Scenes of 'panic' at hospital as girl's tragic two-year battle for life began

Alta Fixsler, who died following two High Court battles
-Credit: (Image: Irwin Mitchell/PA Wire)


In October 2021, two-year-old Alta Fixsler's life support was turned off. The Greater Manchester toddler suffered a brain injury from birth which left her needing ongoing medical support throughout her life.

The decision followed two high-profile battles, and the youngster passed away after a High Court judge ruled that life support was no longer in her best interests. Now, her family's long-awaited search for answers is finally underway.

Today (September 24), Alta's heartbroken father battled tears as he recalled the moment his pregnant wife was rushed to hospital while their unborn daughter began her fight for survival.

Manchester Coroner's Court heard that little Alta suffered a brain injury caused by hypoxia - a lack of oxygen - which was due to a placental abruption.

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Her mum, Chaya Fixsler, had attended St Mary’s Hospital on a number of occasions having suffered bleeding during her pregnancy. The pregnancy was deemed 'high risk' by medics due to Mrs Fixsler's medical history.

But Dr Sarah Vause, consultation obstetrician at Manchester University NHS Foundation Trust (MFT), told the inquest this was separate to the 'unpredictable' placental abruption. On December 23, 2018, Mrs Fixsler suffered ‘severe' bleeding while at home alone.

Abraham and Chaya Fixsler
Abraham and Chaya Fixsler -Credit:Adam Vaughan

She had previously attended hospital for bleeding during her pregnancy, and was told to return in the event of another incident. The inquest heard that December 23, 2018, was the first incident of bleeding since October 9, while Dr Vause said her pregnancy was deemed 'stable' earlier in December 2018.

The court heard Mrs Fixsler contacted a midwife, who called for the Hatzolah ambulance and contacted her husband Abraham Fixsler, who rushed to their home in Salford. Mr Fixsler, who attended court with a large teddy bear that featured a photo of Alta, said: "I saw a lot of blood but I didn't know what it meant, not to my wife, and not to the child."

Mr Fixsler described scenes of 'panic' at St Mary's Hospital, with doctors 'coming in and out'. The court heard Alta’s pulse was checked and found to be ‘very low’, before the couple were told an emergency caesarean section would be needed following the results of a blood test.

Notes from four MFT medics suggested Mrs Fixsler had initially refused an emergency caesarean under general anaesthetic, but asked if she remembered this to be the case, she told the inquest: “No, not at all.” Mr Fixsler added: "The doctor that checked [Alta's] heartbeat told me the child is not going to survive if we are not going in as soon as possible to a caesarean section.

"I explained to [Mrs Fixsler] that if we want a child we need to go to the caesarean section as soon as possible. She said 'fine but I just want to know can we do it without a general anaesthetic."

Abraham Fixsler outside court following an earlier hearing
Abraham Fixsler outside court following an earlier hearing -Credit:MEN

Mr Fixsler told the court it was '12 or 13 minutes' between being told they would need the emergency caesarean section and his wife going in for the surgery, with medics waiting for blood test results. Dr Vause told the inquest that 'every second counts' when an unborn child is suffering hypoxia.

She suggested the delay was due to the couple's questions around the need for to have general anaesthetic, which ultimately 'contributed to Alta's hypoxia'. Dr Vause was repeatedly questioned on the suggestion by coroner Zak Golombeck, who asked if she was placing 'too high an expectation' on expectant mothers in an emergency to know the medically correct thing to do.

And David Pojur, representing the family, asked Dr Vause if she could 'empathise' with Mrs Fixsler. Dr Vause told the inquest: "I think the majority of women would just say 'I want my baby out as quickly as possible'."

Mr and Mrs Fixsler both insisted they had insufficient information about the risks of placental abruption during the pregnancy. Mr Fixsler told the inquest they could have used that information to seek further medical interventions, such as private care, in an effort to prevent Alta's hypoxia.

But when pressed on the matter by Elspeth Rose, representing MFT, Dr Vause stated the risk of a severe placental abruption taking place was 'one per cent or less' and 'did not warrant an admission' to hospital prior to December 23, 2018. Alta's family have waited almost three years for the inquest following their daughter's death on October 18, 2021.

Life support was switched off after MFT asked the High Court to decide if it was in the two-year-old's best interests to withdraw treatment at the Royal Manchester Children's Hospital, and if this should be done at a hospice. Her parents, who are members of Salford's Hasidic Jewish community, insisted their faith meant they could not agree to steps which would lead to her death.

They wanted her to travel to a hospital in Israel for life-sustaining treatment instead, but judges twice ruled against the family. The inquest, which is expected to focus on the causes of Alta's brain injury, is due to conclude on Wednesday (September 25).

Proceeding.