Inquest into the Death of Child R (Name Subject to Suppression Order)

11y · Female·Complications of E. coli sepsis in association with intestinal obstruction due to faecal impaction of megacolon in a child with anorectal anomalies (operated)

Child R, an 11-year-old Aboriginal girl with congenital anorectal anomalies causing chronic severe constipation, presented to Halls Creek Hospital on 5 January 2017 with severe abdominal pain and vomiting. She died 12 hours later from E. coli sepsis associated with intestinal obstruction due to faecal impaction of megacolon. Critical delays in management included: a three-hour delay administering the phosphate enema after consultant recommendation at 8:30am; unclear handover of care between two doctors creating a gap in responsibility; failure to transfer to Broome Hospital until 11:40am when her condition was already critical; and unavailable age-related reference ranges for blood test interpretation. The child remained in the ward rather than the Emergency Department despite being unstable. Cultural miscommunications with the Aboriginal family, inadequate staffing, and limited hospital facilities contributed to delays and diagnostic uncertainty.