Toddler may have lived if she remained in hospital - inquiry

Two toddlers died on the same day in December 2016 at the Royal Hospital for Children in Glasgow

A toddler who died of pneumonia after her parents repeatedly took her to A&E might have lived if she had remained in hospital, an inquiry has found

Cailyn Newlands, from Renfrew, was nearly two years old when she died at Glasgow's Royal Hospital for Children (RHC) in December 2016.

A fatal accident inquiry heard she was discharged from the emergency department on three occasions in the four days before she died.

Sheriff Brian Cameron ruled that a "reasonable precaution" that might have prevented her death would have been to keep her in a specialist observation unit.

However, he said there had apparently been a miscommunication between doctors and there were no defects in the system.

He made no recommendations.

The hearing was told that Cailyn's mother had taken her to see a GP on 2 December 2016 after she developed a rash and a fever.

The doctor arranged for an ambulance to take her to A&E at the RHC, which is part of the Queen Elizabeth University Hospital campus.

Extended observation

Cailyn, who was 23 months old, was bright and active when examined, and was discharged with her mother told to bring her back if her condition worsened.

Three days later, Cailyn's mother took her back to the A&E department because she was not improving.

A doctor who examined her believed the child had a viral infection, but she was alert and hydrated, so she was discharged again.

On the way home, Cailyn vomited in the car so her mum decided to return to the hospital.

The doctor sought advice from a colleague who suggested she needed an extended period of observation.

The more senior medic thought this should last up to 24 hours in the Clinical Decision Unit but did not expressly say this.

Instead Cailyn was kept in A&E and was passed into the care of another doctor after a shift change, and was later sent home again.

The following day, on 6 December, her mother noticed a rash again and took her back to the hospital where Cailyn's condition deteriorated and she died.

The children's hospital is part of the Queen Elizabeth University Hospital

The inquiry also considered the death of Sonny Campbell, another toddler who died on the same day at the hospital.

In his case the sheriff concluded there were no reasonable precautions that could have prevented his death.

However, he did say the long wait for a ruling, due to procedural delays, was "unacceptable" and would have added to the parents' grief.

The hearing was told that a GP had referred him to the hospital on 5 December.

Sonny, who was 22 months old and lived in the Caryntyne area of Glasgow, was assessed as having a virus but also sent home with advice that his mother should bring him back if he got any worse.

The following day he became pale with laboured breathing, and was taken back to the hospital by ambulance but he had no pulse on arrival and was pronounced dead a short time later.

The cause of death was acute haemorrhagic leucoencephalitis, a rare brain condition caused by infection.

Due to his sudden decline, the sheriff ruled that it was unlikely any alternative treatment would have led to a different outcome.

Sheriff Cameron highlighted that delays in proceeding with the inquiry were "unacceptable" which would have added to the grief of the parents of both children.

The Crown Office and Procurator Fiscal Service said a number of changes had since been made after lessons were learned from the case.

The sheriff offered his condolences to both families.