Cassian Curry: Doctor gives evidence at inquest into miracle IVF baby's death and describes his final moments

The premature baby who died two days after his birth in a Sheffield hospital had 10ml of 'yellow, cloudy' fluid removed from the area around his heart moments before his death, an inquest heard.

Wednesday, 20th April 2022, 7:26 pm

'Small but strong' Cassian Curry, was born at the Jessop Wing maternity unit at 28 weeks and weighed 1lb 10oz on April 3, 2021.

He died two days later in the early hours of April 5, over the Easter Bank Holiday.

Following his death, his parents, Karolina and James Curry, raised concerns about the management of Cassian's umbilical venous catheter (UVC) after he was placed on total parenteral nourishment (TPN), which is typically given for premature babies.

Karolina said both she and her husband were ‘struggling so badly’ since their son’s death and that she could not bear to be alone. Pictured: Karolina and James on their wedding day. Picture by Karolina Curry and James Curry .

The second day of the inquest held on Wednesday, April 20 heard from Dr Mark Attard, a then junior neonatal doctor who is now based at the Aberdeen Maternity Neonatal Unit.

He said Cassian initially 'progressed really well' after his birth, but he identified pericardial tamponade around his heart during resuscitation.

Pericardial tamponade or cardiac tamponade happens when extra fluid builds up in the space around the heart, putting pressure on the heart and preventing it from pumping well.

He had previously looked at a X-ray of Cassian's tiny body, which showed that the UVC was 'projecting into the cardiac shadow', which he raised with his colleague, neonatal consultant Dr Elizabeth Pilling, on the morning of April 4.

Karolina Curry and James Curry on their wedding day. Cassian Curry was their 'miracle' baby after many unsuccessful attempts. Picture by Karolina Curry and James Curry

He said: “I asked her about this and she said, she was aware of it but the line insertion on Cassian took so long and she was quite conscious this might unbalance him in terms of temperatures, sugar and she told me on a balance of these decisions to leave there at that moment.”

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‘We did not consider cardiac tamponade’

He said he was then 'called urgently' on 1.30am on April 5, when resuscitation attempts were taking place, and was 'shocked' to learn that it involved Cassian.

'Small but strong' Cassian, was born at 28 weeks and weighed 1lb 10oz on April 3, 2021 at the Jessop Wing maternity unit in Sheffield but died in the early hours of April 5 - over the Easter Bank Holiday.

He said at that time he did not consider cardiac tamponade to have been the cause.

He said: “I did not consider at all at the time in my experience since (I started practising in) 2007.

“Cardiac tamponade was far down the list of causes and at the time, I didn't even cross my mind with Cassian."

He said while checking for hemothorax – a collection of blood in the space between the chest wall and the lung- using an ultrasound machine, he noticed the pericardial shadow was 'far larger than the heart'.

Dr Attard said: “There was a lot of fluid around the heart and there was cardiac tamponade and at that point we identified the cause.

“We were late in the resuscitation process but I don't think it's a fault of us not thinking about it, but just that in the algorithm, that's where it is when you start looking for things like that.”

He said he started draining the fluid and they stopped chest compressions to make sure they don't injure the heart in the process.

“We removed 10ml of yellow cloudy fluid,” he said.

‘UVC might be the problem’

Asked if this was consistent with TPN, he said he couldn't be sure at this point, but it was 'already a suspicion.'

He said: “As soon as I saw the fluid, I thought of the UVC that the UVC might be the problem and to be honest, even if there was pericardial tamponade, it didn't cross my mind.”

He said CPR stopped just before 2.20am because based on his understanding, the resuscitation had taken its course for 30 minutes and the outcome for babies who have such prolonged resuscitation 'would not be good.'

“The chance of survival is very low,” he said.

Cassian was conceived through IVF treatment after multiple unsuccessful attempts by his parents over the course of six years.

Karolina said Cassian was her and her husband James Curry's 'miracle baby' after James was diagnosed with testicular cancer.

Cassian’s funeral was held on April 30, 2021 and he was cremated.

Sheffield Teaching Hospitals NHS Foundation Trust has also issued an apology over Cassian’s death which they attributed to 'human error'.

Following Cassian’s death, the couple's friend Tara Proctor, launched a fundraiser for both Karolina and James to help them in times of need.

The inquest resumes tomorrow.