A NINE-year-old boy died from sepsis just days after being sent home from hospital with ibuprofen and a “flu advice” sheet, an inquest was told.
Dylan Cope, from Newport, was taken to the Grange Hospital in Cwmbran, Torfaen, with suspected appendicitis – but was diagnosed with influenza.
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He was seen by several medics, including an unknown clinican who “dismissed any concern with Dylan’s appendix”, Gwent Coroner’s Court in Newport heard.
Dylan was discharged on December 6 after blood tests showed he had swollen lymph glands and had tested positive for flu.
The youngster was given ibuprofen before he was discharged, and his worried parents, Corrine and Laurence Cope, were given a leaflet on “coughs and colds in children”.
But Dylan didn’t get better, and just days later, his condition deteriorated while the family waited two hours for an NHS 111 call back.
Mr Cope was waiting for a doctor’s call when Dylan started shouting, “My legs, my legs.”
“His legs had started to mottle – Corrine said it was either meningitis or sepsis,” he added.
Mr Cope drove him back to A&E at the Grange, and he was immediately transferred to the University Hospital of Wales in Cardiff, where it became clear his appendix had ruptured.
“The doctors told us there was nothing more they should do for him; it was highly unlikely Dylan would survive,” Mr Cope said.
When we should have been watching him perform as a reindeer in the school play, we were watching him die
Laurence Cope
Life support was gradually withdrawn, and Dylan died on December 14 of sepsis.
His parents described him as a “fit and healthy young boy” who enjoyed life and loved his family, especially baking with his mother and wrestling with his brother.
Opening the inquest on Monday, senior coroner for Gwent Caroline Saunders said the inquest is being held to examine whether Dylan’s appendicitis could or should have been picked up earlier.
In a statement read out by Ms Saunders, Dylan’s father said: “He was very loving, and nothing delighted him more than hearing over Alexa that there were free hugs available in the lounge.”
He added: “When we should have been watching him perform as a reindeer in the school play, we were watching him die.”
Mr Cope’s statement went through the events leading up to his son’s death, with Dylan having been ill with what his parents thought was a stomach bug.
After Dylan began to experience severe pain, his parents took him to his GP, Dr Amy Burton, who suspected he had appendicitis.
Ms Burton advised him to go immediately to the Grange Hospital, and she called ahead with her diagnosis.
While there, Dylan was seen by Samantha Hayden, a paediatric nurse practitioner for the Aneurin Bevan Health Board.
Hospital was ‘exceptionally busy’
The inquest heard that while Ms Hayden had been aware that his GP had seen Dylan, Dr Burton’s diagnosis was not passed on, and she did not follow up on the notes.
Ms Hayden said this was normal because she did not want to be led by the GP’s assessment and took a thorough history and examination for herself.
She also described that day as having been “exceptionally busy”.
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Addressing Ms Saunders, she said she did not recall Dylan or his father expressing concern about the severity of pain the young boy was experiencing and that he seemed to be walking fine, but this was not noted in her notes.
The coroner said she was “concerned” by elements of Ms Hayden’s statement to the inquest.
Her notes said that Dylan had a tenderness on the right-hand side of his body – which would indicate appendicitis – but it was not documented in her statement to the coroner’s court.
She also said she had not ruled out appendicitis despite her listing influenza as her diagnosis in the discharge notes.
Ms Hayden said she had sought a senior review for Dylan to check her assessment for influenza.
The court heard that a man wearing scrubs later saw Dylan, but he did not introduce himself, and Laurence assumed he was a surgeon.
Asked if she had received more notekeeping training since the incident, Ms Hayden said she had not received formal training but was told that her documentation needed “improving,” which she said she has now done by recording all conversations with senior staff.
What is appendicitis? And what are the symptoms?
THE appendix is a small pouch which is about two to four inches long and is connected to the large intestine, where faeces are formed.
The organ projects out from the colon in the lower right abdomen.
Appendicitis is when the appendix gets inflamed and swells, causing intense pain in the abdomen region.
Thankfully the body can survive without the appendix, so removing it immediately to get rid of the pain is the usual course of action.
Appendicitis is a painful swelling of the appendix.
Nobody knows exactly what the appendix does, but removing it is not harmful.
What are the symptoms?
Appendicitis typically starts with a pain in the middle of your tummy (abdomen) that may come and go.
Within hours, the pain travels to your lower right-hand side, where the appendix is usually located, and becomes constant and severe.
Pressing on this area, coughing or walking may make the pain worse.
If you have appendicitis, you may also have other symptoms, including:
- Feeling sick (nausea)
- Being sick
- Loss of appetite
- Constipation or diarrhoea
- A high temperature and a flushed face
The court heard that the health board has already made changes to its practices.
While patients were previously sent home only with a leaflet for the diagnosis, they are now also sent home with one for the presenting complaint, meaning Dylan would now be sent home with one for appendicitis as well.
The inquest continues.
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What is sepsis?
From sweaty hands to a rash and even diarrhoea, sepsis can present itself in various different ways.
This is because the condition can affect many different areas of the body, so there are many possible symptoms.
Sepsis is life-threatening and can be difficult to spot, accounting for about 50,000 deaths each year in the UK.
It happens when the body attacks itself in reaction to an infection, like a urinary tract infection (UTI) or pneumonia.
It can lead to tissue damage, organ failure, and death.
Globally, one-third of people who develop sepsis die, according to the World Health Organisation (WHO).
And many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and amputations.
Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.