A CONSULTANT who was part of a transport team preparing to move a “very ill” five-year-old boy from Rotherham Hospital to Sheffield Children’s Hospital told his inquest they had been handling “two very difficult situations” as his condition deteriorated.
On the third day of an inquest into the death of Shay Turner (pictured), Dr Fatemah Rajah, consultant in transport medicine for Embrace, based at Sheffield Children’s Hospital, said she had been unsure if the Rawmarsh youngster would survive after she arrived to help Rotherham staff in the early hours of Saturday, March 31, last year.
The doctor, who works for the highly specialist, round-the-clock transport service for critically ill infants and children, said both her team and the staff on the High Dependency Unit at Rotherham Hospital had found it hard to keep Shay stable after he began to have a seizure.
Speaking at the inquest on Tuesday, Dr James Donnelly, paediatric consultant at Rotherham Hospital, said as well as dealing with a working diagnosis of diabetes, which he had begun to question, he had suspected Shay’s brain was filling with fluid and had called on the Embrace team for further help.
Dr Rajah said: “We thought Shay was very ill due to an infection, but was unsure where the infection was coming from.
“I told the parents I wasn’t sure that Shay would survive.”
She added that Shay’s condition had been “never black and white”.
The team had been following the guidelines of the diabetes diagnosis, Dr Rajah said, but also juggling with the signs of celebral ischemia, which causes a insufficient flow of blood to the brain as well as seeing signs of swelling in Shay’s abdomen.
Dr Rajah said she had been made aware of an incorrect dose of insulin being administered to Shay earlier on in the evening.
She felt it had not played “a direct part” in Shay's death but may have made the clincial pictured “a little less clear”.
Shay transferred by Embrace to Sheffield Children’s Hospital and seen by Sean Marven, consultant paediatric surgeon.
Mr Marven found he had ischemic colitis, an inflammed bowel due to infection which had turned gangrenous.
He described this as being the “most extreme form” and said he had needed to operate immediately.
“It is difficult to say what the cause was and when it developed, but Shay was in shock and needed to be operated on,” Mr Marven added.
The surgeon also said the ischemic colitis had been a “major factor” in Shay’s death.
Rebecca Salter, a consultant in paediatrics and emergency medicine, gave a report on the insulin overdose.
She deemed Shay’s treatment a “very difficult emergency situation” and said it had been a complex case for the staff to deal with.
Ms Salter said that in her opinion, the insulin prescription error did not have an effect on Shay’s death.
She said the cause was multiple-organ failure and septic shock but could not say whether severe sepsis had been involved.
The inquest continues.