Doctors admit baby's brain damage was preventable

Joshua Hughes was only eight months old when he died in October 2023

Doctors at a children’s hospital have admitted there were several failings in the care of a premature twin baby who died aged eight months.

Joshua Hughes was born in Barnsley on 17 January 2023, but struggled with numerous complex medical issues as a result of being born 15 weeks early, an inquest heard.

During his time on the critical care unit at Sheffield Children’s Hospital, he also sustained a brain injury after staff failed to take action when his blood pressure dropped to dangerously low levels.

While doctors admitted the brain injury could have been prevented, they agreed it did not contribute to his death several months later, on 9 October.

During the inquest at Sheffield’s Medico-Legal Centre on Thursday and Friday assistant coroner Hannah Berry heard that while Joshua's sibling was eventually discharged, Joshua had what doctors described as “an incredibly rocky start”.

The inquest was told he suffered from a serious gastrointestinal problem as well as other illnesses such as sepsis and severe chronic lung disease.

Due to his deteriorating health, he was eventually transferred to the critical care unit on 9 May.

On 25 June, he underwent surgery to have a new IV feeding line fitted, during which he suffered a two-minute cardiac arrest.

Concerns were raised overnight when Joshua’s blood pressure dropped significantly, but action to address the hypotension was not taken until 05:00 BST that morning.

Evidence given by various doctors and nurses stated there had been confusion about Joshua’s blood pressure target and handover notes post-surgery lacked detail.

'Completely different baby'

Joshua’s mother, Kimberley Bradder, told the inquest she noticed a substantial change in her son’s presentation on 27 June.

“While he did have his eyes open, they did not fix on anything - he was like a completely different baby,” she said.

“He was not responsive, he no longer smiled and it was difficult to say whether he could hear or see.”

Consultant paediatric neurologist Dr Mark Atherton told the court scans revealed Joshua had sustained severe brain damage caused by low blood pressure and was suffering from symptomatic epileptic seizures.

He, as well as Dr Judith Short, a consultant in paediatric anaesthesia, agreed that the brain injury could have been prevented.

Dr Short said a subsequent investigation found several failings had contributed to the injury, such as failure to highlight that Joshua might be more vulnerable to further complications post-surgery.

There had also been a lack of clarity around how his blood pressure target was being measured, she said, which led to a delay in treatment.

'Huge regret'

Dr Short said to prevent similar situations arising in the future, several recommendations were made, including improving handover notes and recording clear targets for maintenance of cardiorespiratory functions.

She said: “We all regret hugely what happened to Joshua and accept there were areas where things could’ve been done so much better but there has been learning from this.”

While doctors described his brain injury as a “tragic occurrence”, they unanimously agreed it did not impact his respiratory issues, which eventually led to his death.

A statement from Joshua’s mum read out in court paid tribute to the much-loved baby boy.

“Joshua didn’t have the best start to life but despite everything thrown his way, he fought to stay with us,” she wrote.

“We all love you forever, Joshua, and we miss you every day.”

The inquest continues.

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