Boy's sepsis death after worry dismissed - inquest
A nine-year-old boy died from sepsis days after being seen by a medic who assured his father he was suffering with swollen “nodes”, an inquest was told.
Dylan Cope, from Newport, was taken to the Grange Hospital in Cwmbran, Torfaen, with suspected appendicitis but was diagnosed with influenza.
He was seen by several clinicians including an unknown medic who “dismissed any concern with Dylan’s appendix”, Gwent Coroner's Court in Newport heard.
Days later, Dylan was diagnosed with a ruptured appendix and sepsis and died at the University Hospital of Wales in Cardiff on 14 December 2022.
Dylan was described as “very loving”, and enjoyed baking, wrestling, and trampoline.
His mother and father, Corinne and Laurence Cope, said: “He was such a unique character, and a lovely brand of feisty and sensitive."
Dylan was taken by his father to A&E at the hospital on 6 December after his GP diagnosed him with suspected appendicitis.
The court heard a note was passed by the GP to the hospital to “query appendicitis”.
In hospital, Dylan was not seen by a triage nurse for one hour 15 minutes. The target time is 15 minutes.
A nurse said that reflected the “busy-ness and demand in the department”.
Dylan was then seen by paediatric nurse practitioner, Samantha Hayden, who told the inquest she was aware Dylan had been seen by a GP, but she did not review the referral document.
She said she also did not look for that document.
“It was exceptionally busy in the department that day," she said.
She said it was not unusual to see patients without seeing notes from their GP.
Asked whether she asked Dylan or his father about his abdominal pain, she said she "probably should" have taken more time to ask them about it.
She added: “I don’t recall definitely asking."
Ms Hayden told the inquest she did discuss appendicitis with Dylan’s dad.
She said: “I did consider appendicitis as one of my differentials - I didn’t disregard that as a possibility."
She said she asked Dylan a number of times where the pain was, and he said it was on the left side. The court was told the appendix is on the right side of the body.
The court heard “a male medic” wearing scrubs and face mask later saw Dylan.
Mr Cope said the medic did not introduce himself, but he assumed he was a surgeon.
He said the medic came across as “calm, casual, relaxed and confident".
He said he “spoke in a lovely calming reassuring way” and that “he seemed very sure of himself”.
He said the medic explained that it was “highly unlikely it was an issue with his appendix”.
However, Mr Cope said he did not remember the clinician physically examining Dylan.
'Writhing' on sofa
Mr Cope said the clinician “dismissed any concern with Dylan’s appendix being the cause of his symptoms” and said it was his “nodes”.
He said: “This unidentified medic appeared the most senior and reassuring."
The court was told another clinician then came back into the room saying Dylan had tested positive for influenza, and that his stomach pain may be coming from “swollen glands”.
The court heard Dylan was discharged from hospital with a coughs and colds advice sheet.
His condition did not improve, and on 10 December Dylan's father rang the emergency number on the A&E discharge sheet.
He was advised to contact NHS 111 and after they did, Dylan’s parents became concerned when he started “writhing” on the sofa.
Mr Cope drove Dylan back to the Grange Hospital. He was transferred to University Hospital of Wales in Cardiff where his parents were told Dylan had “irreversible septic shock, and his organs were too damaged and there was no chance of recovery”.
Dylan’s parents were advised that life support treatment should be withdrawn.
The senior coroner for Gwent, Caroline Saunders, said Dylan died on 14 December 2022, and that the medial cause death was “septic shock with multi-organ disfunction caused by a perforated appendix”.
The inquest continues.
