A MUM claims medics failed to spot a deadly condition in her 24-year-old son after he ran naked through wards and punched her in the face.
Milo Peart died on July 4, 2020, after sodium levels in his blood dropped below normal, causing his brain to swell.
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This is a condition known as hyponatremia, but doctors didn’t spot it until it was too late.
Milo’s mother, Gihan El Halwagi, 58, from Soberton, Southampton, watched in horror as her son’s condition deteriorated over 36 hours and his behaviour became increasingly erratic.
A coroner ruled that Milo’s premature death was partly due to the “gross failure to provide basic care” that amounted to “neglect” and said opportunities to potentially save his life had been missed.
“Milo’s death should not have happened,” Gihan told PA Real Life.
“It is unforgivable, there is no amount of words that I have, something like that should just never have happened.
“I have had a really tough time since Milo died.
“I can’t bring him back, but I can try and stop something like this from happening again.”
The mum-of-three is now campaigning to stop “preventable deaths” in hospitals across the UK and has launched a petition on change.org demanding the government intervene.
‘SOMETHING WAS COMPLETELY OFF’
When Gihan was pregnant with Milo, an ultrasound showed his bladder was blocked, causing urine to back up and flood his kidneys.
He was born with chronic renal failure and spent two years at Great Ormond Street Hospital before doctors deemed him well enough to receive a kidney transplant.
Milo, one of the youngest patients ever to receive a kidney, recovered quickly.
For the next 20 years, he lived a “wonderfully healthy and normal life”, playing sports at school and graduating from the Chelsea College of Arts.
Milo was planning on moving to London in 2019 but his kidney started failing.
Put on dialysis while waited for a donor match, Milo had a second kidney transplant at Queen Alexandra Hospital in Portsmouth in November that year.
But his health took a sudden turn for the worse in the summer of 2020.
When I got to the hospital the next morning, Milo was flipping left, right, left, right. He looked at me and punched me twice in the face
Gihan El Halwagi
On July 1, Milo spent the afternoon gardening and playing football with his brothers – Atti, 30, and Finn, 27 – before having a family dinner with some games.
Gihan went to bed at around 9pm and was sound asleep when Milo suddenly burst into her room a few hours later.
“He woke me up and said, ‘Mum we need to go and fly a kite because of Covid-19’,” explained Gihan.
“I knew something was completely off. He was dripping in sweat and wasn’t coherent.”
Gihan tried to convince Milo to lie down but he was “restless” and wanted to have a shower.
The mum dialled 999 but by the time the ambulance arrived Milo couldn’t understand what people were saying or answer simple questions.
Despite Covid restrictions, Gihan was permitted to accompany him.
‘HE DIDN’T RECOGNISE ME’
Milo was admitted to the A&E Department at Queen Alexandra Hospital on July 2, where doctors suggested he could be suffering from encephalitis or meningitis.
They found sodium levels in his blood were 129, lower than expected. The normal range for blood sodium levels is 135 to 145 milliequivalents per litre (mEq/L).
At around 5am, Gihan was told she could return home as Milo’s condition was stable, and the next morning a doctor called to say he was ready to come home.
Unfortunately this would never happen, as just a few hours later, Gihan received another phone call to say Milo had been found slumped in the toilet completely disorientated.
“This is two hours after a senior kidney specialist told me that my son could be discharged,” she said.
“Before Milo collapsed his sodium levels were 125 and hospital protocol states that at this point a patient should have immediately been taken to ICU, which they did not do.
“And Milo’s not a normal patient, he’s a renal patient for God’s sake. They completely missed it.”
Gihan raced to the hospital but by the time she arrived, Milo had pulled out his IV lines and was running around the ward naked, completely confused and disorientated.
Had he been sent to ICU, he’d probably still be alive
Gihan El Halwagi
It took three security guards to restrain Milo and take him back to his bed, before he was sedated for his own safety and that of other patients.
Milo’s brain was swelling due to a condition called hyponatraemia, which occurs when the concentration of sodium in the blood is abnormally low.
