Herefordshire child died after life-threatening illness diagnosed as mental health problem

A CHILD who could not walk or feed herself, and had eyesight loss and dizziness was left without any real medical help until it was too late even though a number of medical professionals saw her symptoms.

Her foster carer has criticised Hereford’s social and medical services after her foster daughter’s life-threatening illness was repeatedly deemed a mental health problem in the months before her death.

Her comments came during an inquest into the child’s death, which followed a damning judgement in which High Court judge Mr Justice Keehan slammed Herefordshire’s children’s services for their role in the child’s care.

The child, who cannot be named for legal reasons, had been living with their current foster carers since 2012, and had started complaining of headaches in February 2019, Herefordshire coroner Mark Bricknell heard.

By March, the headaches had become a daily complaint, and the child was twice taken to see her GP, who told her carers to give her paracetamol.

She was repeatedly taken to the GP, who felt she was suffering from anxiety, and twice to A&E through April and early May after her symptoms worsened after an upsetting visit from the family’s new social worker in late April, developing chest pains and an uncontrollable tic on her left side which left her unable to to school or to carry out basic tasks such as washing her hair and feeding herself.

She was later seen by her GP, who prescribed Diazepam, before being diagnosed with PANDAS (Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection) by the child and adolescent mental health service and being prescribed antibiotics, while the foster mother repeatedly informed children’s services of her concerns.

By May 26 her condition continued to worsen and she was again taken to A&E in Hereford, before being urgently transferred to Birmingham Children’s Hospital, where she was taken for urgent heart surgery after a scan showed she had suffered multiple brain infarcts and damage to her heart and was suffering multi-organ failure.

The child survived surgery and remained on life support in an induced coma, but continued to deteriorate and after an unsuccessful surgery to stem a large internal bleed, it was decided that nothing further could be done for the child and she died in June.

A post-mortem revealed the child had been suffering from culture-negative endocarditis complicated by an invasive aspergillus infection.

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In a statement to the court, the foster mother said she did not think the local authority had taken her concerns seriously and that she felt they thought she was overreacting.

“I do not think Hereford County Hospital did any investigation into the physical causes of her illness,” she said.

“I believe that was due to her being a looked-after child they labelled as anxious and having mental health problems even though she had never displayed these problems before. I feel she was completely let down by the local authority, social workers, GPs, and A&E, who told me there was nothing physically wrong with her.

“I did my best to take her to different GPs and to try to find one who would find out what was wrong and I would like to know why a child who could not walk or feed herself, and had eyesight loss and dizziness was left without any real medical help until it was too late even though a number of medical professionals saw those symptoms.”

Consultant Paediatrician Dr Ian Darwood said he would not have expected staff at the hospital to have carried out further testing or scans on either of the first two visits to A&E as her observations were normal on both occasions.

“We see lots of children with tic disorders. They are common and often associated with anxiety,” he said.

Dr Darwood said that in 20 years of working in the UK he had not seen such tics associated with heart disease in children but that all paediatric staff had undergone new training on tics following the death.

“This has deeply affected our department,” he said.

“I think of her every time we have a child admitted with a tic. I am just so sorry to her siblings, parents, and carers.”

Hereford Times