Latest news with #PippaMaeWhite
The Guardian
28-05-2025
- General
- The Guardian
Pippa White's death in NSW hospital was preventable and ‘system failed her', medical experts tell inquest
The septic shock death of a two-year-old girl in a regional New South Wales hospital was preventable, senior medical experts told an inquest. Pippa Mae White died on 13 June 2022, two months before her third birthday, after doctors at the hospitals in Cowra and Orange wrongly assumed she had an acute viral illness rather than the serious bacterial infection that killed her. Giving evidence on Wednesday at the coronial inquest into her death, a 'conclave of experts' who weren't involved in Pippa's treatment said she should have been checked and treated for potential sepsis much earlier than she was. The NSW deputy state coroner Joan Baptie is examining whether Pippa's death was preventable and whether she received appropriate care in Cowra and Orange, and from the Newborn and Paediatric Emergency Transport Service team. The inquest previously heard that Pippa presented to Cowra hospital about 2pm on 12 June 2022 with a fever, vomiting, and a heart rate of 171 beats per minute, considered in the 'red zone' for sepsis. She did not have a blood test until nearly 4am on 13 June, after she was transferred to Orange, which revealed she had a serious infection. She was administered antibiotics and given a chest X-ray, which showed she had pneumonia that had caused a 'complete whiteout' of her left lung. She suffered two cardiac arrests and died just after 1pm. Five of the seven medical experts who submitted a joint report to the inquest gave oral evidence on Wednesday: Prof Simon Craig, Prof John Raftos, Prof Warwick Butt, Prof Adam Irwin and Associate Prof Phillip Braslins, along with GP Robert Morton. While there was some disagreement on when the paediatric sepsis pathway should have been activated for Pippa, all the doctors agreed investigations into possible sepsis – including blood tests – should have been started much sooner than they were. The experts agreed medical staff became 'anchored' on the wrong diagnosis of a viral illness. They stressed the importance making 'serial observations' of vital signs heart rate and oxygen saturation more frequently than was done in Pippa's case. The inquest was previously shown a video of Pippa in the Cowra emergency department making a 'grunting' noise while breathing, which the doctors on Wednesday said would have been identifiable with a stethoscope. Raftos said Pippa was already a 'very sick' and 'lethargic' child when she was taken to Cowra and she needed a rapid response. He said if medical staff in Cowra didn't have the capacity to treat Pippa right away, as the inquest previously heard, they should have arranged for an ambulance to take her to Orange, or for her mother, Annah, to drive her there. Raftos said the alternative was 'doing nothing, which is what they did'. Craig said the 'make or break' point when 'things went absolutely wrong' was at 1am on 13 June when there were 'delays in escalation' at Orange hospital despite Pippa having become 'critically ill'. The junior doctor in charge of looking after Pippa in Orange, Dr Christopher Morris, last year cried in the witness box as he gave evidence to the inquest and said he wished he had called a rapid response earlier in the night. The experts on Wednesday said the senior paediatrician on-call the night Pippa was admitted, Prof Adam Buckmaster, should have assessed her that evening. The inquest previously heard he didn't attend the hospital until the morning of 13 June. Most of the experts agreed Pippa should have had her blood tested and been administered antibiotics around 9pm on 12 June after arriving at the hospital. 'She should have been on the [sepsis pathway], she should have had an IV [intravenous drip] inserted, she should have had bloods done, and she should have had antibiotics given. I think it's very clear,' Butt said. 'I believe the death was preventable, and that means the system failed her,' Butt said. The inquest continues, with a final block of hearings expected later this year.
