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Six children have died with Strep A bacterial infection
Patient Safety Learning posted a news article in News
There have been five recorded deaths within seven days of an invasive Strep A diagnosis in children under 10 in England this season, the UK Health Security Agency has said. A child under the age of 10 has also died in Wales after contracting the infection. Group A strep bacteria can cause many infections, ranging from minor illnesses to deadly diseases, but serious complications and deaths are rare. According to UKHSA data, there were 2.3 cases of invasive disease per 100,000 children aged one to four this year in England, compared with an average of 0.5 in the pre-pandemic seasons (2017 to 2019). There have also been 1.1 cases per 100,000 children aged five to nine, compared with the pre-pandemic average of 0.3 (2017 to 2019). The UKHSA said investigations are under way following reports of an increase in lower respiratory tract Group A Strep infections in children over the past few weeks, which have caused severe illness. It added that there is no evidence to suggest a new strain of Strep A is circulating, and the increase is most likely related to high amounts of circulating bacteria and social mixing. Read full story Source: Sky News, 3 December 2022- Posted
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Parents urged to get children flu vaccine as infections rise
Patient Safety Learning posted a news article in News
Parents of children under five are being urged to get them a flu vaccine after a 70% jump in hospitalisations. The UK Health Security Agency (UKHSA) said an 11% fall in the uptake of the vaccine among two and three-year-olds came as flu circulated at higher levels than in previous years. Anjali and Ben Wildblood from Bristol saw their two-year-old son Rafa become "very sick" with flu just days before he was due to have the vaccine. The pair, who are both NHS consultants, said their concerns prompted them to take him to A&E where he was treated and sent home. "But his condition got worse again, with a soaring temperature and exhaustion - he had no strength whatsoever and what was so extremely worrying was that he barely had the strength to breathe - every parent's worst nightmare," they said. After returning to hospital, Rafa was admitted to a paediatric intensive care unit where he was put under general anaesthetic and intubated. Covid restrictions have meant most young children have never encountered flu and have no natural immunity to the virus, the UKHSA said. This increased risk has coincided with the uptake of the flu vaccine among two-year-olds standing at 31% and 33% among three-year-olds. All children under five can get vaccinated at their GP surgery. Read full story Source: BBC News, 30 November 2022- Posted
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Landlord was warned of mould that killed toddler in Rochdale flat
Patient Safety Learning posted a news article in News
A health visitor wrote to housing officials expressing concern about conditions in a rented flat months before a two-year-old died after his exposure to mould. An inquest in Rochdale is investigating the death of toddler Awaab Ishak who lived with his mother and father in a one-bedroom housing estate flat managed by Rochdale Boroughwide Housing (RBH). Awaab’s father, Faisal Abdullah, first reported the damp and mould in autumn 2017, a year before the birth of his son. He made numerous complaints – phoning and emailing – and requested re-housing. In December 2020 Awaab developed flu-like symptoms and had difficulty breathing. He was given hospital treatment and then discharged. Two days later his condition at home worsened and he was seen at Rochdale urgent care centre where he was found to be in respiratory failure. He was transferred to Royal Oldham hospital where, upon arrival, he was in cardiac arrest and died. It was just a week after his second birthday. A pathologist told the inquest that the child’s throat was swollen to an extent it would compromise breathing. Exposure to fungi was the most plausible explanation for the inflammation. Lawyers for the family say the inquest will consider a number of matters including concerns about mould and damp and how they were dealt with. It will also look at the sharing of information between agencies and how the family’s cultural and language requirements were taken into account. Officials from RBH have yet to give evidence at the inquest but a statement was provided to the coroner on Tuesday in which RBH admits it “should have taken responsibility for the mould issues and undertaken a more proactive response”. Read full story Source: The Guardian, 8 November 2022- Posted
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Warning for parents after rise in hospitalisations for flu in children under 5
Patient Safety Learning posted a news article in News
