Hyponatraemia: Belfast trust admits liability for two deaths

The deaths of Claire Roberts and Adam Strain are being examined by the hyponatraemia public inquiry

A health trust has admitted liability for the deaths of two children in its care during a public inquiry into hospital deaths in Northern Ireland.

Claire Roberts and Adam Strain died months apart while they were being treated at the Royal Belfast Hospital for Sick Children in 1995 and 1996.

Their deaths are being investigated by the inquiry into hyponatraemia-related deaths in Banbridge, County Down.

The issue of hospital fluids management is central to the public inquiry.

Hyponatraemia is the term for a low level of sodium in the bloodstream, which causes the brain cells to swell with too much water.

Four-year-old Adam Strain died shortly after undergoing a kidney transplant at the Royal Belfast Hospital for Sick Children in 1995.

Claire Roberts was nine when she died at the same hospital the following year.

'Sincere apology'

She had been admitted following vomiting and drowsiness and doctors prescribed intravenous fluids.

However, Claire was given a fatal overdose of fluids and drugs.

In the 17 years since her death, Belfast Health Trust had denied that fluid management played any role and wrongly attributed Claire's death to a brain virus.

The trust maintained its stance during the child's inquest in 2006.

However, at the public inquiry on Thursday, the trust's lawyer said his client now accepted it was liable for Claire Roberts' death and made "a full and frank admission of liability on behalf of the Belfast Trust".

He said it also wanted to offer "a sincere apology for the shortcomings in the management of Claire's treatment" and acknowledged that it had failed to treat the child to an appropriate standard.

During the hearing, the Belfast Health Trust also admitted publicly for the first time liability in the earlier case of Adam Strain.

It had previously settled this case with Adam's family but a confidentiality clause prevented any detail of that settlement from emerging.

The public inquiry is also investigating specific issues around the treatment of 15-year-old Conor Mitchell who was admitted to Craigavon Area Hospital on 8 May 2003.

The following day, the teenager was transferred the Royal Belfast Hospital for Sick Children, where he died on 12 May.

At Thursday's hearing, the Southern Health Trust admitted that guidelines had not been followed when the teenager was treated in Craigavon Area Hospital and it apologised to his family.

However, the Southern Health Trust has not accepted liability for Conor's death.

The inquiry chairman, Justice John O'Hara QC, welcomed the admissions and acknowledged that it was "never easy to admit when mistakes had been made".

Mr O'Hara said the families had made it clear that their pursuit of the truth was "in memory of their children" and that he hoped that today "they feel there is some added justification for what they have done".

Speaking to BBC Northern Ireland after the hearing, Claire Roberts' parents welcomed the trust's apology and admission of liability as a small step forward but said there were still many questions over their child's death that had not been answered.

Lethal dose

The inquiry into hyponatraemia-related deaths is investigating fluid management issues after the deaths of five children in Northern Ireland hospitals.

It is looking into the deaths of three of the children, the events following the death of another and a number of issues arising from the death of a fifth.

The deaths all took place between 1995 and 2003, and in each case, the way in which fluids were given to the children following surgery is implicated in their deaths.

On August 30, the Western Health and Social Care Trust admitted liability over the death of nine-year-old Raychel Ferguson.

Raychel died in June 2001, a day after an appendix operation at Altnagelvin Hospital, Londonderry.

She was administered a lethal dose of intravenous fluid after her appendix was removed.