“When I got to the hospital the next morning, Milo was flipping left, right, left, right,” said Gihan.
“He looked at me and punched me twice in the face – he didn’t recognise me.
“So the last time I spoke with my son, was the evening we had dinner and played a game, I never had a conversation with Milo again,” she added through tears.
Once sedated, Milo was not properly monitored for the next 16 hours, despite evidence his sodium levels were falling.
Gihan said doctors carried out a blood test early on July 3, but were unable to locate the results for several hours, and when they finally did, Milo’s sodium levels were 120.
“It was the first time they mentioned hyponatremia,” she said.
“Had he been sent to ICU, he’d probably still be alive.
“It was a simple case of decreasing his fluids and increasing hypertonic saline – a fluid dissolved in water that contains sodium.”
At around 10am, Gihan left Milo to get a cup of coffee downstairs which she “regrets deeply to this day”.
Milo suffered a heart attack and was transferred to the Intensive Care Unit where doctors raced to raise the amount of sodium in his blood, but it was too late.
He was declared dead on the morning of July 4, 2020.
‘MISSED OPPORTUNITIES’
An inquest at Winchester Coroner’s Court concluded on June 16, 2023 and found there had been “gross failures amounting to neglect” and many “numerous missed opportunities to diagnose Milo’s hyponatremia”.
Senior Coroner, Mr Christopher Wilkinson, reported based on the evidence, that none of the three primary doctors assessing Milo over the first 12 hours had a full picture, which led to a number of “missed opportunities”.
The report states that over a 16-hour period there was “no systematic or consistent monitoring of Milo’s sodium levels”, due to “a lack of recording of the information and effective communication of that information between departments”.
Mr Wilkinson concluded that the hospital’s “gross failure to provide for a basic provision of care” amounted to “neglect”.
Gihan has now launched a petition on Change.org demanding the Government investigates “preventable deaths occurring in all UK hospitals”.
What is hyponatremia?
HYPONATREMIA is when the level of sodium in your blood is lower than normal.
Sodium is an important mineral that helps balance the amount of fluid in your body. It also helps your nerves and muscles to work properly.
Your kidneys play an active role in keeping your sodium and fluid levels balanced. People with more advanced stages of chronic kidney disease may have a hard time balancing their fluid and blood sodium levels.
When the sodium level in your blood is too low, extra water moves into your cells and makes them swell. This can be dangerous, especially in the brain where there is not a lot of room to expand.
Most people with mild hyponatremia may not have any symptoms.
If symptoms occur, it is usually when the level of sodium in your blood is very low or or has dropped very fast.
These symptoms can include:
- Nausea and/or vomiting
- Headache
- Muscle weakness, spasms (twitching), or cramps
- Low blood pressure
- Dizziness when standing up
- Low energy or fatigue
- Loss of appetite
- Restlessness or bad temper
More serious symptoms can happen in severe cases when the level of sodium in your blood is extremely low. These include:
- Altered mental status (severe confusion)
- Hallucinations
- Decreased consciousness
- Seizures
- Coma
Source: National Kidney Foundation
“I don’t want people thinking it’s justice for Milo because as I say, I can’t bring Milo back,” she said.
“This is about protecting future generations. The Government needs to step in.”
Penny Emerit, chief executive at Portsmouth Hospitals University NHS Trust, said, “I would like to say how sorry I am and again offer our heartfelt condolences, on behalf of the Trust, to Milo’s family.
“We recognise that there are things we should have done differently when it came to the care that Milo received.
“As a Trust, we have taken the time to reflect on our investigation and take action to address the issues raised. This includes further education of our staff in recognising deterioration in patients and how to escalate when there is cause for concern.
“This is an ongoing programme of work that means families with any concerns can easily communicate these with our critical care outreach team.
“There are no words to change what happened, but I would like to assure Milo’s family and our patients that we continue to learn from Milo’s case and safety remains our top priority.”
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