Four-Year-old Boy Dies from Strep A Infection During National outbreak
Samar, a four-year-old boy, died on December 12, 2022, at Leicester Royal infirmary after developing a cough adn being diagnosed with a severe Strep A infection. An inquest concluded that Samar died of natural causes, specifically sepsis due to invasive group A streptococcal infection.
Samar was initially assessed on December 11, 2022, with a FeverPAIN score of 2. The threshold for administering antibiotics at the time had been lowered to 3 due to a national increase in strep A infections. Based on his score and clinical presentation,antibiotics were not deemed necessary during that initial visit.
He was subsequently re-admitted to the emergency department on December 12th. He was quickly assessed with a paediatric observation score of 8 and moved to a high dependency bay. A children’s registrar assessed him within 13 minutes. A chest X-ray revealed abnormalities in the right and middle lobes of his lung, and a large fluid collection on the right side of his chest, leading to a diagnosis of empyema.
While preparations were being made to obtain a paediatric surgeon to drain the fluid, Samar collapsed and cardiac resuscitation was initiated. Seventeen clinicians worked for 45 minutes to try and save him, but were unsuccessful.During resuscitation, drugs were calculated for a weight of 18kg, despite Samar weighing 26kg. though, doctors and an independent expert witness, Dr. Fitzsimmons, stated this dosage error did not affect the outcome, given the volume of medication administered during the prolonged resuscitation attempt.
Dr. Fitzsimmons concluded that there were no breaches of duty in the standard of care provided to samar during his admissions on December 11th and 12th. The inquest also heard that even if antibiotics had been administered on the morning of December 12th, they would not have had sufficient time to take effect and alter the outcome.
Samar was declared dead at 3.55pm on December 12, 2022. At least 16 children in the UK died from invasive Strep A in 2022.
Symptoms of sepsis in babies and young children, according to the NHS, can include blue, grey, pale or blotchy skin, and difficulty breathing, or increased sleepiness. Strep A infections are generally more common in children and are usually treatable with antibiotics, though they can rarely lead to serious, invasive complications.