A Doncaster girl who died from brain damage following heart surgery could have been saved if doctors had carried out the right scans at the right time, an inquest heard.
Four-year-old Mylee Weetman from Doncaster, South Yorks., died after surgery to remove excess muscle in her heart led to two strokes, causing her brain to be “starved of oxygen”.
Mylee’s death came days before the children’s heart unit at Leeds General Infirmary - where the surgery had taken place - was temporarily closed from concerns over its death rates.
Her devastated mother Siobhan Casey told the inquest in Wakefield on Monday how the family were “still waiting” to find out why Mylee died.
A relative of Mylee’s left the court in tears at the hearing today (Weds), as it was said how doctors at the unit “missed opportunities” in recognising Mylee was suffering a series of back to back seizures known as status epilepticus.
Leading paediatric neurologist Professor Fenella Kirkham told the inquest how the hospital could have taken further steps which may have saved Mylee and allowed her to live a reasonably able life.
Professor Kirkham said doctors should have carried out an ECG scan to check for seizures she had during or at the end of her operation, and that they shouldn’t have waited until the next morning to carry out a CT scan once they noticed Mylee’s left side had gone stiff.
Adam Korn, representing the family, asked Professor Kirkham: “You say the missed opportunity was to perform an earlier scan to see if Mylee was in status epilepticus.
“Had that been done, had it showed whatever it showed, could Mylee have been treated in such a way that would have avoided her death?”
She replied: “Possibly, yes. I think there are two things that could have been done.
“If the seizures were controlled more the swelling [of Mylee’s brain] may have been less.
“The second is if the CT scan had been done earlier”
Mr Korn said: “Had that been done and had she survived, would she have been brain damaged?”
The professor replied: “Yes, I think she would have been brain damaged. She might have been able to walk.
“She was four and [the damage] was left-sided so it would have probably affected her language, but often language can switch to the other side [of the brain] so she probably would have been taught.”
Coroner David Hinchliff said: “An inquest is a voyage of discovery. If there’s some suggestion that something has contributed to Mylee’s death, either by negligence or naturally, it will be taken into account.”
Mr Korn added: “She is entirely able to give an opinion of avoidability of Mylee’s death.”
He asked: “Are you critical of the fact that the CT scan was performed the morning after?”
Professor Kirkham added: “Yes, I do think so, and the reason I think is that Mylee had ongoing deviation of the eyes and irregular heart rate and rhythm.
“There was a distinct possibility of brain damage.”
She added: “The main missed opportunity was not conceiving the possibility that the seizures were ongoing.
“The scan could have shown what was going on. The difficulty is that Mylee had a seizure and her eyes were deviated to the right, and nobody had any understanding of what was going on.”
Professor Kirkham added that it wasn’t mandatory to perform the relevant scans, but that she “would have had to in this case”.
The inquest also heard how doctors were left scratching their heads as to what exactly caused Mylee’s brain damage.
Paediatric consultant Dr Mohammed Doulah said: “The father was angry and upset and said he didn’t want Mylee’s organs to be donated.
“He asked if the coroner would want to investigate and I assured him the coroner would be involved as we did not know why Mylee had died.”
The tot was born with a heart defect called tetralogy of Fallot - meaning she had a hole in her heart as well as other abnormalities.
She had surgery to correct this and Mylee’s family were told she would lead a normal life, until she was called back to hospital with a thickness of muscle on one side of her heart.
The surgery left Mylee with “horrific brain damage” and she died days later on March 21, 2013.
Questionning paediatric neurologist Dr John Livingstone, coroner David Hinchliff said at the hearing today: “What we don’t know is the phenomena which caused the brain damage to happen.”
Dr Livingstone replied: “That’s right.”
“It could have been a clot cutting off oxygen to the brain or air getting into the system.”
He added: “Medicine is never a question of 100 per cent.
“The most likely cause of injury in hypoxic damage caused by a lack of profusion, but then again that doesn’t mean that’s what actually happened.”
The court heard Mylee’s cause of death was ascertained as hypoxic ischemic encephalopathy, when the brain is starved of oxygen, but that doctors did not know the exact cause for this following the heart surgery.
Child neurologist Ann-Marie Childs said she examined a CT scan of Mylee’s brain, saying “you would have to have multiple strokes to cause that appearance”.
The court heard how doctors thought Mylee would survive but with permanent brain damage, before realising she would not survive her injuries.
Speaking to neurologist Dr Ian Craven, Mr Hinchliff said: “What started as this little girl having permanent brain damage has now turned into her being not likely to survive, is that right?”
Dr Craven replied: “Yes”.
The inquest continues.