An inquest heard mistakes in diagnosis and treatment at Leeds General Infirmary were directly associated with eight-month-old Eloise Lema Dalton’s death at the hospital on December 17, 2009.
Eloise suffered multi-organ failure due to pneumococcal meningitis and septicaemia.
Recording a narrative verdict, West Yorkshire Coroner David Hinchliff said missed opportunities to appropriately care for Eloise amounted to neglect.
The inquest heard an investigation by Leeds Teaching Hospitals NHS Trust led to a report recommending 22 changes in paediatric care, which have since been implemented.
After the hearing, Eloise’s mother Abby Dalton, 37, of Guiseley, said: “All of this was too late for Eloise, but if it stops even just one more child facing what she faced and being denied the care they desperately need then Eloise’s death was not in vain.”
Miss Dalton added: “Leeds General Infirmary cost Eloise her life and I can never forgive them for that, but they have made changes.
“The changes should be attributed to Eloise, because she paid the highest price imaginable.”
Miss Dalton feared her daughter was displaying classic meningitis symptoms and took her to A&E at LGI on December 11 2009.
Eloise’s condition was dire, with her appearance, pale, her skin mottled and a rash on her chest.
The baby was also listless but her condition was not identified.
The inquest was told Eloise was diagnosed as suffering from a virus and Miss Dalton was advised to give her ibuprofen and Calpol before mother and baby were sent home.
In the early hours of December 13, Miss Dalton took Eloise to A&E at LGI after the baby’s temperature rose to 41 degrees.
Elosie suffered a 30-minute seizure at LGI on the night of December 13, but wasn’t admitted to the paediatric intensive care unit until around 8pm on Thursday December 14.
Summing up evidence from expert witness Dr Nelly Ninis, a consultant in paediatrics at St Mary’s Hospital, London, Coroner Mr Hinchliff said: “Dr Ninis stated that had Eloise been recognised as being at risk from the 11th and put straight on antibiotics from then, she believed she would have survived intact.”
A Report into Eloise’s care by Dr Dominic Bell, a consultant in critical care at LGI, found a raft of failings including a failure to act on parental concerns and misdiagnosis.
Dr Yvette Oade, Chief Medical Officer at Leeds Teaching Hospitals, said: “I would like to extend our sincere sympathy to the family of Eloise and to apologise for the failings in her care, which we fully acknowledge and have taken detailed steps to address.
“After Eloise’s tragic death in 2009 a full, thorough and open investigation was carried out by a senior clinician at the trust.
This made a series of recommendations for improving the care we provide, and the coroner heard in detail about these and was satisfied that they have been fully implemented.
“It is important to stress that in addition to making changes to our clinical practices, the way the trust is organised has been significantly changed since the time of Eloise’s death, with a much greater input from senior clinicians to the care of all patients in the children’s wards.”