Joshua Hughes: Eight-month-old baby boy who died had brain injury which could have been prevented if treated quicker

An inquest on eight-month-old Joshua Hughes from Barnsley - born prematurely at 25 weeks and weighing less than two pounds - revealed failings in his care contributed to a preventable brain injury.

Joshua, a twin born in January 2023, faced significant medical challenges from birth, including chronic lung disease, requiring extensive intervention.

However, his condition rapidly deteriorated following a procedure in June 2023 to insert a new feeding line at Sheffield Children’s Hospital.

During the procedure, Joshua suffered a short cardiac arrest and was resuscitated but his condition worsened in the following days and he suffered a severe brain injury on June 26 due to prolonged low blood pressure, which deprived his brain of oxygen.

Assistant coroner Hannah Berry, for South West Yorkshire, emphasised this injury was preventable, citing poor communication between medical teams as a key factor.

Joshua’s brain injury would not have occurred if he had “been treated in a timely manner”, she said..

“Much of this was due to poor basic communication between teams”, she added.

Joshua’s mother Kimberley Bradder said it “breaks her heart” to think that “if more care and attention had been taken, Joshua would not have had to endure so much needless pain and suffering as a result of the brain injury”.

Joshua died from ‘natural causes’ on October 9, 2023.

The inquest into Joshua’s death was held at Sheffield’s Medico-Legal Centre on September 5 and 6.

During the inquest Joshua’s mother said she and her family were led to believe his prognosis was good before his brain injury.

“We were certainly never under the impression that his lung issues were likely to cause his death”, she added.

However, while giving evidence, Dr Alison Scott, consultant in paediatric respiratory medicine at Sheffield Children’s, said ‘there were a number of conversations when he was unwell that he may not make it through’.

Dr Scott added: “Those conversations happen at acute times. When those babies are stable, we have hope.

“The babies are precious, they are people’s family. I don’t think it is routine to say ‘they still may die’ - we are optimistic.”

During evidence the court also heard further details about Joshua's condition following the brain injury.

On June 29, he was ventilated for neuroprotection and remained on ventilatory support until July 6.

Although he was transitioned to non-invasive support via a face mask, the inquest heard Joshua struggled with this form of ventilation and required sedation.

Ms Berry said she accepted his difficulty tolerating the mask was likely due to various factors including infections, age-related development and possibly his brain injury.

By August 7, Joshua had developed a pressure ulcer from the mask, leading doctors to discuss the option of a tracheostomy.

On September 1, Joshua underwent a tracheostomy procedure.

However, post-surgery complications - including infections and increased oxygen requirements - led to a rapid decline in his health.

On October 9, after developing a pneumothorax - a condition in which air can collect on the outside of the lung and put pressure on the lung and can cause them to collapse - Joshua’s condition deteriorated further and no additional treatment options were available.

Ventilatory support was withdrawn and Joshua died on that day.

The inquest revealed it was not until September, following an internal investigation, that the true cause of Joshua’s brain injury was understood.

Ms Berry gave a narrative conclusion on September 9, which she said was more appropriate to “reflect Joshua's complex circumstances.”

His death was attributed to natural causes.

Ms Berry concluded “on the balance of probabilities” Joshua's brain injury “did not impact on his subsequent treatment or his ability to respond to that treatment”.

“It did not impact on his respiratory function that ultimately caused his death and as a result did not cause or contribute to his death”, Ms Berry said.

“I have not considered incorporating neglect into my conclusion in light of my finding that the brain injury did not cause or contribute to Joshua's death.”

The hospital trust has since implemented eight key recommendations, including improved monitoring and communication between teams, to prevent similar tragedies in the future.

During the inquest on Friday (Sept 6), a statement was read out on behalf of Joshua’s emotional mother.

In the statement, she said: “Joshua didn't have the best start to life.

“Despite everything thrown his way, Joshua fought to stay with us. He was a feisty baby.

“We were lucky forever, Joshua, and we miss you every day.”