Parents are being told to urgently bring their children forward for flu vaccinations as new data reveals the rate of hospitalisation and ICU admission for people with the virus is rising fastest among those under five years old. New figures published in the UK Health Security Agency’s (UKHSA) National flu and Covid-19 surveillance report show that cases of flu have climbed quickly in the past week, indicating that the season has begun earlier than normal. According to the UKHSA, vaccination for flu is currently behind last season for pre-schoolers (12.1% from 17.4% in all two-year-olds and 12.8% from 18.6% in all three-year-olds). It has also fallen behind in pregnant women (12.4% from 15.7%) and under 65s in a clinical risk group (18.2% from 20.7%). Dr Mary Ramsay, director of public health programmes at the UK Health Security Agency, said: “Our latest data shows early signs of the anticipated threat we expected to face from flu this season. “We’re urging parents in particular not to be caught out as rates of hospitalisations and ICU admissions are currently rising fastest in children under 5. “This will be a concern for many parents and carers of young children, and we urge them to take up the offer of vaccination for eligible children as soon as possible.” Read full story Source: The Independent, 20 October 2022- Posted
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Urgent polio boosters for London children
Patient Safety Learning posted a news article in News
All children aged one to nine and living in Greater London will be offered a polio vaccine after the virus was detected in sewage. The virus, which can cause paralysis, has been found 116 times in London's wastewater since February. The urgent immunisation campaign will see nearly a million children offered the vaccine - including those already up to date with their jabs. Parents and carers will be contacted by their GP within the next month. Polio is seen as a disease of the past in the UK after the whole of Europe was declared polio-free in 2003. Dr Vanessa Saliba, a consultant epidemiologist at UKHSA, said: "All children aged one to nine years in London need to have a dose of polio vaccine now - whether it's an extra booster dose or just to catch up with their routine vaccinations." She said the risk for the majority of the population who are vaccinated remains "low" but said it was "vital" parents ensure their children are fully vaccinated. Read full story Source: BBC News, 10 August 2022- Posted
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The reporting reveals a legal and medical system that sometimes struggles to differentiate accidental injuries from abuse, particularly in cases involving children too young to describe what happened to them. Physicians intent on protecting the most vulnerable in some instances have overstated the reliability of their findings, using terms such as “100 percent” and “certain” to describe conclusions that usually cannot be proven with absolute confidence. Child welfare workers, overworked and untrained in complex medical issues, are not always sure how to proceed when the primary evidence against a caregiver comes in the form of a doctor’s note. Under this system, children are sometimes taken from seemingly caring parents, while others are left in situations that, in rare cases, turn out to be deadly. Parents managed to regain custody in most of the cases reviewed by reporters, in some instances after additional medical findings or reports from outside experts raised doubts about the initial abuse determination. Nevertheless, some parents lost jobs or faced financial ruin as the result of their fights with Child Protective Services, and a few children emerged from foster care suffering from depression or other health issues. In a few instances, caregivers were charged criminally or had their parental rights permanently terminated, despite questions about the doctors’ findings in their cases. -
Content Article
MEs are a key element of the death certification reforms, which, once in place, will deliver a more comprehensive system of assurances for all non-coronial deaths, regardless of whether the deceased is buried or cremated. MEs will be employed in the NHS system, ensuring lines of accountability are separate from NHS Acute Trusts but allowing for access to information in the sensitive and urgent timescales to register a death. This case study outlines the approach of South Tees Hospitals NHS Foundation Trust as one of the early adopter sites. To date, the following learning points have been identified and explored: End of Life Care, ceilings of care and avoidable admissions Some investigations have highlighted cases where the End of Life Care pathway could have either been established or fully implemented, where this would have been of benefit to patients and their families. Some patients may not have been cared for in the right location, and some admissions could have been avoided if the End of Life Care pathway had been suitably established and followed. Early detection and response to physiological deterioration, and effective communication Response stretched by implementation of National Early Warning Score (NEWS) but still learning around effective communication of escalation. The use of standardised communication tools is essential. Record keeping and organisation of medical records Some learning was identified in relation to the accuracy and completeness of medical records. It was evident that not all records are reflective of the clinical picture. Discussion with specialty teams is vital to support the investigation An independent review by the ME should be further supported by speciality ‘experts’, and if possible, peer review from other trusts can be sought to allow for full independent review. Seeking speciality opinion from those not directly involved with the case within STHFT has also been shown to be effective. Pathways for links to wider clinical governance processes have been strengthened.- Posted
