Nottinghamshire girl died from strep A infection after hospital failed to notice serious condition

A girl who died from strep A could have been saved if staff at a Nottinghamshire hospital had recognised and properly treated the serious condition. Five-year-old Meha Carneiro died on December 5, 2022, after medics at King's Mill Hospital in Sutton-in-Ashfield failed to diagnose the Group A streptococcus infection, which caused what a coroner described as "overwhelming sepsis" and resulted in her fatal cardiac arrest.

Dr Elizabeth Didcock, assistant coroner for Nottingham and Nottinghamshire, said Meha - who had Down's syndrome, which gave her a greater risk of dying from the bacterial infection - would have likely survived if the infection had been detected and treated with intravenous fluids and antibiotics. In a prevention of future deaths report published earlier this month, which followed an inquest that was heavily critical of King's Mill Hospital, Dr Didcock urged operator Sherwood Forest Hospitals Foundation Trust to improve its procedures to prevent more deaths.

Dr Didcock outlined there were an insufficient number of trained paediatric nurses on duty in the Emergency Department (ED), when Meha was brought into hospital, and there was no effective way to escalate this problem to senior nursing staff. "There was overall a lack of recognition of how unwell Meha was on admission and over the subsequent hours prior to her death - this included both nursing and medical staff in ED."

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Staff originally believed Meha had gastroenteritis, which is an inflammation of the stomach and intestines, with the young girl spending more than four hours in A&E despite displaying "red flag" symptoms of strep A. Dr Didcock further explained there was "insufficient and ineffective" handover between medical staff, along with a lack of key documentation and agreed clinical plans.

"I am not reassured that necessary actions to address these serious issues identified are in place," the coroner added. The report, which was sent to the trust's Chief Executive, stated the organisation had to respond to the coroner's concerns by May 29.

This response must contain details of action taken or proposed to be taken or an explanation of why no action is planned, Dr Didcock added. The report was also sent to Meha’s family and the Care Quality Commission, which inspects health and social care providers.

Dr David Selwyn, medical director at Sherwood Forest Hospitals, said the trust accepted the coroner's findings and offered his "unreserved apologies" to Meha’s family.“As a trust, we are committed to providing outstanding care to all our patients and we have welcomed the additional scrutiny that the coroner’s review has brought to identify opportunities where we can learn and improve," Dr Selwyn said.

“The comprehensive findings of both the coroner’s review and our own internal investigations have helped us to put in place a rapid programme of improvements that we have made good progress on implementing to ensure we can continue to provide the best possible care in future.”