ABC News
27-05-2025
- Health
- ABC News
Health district tells inquest of protocol lapses after sepsis death of toddler Pippa Mae White
A western NSW health executive has told an inquest that his hospitals are still not consulting a sepsis diagnostic guide enough after a toddler died of the condition almost three years ago. Two-year-old Pippa Mae White died from the disease, and pneumonia, at Orange Hospital in central west NSW in June 2022. She initially presented at Cowra Hospital before being transferred later that night to the health facility in Orange. The inquest into her death previously heard her high heart rate alone at both facilities was considered in the "red zone" for a child likely infected with sepsis and required a rapid response, according to a NSW Health policy document. A rapid response triggers senior doctors to quickly attend and assess a patient, which was not activated at either hospital. The nurse at Cowra said she was aware of the paediatric sepsis pathway document but did not use it, while the nurse at Orange said she had never seen it. Executive director of quality, clinical safety and nursing at the Western NSW Local Health District (WNSWLHD), Adrian Fahy, gave evidence at the inquest on Tuesday. He said he was "concerned" the document was not used in Pippa White's care. "It's indeed quite remarkable," he told the inquest. "Sepsis training has been quite prevalent across NSW Health for a number of years." He said the WNSWLHD made optional training on detecting the condition mandatory since the young girl's death and has so far delivered 75 virtual sessions on the topic. The inquest heard hospitals across the district audited how often the sepsis pathway document was used in the care of patients who were diagnosed with the condition. Mr Fahy said despite an increasing trend, the hospitals were not using it in all cases. "What I think needs to happen is there needs to be a much stronger emphasis. "[And] where needed, having some difficult conversations around 'why wasn't a pathway included?'" Mr Fahy also gave evidence that the district made several changes to improve care since Pippa White died. He said an alert tool was being developed which would send a prompt to clinicians if the vital signs they are logging on the electronic medical record could indicate sepsis. The concern of a parent or carer will also be included in the new paediatric observation chart due to be released next month. "A specific question will be asked around 'do you feel your child is improving or deteriorating?'" Mr Fahy told the inquest. If it was the latter it would trigger an additional "yellow zone" criteria which could result in a clinical review within 30 minutes. The inquest heard Pippa White's mother, Annah White, attempted to activate the REACH initiative (recognise, engage, act, call, help) during her daughter's care without success. The system allowed family members or parents to escalate their concerns with hospital staff about the patient's condition, and prompt a review, which should occur within half an hour. Mr Fahy said the WNSWLHD had tried to make the initiative more obvious, such as clearly including it in local emergency response procedures. Hospitals had also put up posters about the initiative with a phone number and a QR code with a video that explained the process. The inquest continues on Wednesday.
The Guardian
27-05-2025
- Health
- The Guardian
Pippa White ‘probably' died of uncommon bacterial infection, inquest hears
A senior official who oversees the emergency transport of critically ill children in New South Wales believes two-year-old Pippa Mae White's septic shock death was the result of an 'absolutely devastating' bacterial infection, an inquest has heard. Kathryn Browning Carmo, an associate professor in neonatology and acting director of the Newborn and Paediatric Emergency Transport Service team (Nets), on Tuesday told an inquest into Pippa's death the young girl likely had Group A Strep. Pippa died on 13 June 2022, two months before her third birthday, after doctors and nurses at the hospitals in Cowra and Orange assumed she had an acute viral illness. The deputy state coroner, Joan Baptie, is examining whether her death was preventable and whether she received appropriate medical care. Sign up for Guardian Australia's breaking news email Giving evidence at the inquest, Browning Carmo said that from late 2022 until early 2024, there was an increase in cases of invasive group A streptococcus (iGAS). During that period, 77 cases were referred to Nets and four of these children died, she said. Browning Carmo said although Pippa's blood was not tested for the disease, she thought the girl 'probably' had it. The cases and the fatalities recorded by Nets were documented in a paper published last week in the Journal of Paediatrics and Child Health, which said 40% of the patients displayed clinical signs of septic shock. Only five cases of iGAS had been detected in the five years before late 2022, Browning Carmo told the