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By Amie Gordon For Mailonline. A seven-year-old boy died at the UK's biggest private children's hospital after equipment monitoring him was turned off for almost three hours. James Dwerryhouse suffered a catastrophic brain injury at the Portland Hospital in London when the equipment used to monitor him was shut down without a doctor's permission. The youngster, who had Down's Syndrome, was an in-patient at the hospital for a routine bowel operation to treat a condition which left him needing to wear a nappy.
An inquest into James' death heard he died in a hospice close to his home in Ipswich when his life support was withdrawn the following day. James Dwerryhouse died last August after he suffered a brain injury at the Portland Hospital in London. James suffered from sleep apnoea - interruptions to breathing while sleeping that can be life threatening - and was found unresponsive by night staff at around 4am on August 26 last year.
James, a pupil at Thomas Wolsey School and a member of the Ipswich Rainbow Cubs, also had a number of other conditions including mild hearing loss, poor eyesight, epilepsy and sleep apnoea. His father John said after coming round from surgery on the morning of August 25, his son had been energetic and was sitting in his bed playing with his Play Mobil figures. When they arrived, their little boy's eyes were half closed, he was covered in a rash and his dilated pupils indicated he was brain dead.
Mr Dwerryhouse told the inquest: The youngster, who had Down's Syndrome, was an in-patient at the hospital for a routine bowel operation.
Westminster Coroner's Court heard his parents had asked that James not be given a CPAC monitor - which involves a full face mask - and instead asked that a blood saturation monitor be used. The monitor, a peg put on the finger or toe, was used for James at home although the alarm very rarely went off.
Dr Sanjeev Sharma, one of the two doctors who treated James, said monitors would rarely be removed on the decision of nurses. He claimed he had agreed with James' parents that the use of a CPAP machine was unnecessary. Dr Konstantinos Dimitriades, the resident medical officer on duty that night, said that even if a child was fractious they would still have to wear their monitors.
He told the court James had been bright and happy before falling asleep and had wanted to shake his hand, and also asked him to shake his parents' hands. Dr Dimitriades was the first doctor to arrive at James' bedside when he went into cardiac arrest and noticed there was no data from any monitors for the previous three hours. When he was asked if he would have permitted the monitors to be taken off, he replied: You can put the monitor on a toe covered by a sock, you can use diversion - as soon as the child's attention is diverted somewhere else the monitor goes back on.
The two nurses tasked with caring for James told the inquest they were given a 30 minute break before midnight if they were on a 12 hour night shift and a 90 minute or two hour break in the early hours of the morning. James' nurse Mr Cachero went on his break shortly after 2am while Mr Dwerryhouse was lying in the bed with James on his chest trying to get him to settle.
He said James had been pulling off his monitors and lines, and thought it was okay for him to have them off while his father was with him and the boy was awake. The nurse claimed that he and Mr Dwerryhouse had agreed that the monitors didn't have to be on while he was with him. Mr Cachero said that he told the nurse that was covering for him, Anuradhapura Bhupathiraju, that James needed his monitors back on once he was settled.
When he returned shortly before 4am, Mr Dwerryhouse had left and James was asleep but had still not had his monitors reconnected. He said he first thought there was an issue with the blood saturation monitor when he connected it because it was reading zero, and fitted a new one, before he realised James wasn't reacting.
The crash team was recorded on CCTV running to James' bedside at 4: He said Ms Bhupathiraju told him Mr Dwerryhouse had only left a matter of minutes before he returned from his break, when he had left just before 3am. Ms Bhupathiraju, a nurse of 33 years experience, was told she did not have to answer any questions that she felt might incriminate her. She said that James was sleeping and comfortable, and that she was aware of his sleep apnoea. Ms Bhupathiraju said that James' parents hadn't wanted his monitors on, but admitted when pressed that her clinical knowledge of his best interests was more important than the wishes of the parents.
She also admitted that A police investigation was launched when James' doctors at home in Ipswich raised their concerns with the Metropolitan Police. DS Adrian De-Villiers told the court that the hospital's errors didn't meet the threshold for corporate manslaughter, but added: Portland's chief nursing officer Elaine Stewart, who led the internal investigation, said that staff were not permitted two to three hour breaks while on shift, as both Mr Cachero and Ms Bhupathiraju had claimed.
Mrs Dwerryhouse challenged Ms Stewart over the fact she hadn't been allowed to stay with James when she had stayed on every other overnight hospital visit. Ms Stewart said the Portland had now reviewed its policy on special needs children and that she had been unaware of their situation at the time James' operation was booked.
Adjourning proceedings to consider her conclusion, Coroner Dr Shirley Radcliffe said she had 'concerns' about the hospital and specifically about Ms Bhupathiraju. I think it was general incompetence and I think the NMC is the correct route. We have also referred this case to the Nursing and Midwifery Council for its regulatory investigations. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline. RELATED ARTICLES Previous 1 Next.
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