Finding into death of Nghi Trieu Gla Pham

4y · Male·Complications of T-cell lymphoma

Nghi Pham was a 4-year-old admitted to Sunshine Hospital with facial swelling, stridor, and upper respiratory symptoms. He was examined by emergency and ENT teams, diagnosed with adenoiditis and sinusitis, and discharged after improving on antibiotics and prednisolone. He re-presented days later with severe respiratory distress, collapsed in cardiac arrest, and was found to have a large mediastinal T-cell lymphoma. He suffered profound hypoxic brain injury during prolonged resuscitation and died. The coroner found clinical management was appropriate and reasonable—the lymphoma presentation was rare and atypical, the patient clinically improved during admission, and earlier imaging would have required general anaesthetic that could have precipitated arrest given the mass size. Key learning: rare mediastinal masses can present as benign upper respiratory infection; the importance of accredited interpreters when language barriers exist; and consideration of consultant review in unusual cases.