Chances to spot tragic boy’s rare condition ‘missed’

A BOY who needed urgent medical treatment was instead discharged from hospital and sent home with painkillers only to collapse and die four days later, an inquest heard yesterday.

Jacob Long, 15, was taken by his grandfather on May 20, 2009, to the out-of-hours minor injury unit at Otley’s Wharfedale Hospital where a doctor, Javier Abad, was so concerned about his condition he sent him to Leeds General Infirmary in an emergency ambulance with blue lights flashing.

A phone call from Wharfedale was also made to alert staff to the seriousness of Jacob’s condition and ensure his arrival was treated as a high profile referral.

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But despite Jacob being a “red flag” case – he was suffering from chest pains, low blood pressure and had a swelling on his neck, he was not seen for almost three hours and then diagnosed with a chest infection.

The court heard that at no stage during his treatment was that basic barometer of health – his temperature – recorded.

In a scathing overview of Jacob’s treatment at the infirmary, Dr Michael Bell, a consultant in Intensive Care and Anaesthesia at LGI, said there had been several missed opportunities to laser in on Jacob’s extremely rare medical condition and try to prevent his death.

A post-mortem examination following his death revealed the 6ft teenager from High Street, Rawdon, had died from a tear in a major vein in his chest which caused internal bleeding.

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Dr Bell told coroner David Hinchliff at a Wakefield hearing that the condition was “so incredibly rare that senior surgeons had never come across this before. Had it been possible to diagnose the patient’s condition surgical repair may have been possible.”

Leeds Teaching Hospital NHS Trust has apologised for Jacob’s death and for the shortcomings in his care which may have contributed to his death.

The court heard Jacob was seen by a number of doctors and nurses at LGI but the seriousness of his condition eluded them.

A junior doctor, Aishin Lok, carried out a chest X-ray and an ECG which brought up abnormalities.

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Registrar Dr Victoria Cox was then consulted about the diagnosis but she did not assess Jacob herself and he was discharged and told to take paracetamol and ibuprofen.

Mr Hinchliff asked Dr Bell about Dr Lok’s conduct. He replied: “I have not sought to lay culpability at the feet of Dr Lok.”

At an earlier hearing in December last year Jacob’s grandfather, Fred Long, who had adopted the role of father for several years, said his grandson had continued to feel unwell and in the middle of the night woke with serious chest pains.

An ambulance took him to LGI where he was pronounced dead.

Reading Mr Bell’s conclusions, Mr Hinchliff said that despite all the precautions taken by Wharfedale and the ambulance service which radioed ahead to LGI to say: “We are coming in blue lights with an emergency”, there was a “collective failure” by healthcare professionals in the emergency department to recognise the significance of the patient’s condition.

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Mr Hinchliff said of Dr Abad: “He put his finger on what was the problem – bleeding in his chest” but despite that promising start opportunities to act came and went. The court heard the emergency department had been under resourced in terms of consultancy numbers but Mr Hincliff said he was not aware this had been a factor in this case. The inquest continues today.

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