Nurse faces being struck off over boy’s death

A nurse who left a disabled six year-old boy to die in his hospital bed faces being struck off today (FRI).

Isabel Amaro failed to give proper care to Jack Adcock over a seven-hour period while working as an agency nurse at Leicester Royal Infirmary.

Her colleague, doctor Hadiza Bawa-Garba, also made a series of blunders – including mistaking Jack for another child with a do not resuscitate order.

Jack, who had Downs Syndrome, went into cardiac arrest after being admitted to the hospital and died of sepsis the same day.

Both Amaro and Bawa-Garba were convicted of gross negligence manslaughter and given a two-year suspended prison sentence at Nottingham Crown Court last year.

Amaro now faces a fitness to practise hearing before the Nursing and Midwifery Council in central London.

The NMC heard Jack was born with a hole in his heart, which required daily medication, but was described as ‘an energetic and lively boy’.

Matthew Kewley, for the NMC, said: ‘On 18 February 2015, his parents took him to his GP because he had been troubled by diarrhoea and vomiting and, furthermore, his breathing was also noted to be difficult.

‘His GP referred him to the Children’s Admissions Unit [CAU] at Leicester Royal Infirmary.’

Amaro, who trained in Portugal and has nearly 20 years experience, was assigned to be his nurse at the CAU over the next seven and a half hours.

Dr Bawa-Garba, a specialist paediatrician registrant, initially arranged a blood test and an x-ray but later failed to pursue treatment with the ‘urgency, priority and attention it demanded.’

Mr Kewley said: ‘The child had, in fact, sepsis, which needed to be treated with antibiotics.

‘The doctor didn’t prescribe antibiotics because her initial diagnosis was of gastroenteritis with moderate dehydration and, in fact, Child A didn’t receive any antibiotics until around 4pm.’

Jack’s condition deteriorated and at 8pm a crash call was put out – but the doctor announced that the child was not for resuscitation.

Mr Kewley said: ‘As such, efforts to save the child came to an abrupt stop. Unfortunately, Doctor A had mistaken Child A for another child who wasn’t for resuscitation.

‘They called out without having checked the child’s name or otherwise positively identifying him.

‘This particular event did not contribute to the death because, as the interruption was brief and the child’s condition was, by that stage, far too advanced.’

Amaro failed to take regular readings of Jack’s vital signs including temperature, respiratory rate, his blood pressure, his pulse and his oxygen saturation levels, the hearing was told.

Mr Kewley said: ‘Miss Amaro should have taken these observations and recorded them with very few exceptions.

‘Miss Amaro did none of these things. The child’s blood pressure was never taken during the entire time he was on the CAU.’

Amaro did not give evidence at the trial but claimed at the inquest she had raised concerns that Jack should have been on the Intensive Care Unit.

Mr Kewley said: ‘The child died on the evening of 18 February 2011. The doctor who performed a post-mortem examination found that the cause of death was systemic sepsis.

‘The judge concluded that life was cut short prematurely and that was a tragedy.

‘The expert evidence in the trial was that with proper care there was about a 20 per cent chance that the child would have died anyway and that was before making an allowance for the child’s Down’s Syndrome and the hole in his heart.

The sentencing judge, Mr Justice Nicol, told Amaro: ‘Jack’s young life was cut short prematurely. That was a tragedy. No sentence that I pass on you will alter it.

‘There was no evidence that either of you neglected Jack because you were lazy or behaved for other selfish reasons.

‘You both had other patients to attend to. The problem was that neither of you gave Jack the priority which this very sick boy deserved.’

Mr Justice Nicol found that Amaro’s recording of Jack’s fluid balance was ‘woefully inadequate’ and said ‘it is inevitable that her nursing career will come to an end’.

Amaro, who is present at the hearing, admits to the manslaughter conviction but denies that her current fitness to practice is impaired.

The hearing continues.

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