Surgeons at the children’s hospital where a one-year-old boy died following delays to urgent surgery have said his death was avoidable and operation waiting lists had reached dangerous lengths.
Kayden Urmston-Bancroft died at Royal Manchester Children’s Hospital (RMCH) last April, a week after he fell at home and hit his mouth on his bottle, reported the BBC.
A&E staff at a hospital near Stockport discovered a hole in the 20-month-old’s diaphragm, believed to have been there since birth and through which his bowels and stomach had entered his chest.
Kayden was transferred to RMCH the next day for an urgent operation to mend the hernia – but this was delayed repeatedly over three days, his family said.
The toddler had a heart attack and died two days later after suffering severe brain injury.
“We just worry how many more children must die before management is held to account and before the right changes are made,” Basem Khalil, a surgeon at the hospital, told the broadcaster.
Dr Khalil said bosses had given targets for waiting lists priority over emergency operations, adding a surgeon who had offered to cancel elective surgery to see Kayden sooner had not been given the support to do so.
“The waiting list in the children's hospital has basically ballooned over the last few years. We now have hundreds of children who have waited over a year to have their surgery done,” he said.
“They were giving elective cases priority, but it almost became like a culture, that it is difficult to cancel elective cases to do emergency cases.”
RMCH said they had “failed” Kayden, who died in his mother’s arms when his life support machine was turned off.
“Royal Manchester Children's Hospital faces huge demands for its services and occasionally failings regrettably do occur,” said Central Manchester University Hospitals Trust.
“We believe that there are sufficient theatres in our children's hospital to cope with the demand for emergency cases; however, on occasions some children do have to wait for urgent surgery while emergency surgery takes place.”
The hospital trust has apologised to Kayden's family, following his death on 17 April 2016, and recently settled a legal case brought against them by the family for an undisclosed, five-figure sum.
His grandmother Julie Rowlands, a 44-year-old care coordinator for the elderly who lives with her daughter in Stockport, said Kayden’s care was “appalling.”
Everyone the Government blames for the NHS crisis – except themselves
Everyone the Government blames for the NHS crisis – except themselves
1/6 The elderly
“We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital.
2/6 Patients going to A&E instead of seeing their GPs
Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service.
3/6 Simon Stevens, head of NHS England
Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required.
4/6 Previous health policy, not funding
In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals.
5/6 Target to treat all A&E patients within four hours
Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame.
6/6 No one
Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in.
“All we were ever told was that other emergencies were coming in and taking Kayden's place. We felt like he was just being left and he was in so much pain, we couldn't leave his side,” she said.
“We were begging them to transfer him to somewhere that could do the operation, but they told us it wasn't as easy as that. I said if they didn't then something would happen.
“After his cardiac arrest the doctors tried to bring him round, but he was without oxygen for almost half an hour. They took him to theatre, but I knew it was too late.
“It was four-and-a-half hours before they brought him back and they apologised there and then and said as a hospital they had failed him.”
It is thought Kayden’s cardiac arrest was caused by the organs squashed in his chest, putting too much pressure on his heart.
Basem Khalil, a surgeon, says he warned hospital bosses about the problem before the boy's death.
He told the BBC: “The hospital did not take any substantive actions with regard to the warnings that were given by myself or my colleagues.
“I feel children are being let down… and now a child is dead and I think that is completely unacceptable.”
James Moorecroft, a retired surgeon at the same hospital, said he wrote to the medical director saying children's surgical services were unsafe – but did not get a reply.
Stephen Clarkson, a clinical negligence specialist from Slater and Gordon, who represented the family, said: “The real tragedy here is that Kayden's death was entirely preventable. If he had been operated on earlier then he would have survived.”
Additional reporting from Press AssociationReuse content