Canning Town baby died after Royal London Hospital medics failed to spot he had abnormally high insulin levels
PUBLISHED: 09:54 24 January 2018 | UPDATED: 12:01 24 January 2018
A newborn baby from Canning Town died after medics at the Royal London Hospital failed to spot he had abnormally high insulin levels before discharging him, an inquest heard.
Insulin test results for Caliel Smith Kwami were not known when he was sent home with his mother Sabreena Smith on August 2 last year.
He died after going into cardiac arrest 15 days later - hours after she had registered his birth.
Walthamstow Coroner’s Court heard Caliel had spent the first eight days of his life in intensive care at the Whitechapel hospital before he was discharged.
Coroner Nadia Persaud was told a broken machine which should have analysed Caliel’s insulin levels caused a delay in doctors knowing the results but medical staff should have chased the results.
If they had Caliel could have received specialist care to treat neonatal hyperinsulinemic hypoglycaemia - a condition that effects of low blood glucose caused by excessive insulin.
In addition community midwives were also not told about Caliel’s discharge from hospital so they also ‘missed an opportunity’ to chase up his test results.
If his condition had been treated he would probably have survived.
Miss Persaud, who recorded a narrative verdict, has written to the trust raising concerns over a lack of ‘chasing results and accountability’ as well as recommending bedside ketone tests are introduced.
Paying tribute to her son, Sabreena, 26, said: “Caliel was taken from us far too soon but the three weeks I had with him were the best of my life; my life has now been ripped apart since his death.”
Jasicca Nava, expert medical negligence lawyer at Irwin Mitchell, who is representing Sabreena, added: “It is now imperative that the hospital trust learns lessons from Caliel’s death so other families don’t have to suffer the anguish that Sabreena and her family have.”
Barts Health NHS Trust, which manages the Royal London Hospital, carried out a comprehensive investigation report into Caliel’s death which recommended that all neonatal test results were followed up before babies were discharged from hospital.
A spokeswoman for the trust said: “We apologise unreservedly for the distress caused to Ms Smith and her family as a result of failings in the care provided to Caliel.
“We are determined to learn from what happened, and have made many changes to prevent reoccurrence.
Our laboratory systems have been fully upgraded and reporting systems updated to make all safe and reliable.
“In addition, all important and relevant test results are now reviewed by the clinical team before babies are discharged from hospital, and we are reviewing whether ward-based tests for ketones might further improve safety.”