A baby who died of sepsis a day after being taken to hospital was not given antibiotics for many hours, an inquest has heard.
Three-month-old Lewys Crawford died of meningococcal septicaemia at the University Hospital of Wales (UHW) in Cardiff on 22 March 2019.
The inquest at Pontypridd Coroner’s Court heard a nurse suspected Lewys had sepsis when he was first assessed.
But a doctor initially said he had a virus.
He was only diagnosed more than eight hours after he arrived.
Lewys, from Llanederyn, Cardiff, had become unwell at about 16:00 GMT on 21 March when he had let out a “piercing scream” and had had a temperature of 38.4C, the inquest was told.
His mother Kirsty Link said in a statement read to court he was “happy as Larry” apart from the temperature, and he then went to sleep.
But when he woke up he “didn’t seem himself” and his parents took him to the emergency department at the UHW.
Rebecca Murphy, a paediatric nurse who was on duty the night Lewys was admitted, told the court it was “extremely busy” in the paediatric emergency unit.
She explained when she assessed Lewys that she put him in category two, which meant he needed to be seen by a doctor within 10 minutes.
She said his observations were abnormal and that they triggered a “pathway” used by the NHS to diagnosis and treat sepsis.
When asked if she mentioned sepsis to the doctor who was on duty, she said: “Not that I recall,” but added she told the nurse dealing with admissions to the Noah’s Ark Children’s Hospital that they had a “septic baby” who needed treatment.
‘Not confident in diagnosis’
The inquest also heard there was no dedicated paediatric consultant working in the department on the evening Lewys was brought in.
Jo Mower, an adult emergency medicine consultant who was on duty, diagnosed Lewys as probably suffering from a viral illness.
She told the hearing it was “quite rare in my experience to see someone that young” with meningococcal septicaemia and “the children I have seen have been older”.
She added: “I was trying to find a source of the infection. So he’d been grizzly, reduced feeding but still having wet nappies.
“So I was thinking, ‘was there a respiratory problem, was there a urinary problem?’ That was my thought process at that time on that day. I didn’t think of sepsis at that time, at that point.”
Ms Murphy said she was “not confident in the diagnosis” but did not raise it with Dr Mower.
When asked by the coroner if she would have acted differently in hindsight, Dr Mower said: “If the same situation arrived today, I would probably demand that the paeds come down and cannulate [put in a line for treatment].”
There were delays getting Lewys admitted to a ward and in getting antibiotics when sepsis was finally given as a diagnosis more than eight hours after he first came to hospital.
Ms Link’s statement said: “We are concerned about the timeline of the events, the delays between him being admitted and delays in him getting his first dose of antibiotics, and the delay in the time it took to make the diagnosis.”
Before the inquest formally began, coroner Graeme Hughes said he felt it was at least arguable that there had been a breach of the state’s duty in protecting Lewys’s life and that he therefore would look to widen the scope of the inquest to include how and in what circumstances Lewys died.
The inquest is continuing.