Two doctors saw Wigan toddler in days before she died with infection, inquest told
A nurse told an inquest jury of the “chaos” in Wigan Infirmary’s children’s A&E on the night a tragic tot was taken there by her worried parents.
Hailey Thompson was just 22 months old when she died on December 19, 2022 – 24 hours after being sent home from the hospital with a viral infection.
After her death, it was found she had bacterial infection group A streptococcus.
On the second day of an inquest at Bolton Coroner’s Court, paediatric nurse Sharon Taylor spoke about the situation in the department during the night shift from December 17 to 18, 2022, which she described as the “busiest shift I had ever worked on the department”.
She said there were usually four nurses on duty, but there were just two that night, with help from a nurse who was not qualified in paediatric care. A support carer was there for a short time but then left.
There were at least 20 patients continuously in the department, including three very poorly babies, and a four to six-hour wait to be seen by a doctor, she said.
An alert from NHS England about an outbreak of strep A infection had led many worried parents to go to the hospital for antibiotics.
She said: “At the time it was highly televised that there was a strep A bacteria that sits in the throat, but it was actually invading the blood in some children and it had caused a few deaths. I think there had been two or three deaths. Any sign of a cough or sore throat, people were attending the department, and I’m not exaggerating when I say it was chaos.”
Hailey, who lived in Ashton, was taken to the hospital by her parents Kristopher Thompson and Ibolya Adam as they were concerned about her breathing.
Ms Taylor triaged Hailey and found she had a low grade fever with a temperature of 37.9 degrees Celsius, but did not need to do extra work while breathing and her heart rate was normal.
She gave her a score of zero using the National Paediatric Early Warning System (PEWS), which meant there were no immediate concerns requiring her to be prioritised over other patients, and found no issues during sepsis screening.
Hailey was given ibuprofen to reduce her temperature and Ms Taylor told her parents about the wait to see a doctor.
She fondly recalled seeing Hailey throughout the night, remembering her as she wore pink sunglasses.
Registrar Dr Gabriel Obeye spoke to Hailey’s parents and examined her, initially as she slept and then after she awoke.
He said she “seemed quite comfortable” and did not appear to be breathing hard. He listened to her chest, but did not hear anything.
Dr Obeye wanted to examine Hailey’s throat, as he needed to find what was causing her fever, particularly during the strep A outbreak, but he struggled to do so.
He told the court he went to get a stick, known as a tongue depressor, and used this to try to examine her.
It caused her to gag, but he said he saw her tonsils and the back of her throat and established there were no signs of tonsillitis.
Dr Obeye asked for an updated PEWS score and was told it was still zero.
But the court heard it was not possible to confirm whether observations used for PEWS had actually been repeated, as only a reduction in temperature was documented.
He diagnosed a viral upper respiratory tract infection, provided safety netting advice in case her condition worsened and discharged her.
Hailey went home with her family, but she was taken back to the A&E department by ambulance at 5.50am on December 19, after her mum found her cold in her cot. Sadly, she could not be saved.
The inquest earlier heard Hailey had been seen by an advanced nurse practitioner at Ashton Medical Centre on December 7. She had a cough and fever and Miss Adam was worried about strep A.
She was found to have a raised temperature and enlarged tonsils with marks on them, so was diagnosed with tonsillitis and prescribed a 10-day course of antibiotics.
But she developed a rash and Miss Adam contacted the medical centre to say Hailey had stopped taking the medication after three days due to the adverse reaction.
The court heard a request for alternative medication was passed to pharmacist Jayne Brady, but she said she was not qualified in prescribing for children and sent the request back.
Hailey was seen by locum GP Dr Oluwaseyi Agboola on December 16, who said she looked well and did not appear to be in distress.
She had a low grade fever with a temperature of 38.2 degrees Celsius, her chest was clear with no signs of respiratory distress, she did not have a rash and there were no signs of infection in her tonsils.
She diagnosed a viral upper respiratory tract infection, advised the use of paracetamol and ibuprofen, and gave safety netting advice.
Another GP at the surgery, Dr Joseph Laws, told the court Dr Agboola documented the consultation “really well” and he “would have done the same thing” in that situation.
He spoke about two scoring systems used to diagnose bacterial and viral infections and explained how antibiotics are not used to treat viral infections.
Dr Laws also told the coroner how the admin team at Ashton Medical Centre listen for key words when taking phone calls from patients and are “clued up” on recognising symptoms of life-threatening conditions.
They allocated tasks to clinicians in the surgery, but he said there was no reason behind who was allocated what.
The inquest continues on Wednesday.