Child dies at Scots hospital after medics miss ‘abnormality’ on chest x-ray

A Scottish health authority is under scrutiny after a tragic incident where a child suffered a cardiac arrest and subsequently passed away.

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NHS Fife is facing criticism for overlooking an abnormality on a child’s chest x-ray, which led to a critical delay in treatment just weeks before the child’s death, according to an investigation.

The young patient had visited their GP, presenting symptoms like a productive cough, shortness of breath, and sporadic wheezing. They underwent two chest x-rays and later visited the emergency department as their condition worsened.

Upon discharge, the child was given steroids and an inhaler as their x-rays were reviewed. While one scan was mistakenly read as ‘normal,’ the other indicated potential pulmonary edema, a serious condition where excess fluid builds up in the lungs.

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An immediate referral to the respiratory department was made, and the child was prescribed diuretics to reduce the fluid. A further urgent cardiology referral was raised due to suspected heart failure.

However, the child’s health declined rapidly before the cardiology appointment. After a cardiac arrest and attempted resuscitation, they were transferred for surgical intervention but unfortunately did not survive.

The child’s caretaker accused NHS Fife of not acting with necessary urgency, prompting a complaint to the Scottish Public Services Ombudsman (SPSO).

The ombudsman’s probe agreed with the complaint, directing the health board to apologize and make systemic improvements.

Their statement read: “We’ve consulted with three independent clinical advisors, including a radiologist and cardiology consultant. We determined that the child’s initial A&E treatment was suitable based on available information at that time.

“We discovered that the first outpatient chest x-ray, initially reported as normal, was actually abnormal and should’ve been correlated clinically with the child’s symptoms.

“Had this been done, a cardiac origin for the symptoms might’ve been identified sooner.

“For the second chest x-ray, we found that the radiology alert system for flagging critical findings wasn’t used appropriately.

“Nevertheless, the respiratory consultant’s review process and the immediate redirection to cardiology were deemed reasonable, as was starting the child on diuretic therapy.

“Regarding the delay in the cardiology review, we deemed it unreasonable, given the significant signs of heart failure which were evident for some time.

“We acknowledge the child received adequate care upon admission to the CCU and ICU. Weighing all aspects, we’ve upheld the complaint.”

A spokesperson from NHS Fife said: “We express our deepest regrets for the care lapses this child experienced. While we realize that no words can lessen the family’s grief, we’ve extended a heartfelt and formal apology.

“NHS Fife endeavors to deliver top-tier care consistently, but we recognize our failure in this instance. We’re dedicated to enacting the ombudsman’s suggestions fully to prevent such occurrences in the future.”

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