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Sepsis screening tool telephone triage for the under 5s
Claire Cox posted an article in Paediatrics
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Pandemic disrupted routine vaccinations of US kindergarteners
Patient Safety Learning posted a news article in News
Yet another hidden cost of Covid-19 was revealed on Thursday as the Centers for Disease Control and Prevention presented new data showing how the pandemic has dramatically impeded the US effort to vaccinate kids for other diseases. According to the CDC’s report, national vaccine coverage among American children in kindergarten dropped from 95% to below 94% in the past year – which may seem like a small amount but meant 350,000 fewer children were vaccinated against common diseases. “Overall, today’s findings support previous data showing a concerning decline in childhood immunizations that began in March 2020,” Shannon Stokley, the CDC’s immunization services deputy division director, said in a press conference on Thursday. Some of the reasons for the lower vaccination rates included reluctance to schedule appointments, reduced access to them, so-called “provisional” school enrollment, the easing of vaccination requirements for remote learners, fewer parents submitting documents and less time for school nurses to follow up with unvaccinated students. States and schools also told the CDC that there were fewer staff members to assess kindergarten vaccination coverage, and a lower response rate from schools, both due to Covid-19. “The CDC provides vaccines for nearly half of America’s children through the Vaccines for Children program,” Stokley said. “And over the last two years, orders for distribution of routine vaccines are down more than 10% compared to before the Covid-19 pandemic. “We are concerned that missed routine vaccinations could leave children vulnerable to preventable diseases like measles and whooping cough which are extremely dangerous and can be very serious, especially for babies and young children.” Read full story Source: The Guardian, 21 April 2022 -
News Article
Pfizer and BioNTech said Tuesday that they were seeking emergency-use authorisation for the first coronavirus vaccine for children younger than 5 in the US and have begun submitting data on the safety and efficacy of the first two doses of a planned three-dose regimen. The Food and Drug Administration asked the companies to apply for authorization of their vaccine, and in an email, FDA spokeswoman Stephanie Caccomo said the omicron surge had generated new data “impacting the potential benefit-risk profile of a vaccine for the youngest children.” In December, Pfizer and BioNTech announced that the immune response generated by the vaccine in children between 2 and 4 years old was not sufficiently robust. But the companies said the vaccine had provoked a strong enough response in children 6 months to 2 years old. A third shot was added to the trial to increase the immune response. An earlier vaccine trial in children 5 to 11 years old was also focused on showing that those children had adequate immune responses after vaccination. In addition, there were enough cases of illness in that study population to determine that the vaccine was 91% effective in preventing symptomatic illness. The companies said Tuesday that the FDA requested they move forward with an application because of the “urgent public health need in this population,” noting that 1.6 million children under the age of 4 have tested positive for the coronavirus. “The need for a safe and effective vaccine for our youngest children is significant, particularly given the rapid spread of the omicron variant, the notable rise in the number of hospitalizations in young children with severe disease, and the possibility that future variants could cause severe disease in those who are unvaccinated,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement. Read full story Source: The Washington Post, 1 February 2022- Posted
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Doctor struck off for ‘repeated dishonesty’ over death of child in 1995
Patient Safety Learning posted a news article in News
