The death of a Co Meath baby four and a half weeks after his birth at a Drogheda hospital was the subject of an inquest conducted by Co Meath coroner Nathaniel Lacy at Trim Courthouse. Baby Kayden Brogan Mullen, Stahalmog, Carlanstown, Kells was born at Our Lady of Lourdes Hospital on 19th February 2022 and following concerns about his condition was transferred to Temple Street Hospital. He died at Newcastle, Moynalty, Kells on 23rd March 2022.
Senior Counsel Declan Doyle and barrister Sheymus O’Quigley instructed by Ciara McPhillips of Michael Boylan Litigation Law Firm solicitors represented the family while barrister Caoimhe Daly instructed by Niamh O’Herlihy solicitor represented the hospital.
The baby’s mother Keira Brogan told the inquest that she had arrived at the Drogheda hospital at 4.40pm (18th February) as she was experiencing reduced fetal movement. She had been admitted and monitored over a number of hours, including by way of CTG (trace). She said she had been told by a midwife that her baby needed to be born that night and “she was not happy with the trace”.
“However, in my presence, the doctor and ward manager dismissed both the midwife’s and my concerns. I recall the midwife and the doctor having an argument in the corridor. The doctor said that she was happy with the trace”. The next morning, 19th, the doctor on duty told her she needed to have an emergency caesarean section. Her baby cried when he was born, however he was moved straight to the neonatal intensive care unit. Ms Brogan said that they were told during the day that Kayden was improving and they were trying to reduce his oxygen. However, things changed by midnight when they were told he had a temperature which they were trying to get under control. Her baby was moved to Temple Street on 20th February where tests were being carried out.
“On Tuesday evening 22nd I got a call from Richard. I asked Richard ‘was my baby still alive’, he answered ‘yes’. I said ‘but not forever?’ and his reply was ‘no’.” She said she went to Temple Street and saw Kayden there with his ventilator on and wires everywhere and machines beeping. They were told that there was only a one per cent chance of him surviving off the ventilator. “Kayden exceeded all the doctors’ expectations by surviving two weeks and six day off the ventilator when initially we were told he would be like a ‘fish out of water’’.
Our Lourdes Hospital Drogheda where mother Keira was admitted.
“We brought Kayden home on 10th March 2022. We will never forget all the help we got to get him home and make some memories outside of the hospitals. Seeing him in his cot and buggy for the first time and getting to feel like a normal family was amazing as we thought that was never going to happen but Kayden showed us all how strong he truly was”, she said.
Medical and nursing staff who gave evidence at the inquest offered their condolences to the family. Dr Shiraz Elbashier who worked at the Lourdes at the time and is now paediatrics registrar at Temple Street Hospital. He said that the baby was a breech presentation at birth (weight 2.96kg), cried and had delay cord clamping for 40 seconds. He was transferred to a resuscitator and required continuous positive airway pressure. When brought to the ICU a physical examination showed cleft lip and palate and a chest exam revealed respiratory distress. Based on examination in NICU the plan of management was to care with minimal handling. Tests were carried out and a chest x-ray at four hours of life showed “respiratory distress syndrome”.
The doctor said baby Brogan remained stable from the respiratory point of view but at 7.20 he started to have temperature instability and received paracetamol . An hour later his temperature was 38.6 degrees and antibiotic dose was increased. Just before midnight his temperature spiked to 39 degrees and another antibiotic was added.
The baby’s case was discussed with Rotunda Hospital who advised to refer to Crumlin but there was no intensive care unit bed available at that stage. Thirty minutes after midnight the baby started to have abnormal movement in a form of “jitteriness movement” and he was put on a cerebral function analysis monitor.
In the morning at 7.40am his breathing improved and his temperature settled. However, an hour later his condition disimproved. Consultant paediatrician Dr Khalid Khan told the inquest the baby developed a temperature at six hours old. He said that as temperature and respiratory distress was not improving and the baby also had a history of ventriculomegaly (brain condition), the neonatologist at Rotunda tertiary neonatal unit was contacted when the baby was 11 hours old for transfer and management. The baby was not accepted for transfer and advice was given to treat as sepsis and add acyclovir for viral infection. The doctor said he remained concerned and again contacted the neonatologist but a transfer was not accepted and he was advised to contact Temple Street or Crumlin because of the baby’s congenital
abnormalities.
“I contacted the neonatologist at Crumlin” but the transfer was not accepted because, according to them, “the baby was not fulfilling criteria for transfer”. Dr Khan said “Baby developed intermittent jitteriness 12 hours after birth which was suspicious of seizures and started on cerebral function monitoring”. The neonatologist at Temple Street was consulted and transfer to that hospital was accepted.
The coroner returned a verdict that death resulted from bronchopneumonia in the background of a substantial chronic multicystic encephalopathy with severe neuronal loss and gliosis. Mr Lacy and Inspector Alan Roughneen extended their condolences to Kayden’s family.
