Hospital missed opportunities before baby's death - coroner

Iona was admitted to Northampton General Hospital on 28 November 2022 for oxygen therapy

Missed opportunities to treat a nine-month-old baby "probably contributed to her death" in hospital, a coroner's report said.

Iona Buckingham died at Northampton General Hospital in December 2022 after complications from bronchiolitis.

Coroner Jonathan Dixey said the hospital missed opportunities to administer an antibiotic and carry out an X-ray and chest ultrasound.

A hospital spokesperson said they were "saddened" by the death.

In a Prevention of Future Deaths report (PFDR) published after an inquest into the baby's death, Mr Dixey said Iona was admitted to Northampton General on 28 November 2022 for oxygen therapy and feeding support "in view of a diagnosis of bronchiolitis".

A chest X-ray was performed the following day and pneumonia was identified, and she was given antibiotics. The report added that Iona was moved down from high-dependency care as she appeared to show improvement.

Mr Dixey said that there was a "missed opportunity" on 29 November to administer clindamycin, an antibiotic, which may have contributed to Iona's death.

During a review on 3 December - a Saturday - Iona was found to be struggling to breathe and there was a further missed opportunity to carry out an X-ray, administer clindamycin and arrange for transfer to a tertiary centre for the purpose of undertaking a chest drain, the report said.

The coroner said these matters "probably" contributed to Iona's death during an "accidental extubation".

Nine-month-old Iona Buckingham died in hospital after complications from bronchiolitis

She died on 4 December "as a result of bronchopneumonia with empyema due to invasive Group A streptococcal infection", an inquest concluded.

Mr Dixey warned that "future deaths could occur" if children with pneumonia could not get "immediate" access to X-ray and chest ultrasounds.

He said the absence of a paediatric radiologist outside of 09:00-17:00 meant that a child may not receive an ultrasound scan for up to 48 hours if the need arose.

In a statement, a hospital spokesperson said: "We are reviewing the recommendations from the coroner and will be responding within the specified timeframe.

"We are working closely with all system partners across Northamptonshire to discuss the findings and will work together to assess and implement any actions that can be taken."

Northampton General Hospital has until 8 March to respond to the report.