A doctor who attempted to cover up the true circumstances of the death in 1995 of a four-year-old patient has been struck off. Consultant paediatric anaesthetist Dr Robert Taylor dishonestly misled police and a public inquiry about his treatment of Adam Strain, who died at the Royal Belfast Hospital for Sick Children, a medical tribunal found. The youngster was admitted for a kidney transplant at the hospital following renal failure but did not survive surgery in November 1995. Six months later an inquest ruled Adam died from cerebral oedema – brain swelling – partly due to the onset of dilutional hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream. Two expert anaesthetists told the coroner that the administration of an excess volume of fluids containing small amounts of sodium caused the hyponatraemia. But Dr Taylor resisted any criticism of his fluid management and refused to accept the condition had been caused by his administration of too much of the wrong type of fluid. In 2004 a UTV documentary When Hospitals Kill raised concerns about the treatment of a number of children, including Adam, and led to the launch of the Hyponatraemia Inquiry. The tribunal found Dr Taylor acted dishonestly on four occasions in his dealings with the the public inquiry, including failing to disclose to the inquiry a number of clinical errors he made and falsely claiming to detectives he spoke to Adam’s mother before surgery. Read full story Source: The Independent, 22 June 2022- Posted
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Race to find children without full vaccination against polio in London
Patient Safety Learning posted a news article in News
The NHS is urgently tracking down the parents of 35,000 five-year-old children in London who are not fully vaccinated against polio. Health officials are hoping to contain the spread of the virus after detecting the first outbreak since 1984. They are trying to trace it back to a “single household or street” after identifying polio in a sewage plant serving four million people in northeast London. Experts are concerned polio, which had been eradicated in Britain in the 1980s, could take off again due to relatively low vaccination uptake in London. Latest NHS data shows 101,000 five-year-olds in England — 15% of the total — have not had their booster polio dose, offered when they reach the age of three. One third of these, 34,104 in total, live in London. Jane Clegg, the chief NHS nurse for London said they are “reaching out to parents of children aged under five in London who are not up-to-date with their polio vaccinations to invite them to get protected.” Read full story Source: The Times, 23 June 2022- Posted
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Respiratory syncytial virus kills 100,000 under-fives every year
Patient Safety Learning posted a news article in News
Respiratory syncytial virus is killing 100,000 children under the age of five every year worldwide, new figures reveal as experts say the global easing of coronavirus restrictions is causing a surge in cases. RSV is the most common cause of acute lower respiratory infection in young children. It spreads easily via coughing and sneezing. There is no vaccine or specific treatment. RSV-attributable acute lower respiratory infections led to more than 100,000 deaths of children under five in 2019, according to figures published in the Lancet. Of those, more than 45,000 were under six months old, the first-of-its-kind study found. More children are likely to be affected by RSV in the future, experts believe, because masks and lockdowns have robbed children of natural immunity against a range of common viruses, including RSV. “RSV is the predominant cause of acute lower respiratory infection in young children and our updated estimates reveal that children six months and younger are particularly vulnerable, especially with cases surging as Covid-19 restrictions are easing around the world,” said the study’s co-author, Harish Nair of the University of Edinburgh. “The majority of the young children born in the last two years have never been exposed to RSV (and therefore have no immunity against this virus).” Read full story Source: The Guardian, 19 May 2022- Posted
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Alder Hey NHS Trust must pay boy £27m over brain injuries
Patient Safety Learning posted a news article in News
A boy who suffered "catastrophic brain injuries" when doctors failed to see he had a virus and sent him home after he had a seizure has been awarded £27m. The boy, who cannot be identified but is now 13, suffered seizures as a toddler more than a decade ago. Details of the settlement between the boy's father and Liverpool's Alder Hey Children's NHS Foundation Trust were published in a written ruling. High Court judge Mr Justice Fordham said it was a "sensible settlement". Trust bosses admitted "breach of duty" and "causation of loss and damage", the judge said. The judgment, from the hearing in Manchester, said the boy had suffered a seizure at 17 months old on 19 September 2009 and was taken to Alder Hey Children's Hospital. He suffered a second seizure in the accident and emergency department which was seen by medical staff. The boy was sent home and, despite going back to hospital, was not diagnosed with a virus until 24 September. Read full story Source: BBC News, 12 November 2021- Posted
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Government alert over surge in respiratory virus affecting babies and toddlers
Patient Safety Learning posted a news article in News