inquest. Browning Carmo said iGAS was an 'absolutely devastating illness' that was much more aggressive than other bacterial infections of this nature and which resulted in 'catastrophic' cases of sepsis, a potential fatal inflammatory response to an infection. The inquest previously heard that Pippa was presented to Cowra hospital about 2pm on 12 June 2022 with a fever, vomiting, and a heart rate of 171 beats per minute, considered in the 'red zone' for sepsis. She did not have a blood test until nearly 4am on 13 June, after she was transferred to Orange hospital, which revealed she had a serious infection. She was administered antibiotics and given a chest X-ray, which showed she had pneumonia that had caused a 'complete whiteout' of her left lung. Browning Carmo on Tuesday told the inquest she had seen cases of children with iGAS who appeared to be 'very comfortable' only to have their lungs very quickly fill with fluid. 'They could have no pleural effusion to complete whiteout within hours,' she said. 'It was an absolutely devastating illness.' Sign up to Breaking News Australia Get the most important news as it breaks after newsletter promotion The inquest previously heard doctors at Orange called the Nets team just after 6.10am to take Pippa to Westmead children's hospital. A plan was made at 8.30am to put Pippa in an induced coma and intubate her before her chest was drained. But this didn't occur immediately because the operating theatre was busy, the inquest heard. Because of shift changes and weather, the Nets team didn't arrive until 10.10am. Pippa never left Orange – she suffered two cardiac arrests and died just after 1pm. Her parents, Annah and Brock, are pushing for reforms to the way possible paediatric sepsis cases are treated and to empower families of sick children to escalate their concerns. The paediatric nurse in charge of Pippa's care in Orange, Roslyn Sadler, on Tuesday told the inquest she could recall Annah telling her she had asked for her daughter's blood to be tested when she was in the hospital's emergency department. The executive director of nursing at the Western NSW local health district, Associate Prof Adrian Fahy, told the inquest it was 'quite remarkable' hospital staff didn't investigate the possibility of sepsis. 'Sepsis training had been really quite prevalent across NSW health for a number of years,' he said. 'I was concerned to see sepsis hadn't been considered and the sepsis pathway hadn't been referred to.' The inquest continues.
News.com.au
26-05-2025
- Health
- News.com.au
Parents of two-year-old Pippa White speak as inquest examines her death in NSW hospital
The parents of two-year-old Pippa Mae White, who died of sepsis and pneumonia in Orange Hospital three years ago, have spoken of their ongoing heartache as an inquest examines the circumstances surrounding her death. Describing her grief as a life sentence without parole, Pippa's mother Annah White said she feels Pippa's loss in every moment. 'In everything I do, all I see is an outline of where you should be,' she said on Monday. Her father Brock, who is no stranger to tragedy after losing both his parents as a child, said he is 'broken' and 'walks around in a shell of my former self'. Many members of Pippa's family attended the inquest at Lidcombe Coroners Court on Monday wearing her favourite colour, yellow. Her grandmother Marianne Stonestreet said, 'I will always love her with every beat of my broken heart.' Pippa, who was just weeks away from her third birthday, presented to Cowra Hospital in NSW's central west with vomiting, diarrhoea and a high heart rate on the afternoon of 13 June, 2022. She died the next day after being transferred to Orange Hospital and the NSW deputy state coroner is examining whether her death was preventable. At triage, Pippa's heart rate was recorded as 171 beats per minute which is classified in the 'red zone' for potential sepsis and requires a rapid response, according to the NSW Health pediatric sepsis pathway document. The inquest heard that at the time Pippa arrived at hospital, all the emergency department's beds were full and an 8-year-old child who was being resuscitated in an ambulance was about to arrive. There had also been an incident involving another patient and police, and patients were being told at triage to expect a lengthy wait. Ms White took Pippa home to wait but returned shortly afterwards when her condition deteriorated and Pippa was transferred by ambulance to Orange Base Hospital. It wasn't until 4am that Pippa was given a blood test which revealed a serious infection. A chest X-ray then showed she had pneumonia. She was administered antibiotics but died later that day of sepsis and pneumonia. Pippa's parents are now calling for statewide reform to see family members given greater power to raise concerns with hospital staff. Ms White told media gathered outside the courtroom, 'I hope hearing about Pippa's last moments during this inquest lights a fire deep inside you to fight for change.'
