Jessica Agnes Poulson was a 17-day-old neonate born with hypoplastic left heart syndrome, a fatal congenital condition requiring emergency surgery unavailable in the Northern Territory. The parents elected palliative care, supported by paediatric consultants who advised allowing natural death. Jessica was admitted to special care and received appropriate comfort care including oral analgesia and intravenous morphine for symptom management. The coroner found care standards were high throughout her short life. Primary challenges involved managing the mother's difficulty accepting Jessica's terminal prognosis and coordinating care between the hospital, Territory Families, and the family. Communication and support efforts by hospital staff and government agencies were extensive. This death was expected and inevitable from diagnosis; all clinical management was appropriate and aligned with family values and expert medical opinion.
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Specialties
paediatricscardiologyobstetricspalliative care
Drugs involved
morphine
Clinical conditions
hypoplastic left heart syndromecongenital heart defect
Procedures
caesarean section
Contributing factors
Congenital heart defect incompatible with life without emergency surgery
Surgical intervention unavailable in Northern Territory
Mother's difficulty accepting terminal prognosis
Maternal capacity concerns requiring guardianship order
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