Intensive care baby 'died from virus'

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The Independent Online

A five-month-old baby boy died after contracting a virus from another child on a hospital ward, an inquest heard today.

Noe Tomsett, who had a number of severe conditions from birth, caught the adenovirus while on the paediatric intensive care unit at St George's Hospital in Tooting, south London.

Deputy Westminster Coroner Dr Shirley Radcliffe told Noe's parents: "At the end of the day, your baby has died, and your baby acquired an infection on the ward - that must be devastating for you to deal with.

"We have heard today that your baby received excellent care while he was on the intensive care unit, and it was a tragedy that he acquired the adenovirus on the unit.

"But we can understand how these things can happen, with the best will in the world. Even with the best cross-contamination policies in the world, this can happen.

"But from a parent's position, it's not going to be easy for you to deal with, or ever move on from."

The hearing was told that Noe was born to Nicole Deutsch and Brett Tomsett, of Morden, south London, by emergency caesarean section on September 22, 2009.

He had an exomphalos (an abdominal abnormality), and a bronchomalacia, or collapsed airway from the windpipe to the lung, from birth.

He was admitted to the hospital on February 25 with respiratory distress.

He became more unwell on March 16 and 17 and was found to have the adenovirus.

His condition deteriorated and he died at 5.10am on March 21.

Cause of death was given as adenoviral pneumonia but the exomphalos and bronchomalacia were also listed as factors.

Dr Marian Malone, who conducted the post-mortem examination, told the inquest: "This baby boy had numerous severe problems."

A statement was read out from GP Jerome Jephcott which said: "He was born with multiple problems which ultimately became insurmountable. I can only pay tribute to the devotion, care and love shown by his parents."

Dr Martin Grey, a consultant paediatrician at the hospital, said doctors were concerned that Noe had acquired the virus on the ward and asked the medical directors to investigate this potential cross-infection.

"Given that the patient next door had adenovirus, that may have been the source of the infection," he said.

"We can hypothesise that is the most probable solution, but we can't prove it."

He said it was most likely to have been spread by hand contamination and he had attended to Noe at least once without washing his hands, such was the "precipitous" nature of the sudden breathing difficulties he had.

Colleague Dr Jonathan Round said the hospital had looked at its infection control measures.

A study showed that 96% of potential situations were carefully managed. "That's 4% too low, but in a busy unit, that's a reasonable figure."

The doctors had been dealing with danger of cardiac arrest with Noe.

"Proper handwashing does take 30 seconds, to do properly, dry your hands, put on a gown, that's a minute, that's a long time in the context of cardiac arrest."

He said there was no evidence that even if this was done, it completely eliminated the risk.

"We are humans and carry viruses around with us."

Noe's father Brett, a 38-year-old software project manager from South Africa, said after the hearing that he believed the general treatment of the patient next door was the reason Noe got the virus.

"Noe had started in a cubicle and was moved out of it. We wanted him to be in a cubicle," he said.

"I think the virus could have been spread to him by a nurse, or a patient or a visitor."

He added: "I think there was long-term failure in their care of Noe. The general approach of the hospital was chaotic and disorganised.

"I would like someone to take a whip to it and change the system. A scrape on the knee gets treated the same way as a complex child case."

Ms Deutsch, a 31-year-old journalist from Germany, said: "We kept waiting for tests to happen. Everything was taking so long."

A spokeswoman for St George's Healthcare NHS Trust said later: "Our sympathies go to the family at this difficult time.

"In delivering a verdict of death by natural causes, the coroner said that Noe Tomsett had received excellent care in St George's paediatric intensive care unit."