Jax Jefferys: Boy who died of Strep A was 'expected' to be moved to children's unit but was sent home, inquest hears
An inquest into the death of a five-year-old continues
A pediatrician ‘expected’ a young boy who died from died from Strep A to be transferred to a children’s assessment unit for further hospital observations - but was sent home instead, an inquest has heard.
Dr Tiffany Fan, a pediatrician at Queen Alexandra Hospital, was the first witness to give evidence at Winchester Coroner’s Court today (June 10) as the week-long inquest into the death of five-year-old Jax Jefferys continues.
The doctor, who was working in the Children’s Assessment Unit (CAU) on the night on November 30, 2022, said despite not having a ‘cause for concern’, she believed Jax would be transferred to her unit for further observations.
The court heard how Dr Refat Parveen, who was working in the emergency department at the time, spoke to Dr Fan about Jax’s condition where it was agreed blood tests would be carried out and Jax would be moved to the CAU.
Jax was taken to hospital by his mum, Charlene McCormack, after being advised by her local GP - Southbourne Surgery - the previous day to attend A&E if his symptoms of persistent coughing and a high temperature continued.
During their visit, Jax, from Waterlooville, was diagnosed with Influenza A, but it was also noted he presented with tachycardia and tachypnea, as well as a red rash on his face, neck and back.
He was sent home in the early hours of December 1 and died that evening after becoming ‘profoundly unwell’ due to sepsis as a complication of undiagnosed Streptococcus A (Strep A).
“Jax should have been referred to the CAU. I am sure we were expecting him or expecting that he might come down at some point,” Dr Fan said. “From memory, I feel it would have been a responsible approach .
She continued: “I don’t remember being concerned after having the conversation with Dr Parveen. I didn’t feel we needed to go up and review the child in A&E.
“Given we had a diagnosis (Influenza A), I think it warranted a more senior review but not necessarily an immediate treatment.”
Senior coroner, Christopher Wilkinson added: “The evidence would seem to suggest that it is reasonable that you said he should come down to the CAU. So you weren't overly concerned, but concerned enough that he should come down - Jax didn’t come down to the CAU.”
Dr Fan explained it is ‘not usual’ for children not to attend the CAU if symptoms ease.
The inquest previously heard how Ms McCormack asked whether they could go home following Jax's diagnosis, and after having bloods taken, he was discharged on the proviso they would return if the test showed a more serious infection.
The results showed signs of dehydration, and Ms McCormack said she was unaware of the CAU being consulted before leaving.
The court, which has an 11-person jury due to the death involving a notifiable disease, heard how blood tests were ordered but blood cultures and blood gas evaluations were not.
Dr Fan said she was ‘not surprised’ these further tests were taken due to the established diagnosis of Influenza.
Isaac Hogarth, a clinical negligence barrister representing Ms McCormack, explained that while giving evidence Dr Parveen said she was ‘concerned that Jax looked flat and that generally she would expect a blood gas to be done on such a child’.
He said: “The decision to send Jax down to CAU for observations and bloods was with the knowledge there was a flu diagnosis. The reason for that must have been because there was a concern that there was something nastier going on more than the flu.”
He added: “There comes a point, doesn’t there, when you would have been concerned about sepsis? He wasn’t getting any better, he was still tachycardic, he had a temperature and he wasn’t getting better - there is a point at which sepsis becomes a concern.
“Given that Jax presented 20 hours later profoundly ill, in cardiac arrest and showing signs of sepsis… if a decision had been taken to have taken a blood gasses on the 30th, could it have been done?
“Dr Parveen said there was some concern there was something further than the Influenza A which is why you were being consulted.”
The court has been adjourned for a break. More updates to follow.