ABC News
26-05-2025
- Health
- ABC News
Inquest continues into sepsis and pneumonia death of 2yo Pippa Mae White
An inquest has heard a nurse denied suggesting a sick child wait at home because the hospital was too busy, a day before the two-year-old died of sepsis. Pippa Mae White was vomiting and had diarrhoea when she was taken to the Cowra Hospital, in central west NSW, on the afternoon of June 12, 2022. The inquest into her death heard registered nurse Nikota Potter-Bancroft triaged the infant and recorded a heart rate of 171 beats per minute. That rate was in the 'red zone' for children at risk of having sepsis and required a rapid response, according to the NSW Health paediatric sepsis pathway document. Ms Potter-Bancroft told the inquest on Monday the emergency department's beds were full, and she was telling patients during triage to expect a lengthy wait for a doctor. But the inquest heard the child's mother, Annah White, said the nurse suggested they wait at home. Ms Potter-Bancroft said she would "never" tell a patient to do that. "Annah said to me along the lines that she wasn't very keen on waiting in the wait room," Ms Potter-Bancroft said. "[She said] Pippa was miserable and she'd be more comfortable at home. "I said to her, 'It's really up to you where you want to wait. If you won't be in the waiting room when we call for you, I'll take your number down to call you'." Ms Potter-Bancroft said the Cowra Hospital was also expecting a very unwell 8-year-old, who was receiving CPR as they were transported by ambulance. The inquest heard Ms White took her daughter home to wait before returning later that afternoon. They were transferred by ambulance to the Orange Hospital that night. Ms Potter-Bancroft said she did not believe Pippa met the criteria for the life-threatening condition sepsis, and with hindsight, maintained the same position. She said she believed the high heart rate was because the infant was anxious and upset. "There probably wasn't much I could do to confirm that [hypothesis]," she told the inquest. "But this is why I spoke to the doctor and wanted to have an intervention so we could see whether her heart rate improved." Pippa was given an anti-vomiting and nausea medication called ondansetron, which Ms Potter-Bancroft hoped would bring down her heart rate. She was aware of the paediatric sepsis protocol, but said she had not used it at Cowra Hospital. She told the inquest although she accepted it required a rapid response based on Pippa's high heart rate alone, she didn't consider her meeting the threshold. The inquest heard she noted in her triage document the child was "miserable and lethargic", but the nurse said she did not believe she was septic. "I've seen other kids that look visually toxic, they're floppy, they have to be carried," she said. "Pippa looked very tired... but she was still completely conscious and alert and able to interact, even if that was negatively." The inquest heard Pippa's condition deteriorated during the night at Orange Hospital. Former paediatric nurse Roslyn Sadler said when the child arrived on the ward, her breathing wasn't normal. Ms Sadler recorded Pippa's vital signs three times during the night, and recorded her heart rate at 196 beats per minute at 2:35am. She told the inquest she called the doctor about "half a dozen times" over concern for the child. Ms Sadler said in hindsight, she should have called a rapid response based on her condition. "I suppose we should have escalated sooner," she told the inquest. Pippa died later that day due to sepsis and pneumonia. Annah White told the inquest she believed the health system was responsible for her daughter's death, and hoped it would prompt reform. "What will it take for parents' concerns to be heard, and for procedures to be followed?" she told the inquest. "Pippa, I see the spaces where you should be in every single moment. Outside the court, Ms White said she wanted to see a policy change called Pip's Law which would give family members greater power to raise concerns with clinicians. "No parents' plea for help would ever be ignored again," Ms White said. She also wanted mandatory training in paediatric sepsis for all hospital staff, especially in rural and regional areas. The inquest continues on Tuesday.
