Inquest into the Death of Child TJW

7y · Female·aspiration pneumonia leading to multi-organ failure in a female child with complex medical history including cerebral palsy, hypoxic ischaemic encephalopathy, microcephaly, seizure disorder and airway obstruction

A child with severe cerebral palsy, hypoxic ischaemic encephalopathy, microcephaly and seizure disorder died of aspiration pneumonia leading to multi-organ failure. Born with severe perinatal brain injury, she had complex lifelong medical needs including airway management with nasopharyngeal airway, supplementary oxygen, and seizure control. Initially cared for at home with Department support, concerns about malnutrition and respiratory distress in 2016 led to placement in specialist residential care at Lady Lawley Cottage. Her medical management was consistently high-standard with multidisciplinary input. In July 2018, she presented with chest infection, uncontrolled seizures and respiratory distress. Recognizing end-of-life status, the treating team appropriately transitioned to palliative care with family involvement. The coroner found no deficiencies in medical care, supervision or treatment provided by either hospital or Department services. This case demonstrates appropriate end-of-life management in a child with severe neurological impairment.