The chief medical officers of the four UK nations are set to warn about a surge in admissions of severely ill, very young children later this year, due to the resurgence of a respiratory virus which has been suppressed by anti-covid measures, HSJ can reveal. Public Health England modelling shows a possible sharp rise in cases of respiratory syncytial virus (RSV), which can cause bronchiolitis, this autumn and winter, several senior sources said. The modelling shows between 20 and 50% more cases needing hospitalisation than normal, HSJ understands. Official projections conclude that such a surge would require, at least, a doubling of paediatric intenstive care beds and a significant increase in other critlcal care resources for sick children. Most of those expected to be affected by the rise in RSV are forecast to be three years old or younger. The UK’s four chief medical officers are considering the issue and planning to write to ministers to highlight it, the sources said, while NHS England is working on a response plan, and is expected to alert local NHS leaders. Read full story (paywalled) Source: HSJ, 14 May 2021 -
News Article
NHS to benefit from digital 'Redbook' app
Patient Safety Learning posted a news article in News
As part of the NHS Digital Child Health programme, Personal Child Health Records or “Redbook” will receive a digital makeover. NHS Digital has considered the limitations of the physical Redbook and decided that digitalisation is the way forward for parents to easily access important health and development information. Nurturey has been evolving its product to align with NHS' Digital Child Health programme. It aims to be an app that can make the digital Redbook vision a reality and currently in the process of completing all the necessary integrations and assurances. It is hoped that by using smart digital records, parents will be more aware of their child’s health information like weight, dental records, appointments and other developmental milestones. Tushar Srivastava, Founder and CEO of Nurturey, said: “Imagine receiving your child's immunisation alert/notification on the phone, clicking on it to book the immunisation appointment with the GP, and then being able to see all relevant immunisations details on the app itself. As a parent myself, I see the huge benefit of being able to manage my child’s health on my fingertips. We are working hard to deliver such powerful features to parents by this summer.” Read full story Source: National Health Executive, 5 February 2020- Posted
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Myla’s mum left with ‘soul‑destroying sadness’
Patient Safety Learning posted a news article in News
Mother Natalie Deviren was concerned when her two-year-old daughter Myla awoke in the night crying with a restlessness and sickness familiar to all parents. Natalie was slightly alarmed, however, because at times her child seemed breathless. She consulted an online NHS symptom checker. Myla had been vomiting. Her lips were not their normal colour. And her breathing was rapid. The symptom checker recommended a hospital visit, but suggested she check first with NHS 111, the helpline for urgent medical help. To her bitter regret, Natalie followed the advice. She spoke for 40 minutes to two advisers, but they and their software failed to recognise a life-threatening situation with “red flag” symptoms, including rapid breathing and possible bile in the vomit. Myla died from an intestinal blockage the next day and could have survived with treatment. The two calls to NHS 111 before the referral to the out-of-hours service were audited. Both failed the required standards, but Natalie was told that the first adviser and the out-of-hours nurse had since been promoted. She discovered at Myla’s inquest that “action plans” to prevent future deaths had not been fully implemented. The coroner recommended that NHS 111 have a paediatric clinician available at all times. In her witness statement at her daughter’s inquest in July, Natalie said: “You’re just left with soul-destroying sadness. It is existing with a never-ending ache in your heart. The pure joy she brought to our family is indescribable.” Read full story Source: The Times, 5 January 2020- Posted
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Toddlers died after NHS 111 helpline said they were not in danger
Patient Safety Learning posted a news article in News
The NHS 111 helpline for urgent medical care is facing calls for an investigation after poor decision-making was linked to more than 20 deaths. Experts say that inexperienced call handlers and the software used to highlight life-threatening emergencies may not always be safe for young children. At least five have died in potentially avoidable incidents. Professor Carrie MacEwen, Chairwoman of the Academy of Medical Royal Colleges, said: “These distressing reports suggest that existing processes did not safeguard the needs of the children in these instances.” Since 2014 coroners have written 15 reports involving NHS 111 to try to prevent further deaths. There have been five other cases where inquests heard of missed chances to save lives by NHS 111 staff; two other cases are continuing and one was subject to an NHS England investigation. Read full story (paywalled) Source: The Times, 5 January 2020- Posted
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