MacLeod, representing the Condon family, asked Dr Dean: 'That's another indication that his infection is getting worse?' The witness replied: 'Yes it would be, but the difficulty is that I didn't share that view that he was changing that significantly from the end of the bed. 'We had fluctuations in the amount of fluid he was carrying, and you can see slightly puffy eyes and there were a few periods where the diuretics were increased just to try and manage that. 'It's what's expected and not expected in terms of his colour, how he handles and responds to being touched and moved. 'How does to look to me? Is he warm? Is he cold? That's the sort of subtlety you only get by touching and that is difficult to get across in the notes. 'I didn't feel he was changing.' Ms MacLeod suggested Ben was getting worse the day before he died because of a bacterial infection. 'I don't agree with that. There are other markers that we have not talked about as well,' Dr Dean said. 'Two other consultants examined him on the afternoon of April 16 and neither of them felt anything else needed to be changed, it's not just my view on that day. 'He didn't look unwell from the end of the bed, and I appreciate his family feel otherwise. That was just my view at the time. 'The thing about paediatric intensive care is that Ben was actually quite a stable patient in that he wasn't doing anything that I didn't expect. 'Yes, we he had ARDS, and yes, his ventilation was getting worse, not better. But he was stable around that. 'Someone of Ben's age is not going to look stable if they have got sepsis, it just doesn't look like that. 'Regardless of what I saw and thought, I did have two other colleagues look at him that day. Three of us were not concerned that we needed to escalate his treatment.' Dr Dean told the court she had reflected on whether the antibiotics should have been administered sooner. 'I know what I did on that day is different to what some of the experts have suggested, for example,' she said. 'But I think, and I know I keep saying that every child is at risk of secondary infection, but if we treated every child that had a change of x-ray and the changes we saw in Ben with antibiotics, then we would be treating with antibiotics all the time and that's just not the right thing to do. 'We have rely on what we are seeing and if things change, reassess. 'You cannot put someone on antibiotics because there is a risk of it, because every child is at risk of it.' The inquest continues.
